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NUR516 > Pain Management (Intro) > Flashcards

Pain Management (Intro) Flashcards

1
Q

Definition of pain

A

An unpleasant, sensory, & emotional experience associated with actual or potential tissue damage

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2
Q

Pain experience is influenced by what 4 factors?

A
  1. cultural factors
  2. physical factors
  3. psychosocial factors
  4. environmental factors
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3
Q

Is pain the same in every person?

A

No - pain is unique & individual for each person

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4
Q

Pain is often the first sign of the _____ _____

A

disease process

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5
Q

What kind of pain is time limited?

A

Acute pain

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6
Q

Is the cause of pain usually known or unknown in acute pain?

A

cause is usually known

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7
Q

Does acute pain diminish over time or persist?

A

diminishes over time

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8
Q

What are 3 observable signs of acute pain?

A
  1. increased BP and/or HR
  2. agitation
  3. guarding
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9
Q

How long does chronic (non-malignant) pain persist for?

A

persistent (> 6 months)

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10
Q

What kind of pain is purposeless?

A

Chronic (non-malignant) pain

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11
Q

Chronic (non-malignant) pain may lead to ______

A

depression

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12
Q

What type of pain can increase with stress response?

A

Chronic (non-malignant) pain

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13
Q

Chronic (non-malignant) pain often interferes with _____

A

sleep

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14
Q

What type of adaptation is chronic (non-malignant) pain?

A

Autonomic adaptation

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15
Q

Neuropathic pain is _____

A

non-nociceptive path; pathologic pain

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16
Q

neuropathic pain results from injury to or dysfunction of the _____ ______ ______ or _______

A

peripheral nervous system; CNS

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17
Q

Neuropathic pain has _______ neuronal receptor & ______ activity

A

abnormal neuronal receptor & metabolic activity

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18
Q

How is neuropathic pain usually described?

A

burning
shooting
shock-like
numb

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19
Q

List some causes of neuropathic pain

A

diabetes
alcoholism
shingles
HIV

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20
Q

Psychogenic pain is caused by what 3 stimuli?

A

emotional
psychological
behavioral

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21
Q

What is nociception (pain process)?

A

the normal function of the physiologic systems that lead to the perception of noxious stimuli as being painful (4 step process)

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22
Q

List the four steps in nociception (pain process)

A
  1. transduction
  2. transmission
  3. perception
  4. modulation
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23
Q

Nociception (pain process) is ongoing activation of nociceptors capable of _______ ______ in response to _____ ______

A

sensing pain; noxious stimuli

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24
Q

What are nociceptors?

A

free nerve endings in the afferent peripheral nervous system

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25
What are some mechanical noxious stimuli?
Incisions Tumor mass
26
What are some thermal noxious stimuli?
Burn Frostbite
27
What are chemical noxious stimuli?
Toxin Chemotherapy
28
Transduction definition
the conversion of a mechanical, thermal, or chemical stimulus to a neuronal action potential
29
Where/ why does transduction start and what is activated?
starts in periphery in response to noxious stimuli; where primary nociceptive fibers (afferent) are activated
30
Transduction causes the release of what 5 things?
serotonin bradykinin histamine substance P prostaglandins
31
What three places can opioid receptors be found in?
CNS peripheral nerves GI tract
32
What are the 2 naturally occurring morphine-like substances?
endorphins enkephalins
33
Endorphins & Enkephalins act like...
neurotransmitters that block pain
34
Enkephalin affects what two receptors?
Mu & delta
35
What type of receptor do endorphins affect?
only mu receptors
36
What is the second step of nociception?
Transmission
37
What happens in transmission?
stimuli move from peripheral nervous system, to spinal cord through the dorsal root ganglion, into the ascending tract to the brain
38
What are the two types on nociceptive fibers?
A - delta (δ) fibers C-fibers
39
What fibers are thinly myelinated, large in diameter, & fast-conducting fibers?
A - delta (δ) fibers
40
What kind of pain do A - delta (δ) fibers transmit?
sharp, localized (somatosensory) pain that is sensitive to mechanical & thermal stimuli
41
What fibers are unmyelinated, small in diameter, & slow-conducting fibers?
C-fibers
42
What kind of pain do C-fibers transmit?
dull, aching (visceral) pain that is diffuse
43
What is the third step of nociception?
Perception
44
Define perception
point at which person is aware of pain; threshold is reached (end result)
45
Perception includes activation of higher brain structures such as...
thalamus limbic system
46
Is pain perception the same in every person?
No - it varies from person to person
47
What is the 4th step/ phase of pain impulse?
modulation
48
What occurs during modulation?
the brain interacts with the spinal nerves to alter the pain experience; involves increasing (excitatory) or decreasing (inhibition) transmission of pain impulses in the spinal cord
49
What are the pain-inhibiting neurochemicals released during modulation?
substance P Glutamate GABA Norepinephrine & serotonin
50
What are the two types of nociceptive pain?
somatic visceral
51
Somatic pain is _____ localized while visceral pain is _____ localized
somatic = well localized visceral = poorly localized
52
What nociceptive pain is sharp, aching, throbbing, gnawing?
somatic
53
What nociceptive pain is deep, aching, cramping, pressure, referred?
Visceral
54
Somatic pain is the activation of nociceptors resulting from ______, ______, & ______ _____
cutaneous, musculoskeletal, & deep tissue
55
Visceral pain is the activation of nociceptors resulting from _______, _______, or _______
stretching, distention, or inflammation
56
List some examples of somatic pain
bone pain soft tissue injury incisional
57
List some examples of visceral pain
bowel obstruction biliary colic
58
What kind of pain is among the most common chronic conditions
Chronic pain
59
What types of pain/ why are older adults more prevalent to pain?
joint pain activity limitations poorer health
60
List the common causes of pain in older adults (11)
1. osteoarthritis/ degenerative joint disease 2. rheumatoid arthritis 3. fractures 4. osteoporosis 5. post herpetic neuralgia 6. spinal stenosis 7. cervical & lumbar spondylosis 8. diabetic neuropathy 9. PVD 10. temporal arteritis 11. trigeminal neuralgia
61
What is some barriers to pain control in older adults?
1. fear of addiction 2. impaired cognition/ dementia 3. financial 4. thinking pain is a normal part of the aging process 5. not all adults complain of pain 6. younger nurses being afraid to ask in fear of being disrespectful
62
What are 8 consequences of unrelieved pain?
1. impaired mobility 2. post-op complications due to immobility 3. impaired immune function & healing 4. sleep disturbance 5. mental health issues 6. functional loss 7. financial concerns 8. increased HC costs
63
What are examples of post-op complications due to immobility?
DVT emboli pneumonia deconditioning
64
What are examples of mental health issues related to unrelieved pain?
depression withdrawal/ social isolation

NUR516 (36 decks)

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