Test 5 Flashcards
(36 cards)
What is breakthrough pain?
Temp. Flare up of mod. To sever pain that occur even when the pt is taking around the clock meds.
Diff cutaneous, somatic, visceral, and neuropathic pains.
Cutaneous:superficial pain usually involving the skin of sub cut tissue.
Somatic:deeper/bones originating in structures in the bodys external wall.
Visceral:internal organs in thorax, cranium, or abd.
Neuropathic:pain from direct consequence of lesion or dz affecting abnormal functioning of the PNS or CNS.
Define the etiology elements of pain?
Neuropathic:nerve injury
Intractable: resistant to therapy (meds)
Phantom:pain sensation w/o physiologic substance.
Psychogenic:no physical cause can be id’d
What are the four specific physiologic processes involved in nociception?
Transduction:activation of pain receptors
Transmission:pain sensations from injury site move along pathway of spinal cord then higher centers.
Perception:sensory, pain interpretation, pain threshold
Modulation: pain sensation inhibited (neuromodulators)
Describe the gate control theory.
Small diameter nerve fibers send pain towards the brain, while large diameter inhibit transmission of pain impulses from spinal cord to brain.(acting as open/close of gate)
What are the 3 common responses to pain? Example.
Behavioral (voluntary)-moving, grimacing, crying.
Physiologic (involuntary)-super:inc. b/p, P, RR. pallor, tense.Deep:nau/Vom, faint, dec. BP,p. Irreg. Breath.
Affective (psychological)-withdraw,anxiety, dep, anger, fear, fatigue, hopeless, powerless.
What are components of a pain assessment?
Pt verbalized ion and description of pain.
Duration, location, quantity/intensity, quality, chronology, aggravating/alleviating, phy. Indicators, behavioral resp., effect to actives/lifestyle.
REMEMBER:WILDA (words that describe, intense, location, duration, aggrav/Allev.)
What can adjuvant drugs provide?
Typically used for other purposes but can enhance the effect of opioids by providing additional pain relief.
What are 10 alternative pain relief interventions?
Distraction:game, tv
Humor: pt specific, and not w/ severe pain
Music: pt pick, 30 min at time
Imagery:sev. Min., meditate, develope image, helps chronic pain
Relaxation:red. Tension/anxiety
Cutaneous stim: massage, heat/cold, tens, acupuncture.
Hypnosis:change in pain perception
Biofeedback:electrodes making visual pain display, then pt. uses above mentioned tools to decrease pain.
Thera touch:energy transfer from light touch
What are some general factors that affect skin integ?
Personal hygiene (culture, socioeconomic)
State of health (nutrition, sensation, turgor, illness)
Lifestyle (job, drugie)
Diag (albumin)
Thera measure (bed rest, cast, meds)
Diff and define skin lesions.
Non palp, change in skin color: Macule:freckle, petechiae1cm Palp elevated solid mass: Nodule:0.5-2 wart Plaque:>0.5 Tumor:>2cm lipoma Wheal: irreg. Superficial local edema w/ itch (hives, mos. bite) Superficial circumscribed elev free fluid in skin layer: Pustule: pus (acne) Vesicle:herpes serous fluid
Diff ecchymosis, ischemia, and erythema.
ECC-collection of blood in sub cut
Isc-deficiency of blood in area
Ery- redness of skin
Diff jaundice, pallor, vitiligo, and cyanosis.
Yellowing of skin.
Paleness of skin
Whitish patchy (depig)
Bluish color of skin.
What are terms used w/ itching?
Urticaria-hives
Puritic-itching
Wheal-irreg local edema (hive, mos. bite)
What is diaphoresis and hirsutism?
Dia-excessive perspiration
Hir-excess female hairiness
Diff petechiae, purpura, turgor, ulcer, and Eschar.
Pete-small hemor spots Pur-hemor into skin Turgor-skin tension Ulcer-loss of epi, moist, non bleed Eschar-thick, yellow, scab dry crust necrotic. (Must be removed to promote healing)
What are the classification of wounds?
Intentional/Unintentional (how acquired) Open/Closed Acute/Chronic (length of time) Partial thick/full thickness (portion of dermis intact/entire severed) Complex (dermis and sub cut damaged)
There are 16 listed diff types of wounds. Can you name them?
Abrasion (friction, top layer), abscess, contusion (underlying soft tissue, blunt), crushing, incision (aligned cut), laceration (tearing), penetrating (lodged foreign material), pressure ulcer (comp. circ.from pressure/friction), puncture (object punc), avulsion (tearing from ap), chemical, microbial, thermal, irradiation, arterial/venous, diabetic ulcer.
What are general factors that take part in wound healing?
Age
State of wound:clear debri, biofilm, necrosis, infection, bleeding)
Nutrition: minerals (zinc, copper, manganese), vits (KADE), protein, glucose.
Circulation: (blood flow/oxygenation)
Immunosuppresent drugs inhibit healing
What are the phases of wound healing?
Hemostasis/Inflammatory
Proliferation
Maturation/restoration
What occurs in Hemostasis/inflam phase of wound healing?
Immediate constriction of blood vessels followed by dilation leading to exudate which cause pain and edema. Inc. prolif. causes redness, heat. These signal subs to come. Clotting.
Leukocytes arrive and ingest cell debri/bacteria. Macrophages phagocytise debri, release growth factors. Fibroblast fill in and neutrophils die (exudate form). Inc. temp, wbc, malaise.
What occurs in the next phase of wound healing, proliferation?
Fibroblast fill in wound Form new tissue. Caps and epi cells grow across. Granulation tissue forms scar. Red/Bleeds easy due to vascularity.
What occurs in the maturation phase of wound healing?
Collagen deposits form scar.
What wound assessment will need to be documented?
Appearance Size (length in cm, depth w/ cotton tip) Drainage Swelling Pain Drains/tubes
