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Flashcards in these are even painful to make Deck (70):
1

what is pain

anything the patient says it is, wherever the patient says it is, whenever the patient says it is

2

harmful effects of unrelieved acute pain on the endocrine and metabolic system

wt loss
^ HR
^ RR
shock
glucose intolerance
hyperglycemia
fluid overload
hypertension
urinary retension

3

harmful effects of unrelieved acute pain on the cardiovascular system

HTN
unstable angina
MI
DVT

4

harmful effects of unrelieved acute pain on the on respiratory system

atelectasis
pneumonia

5

harmful effects of unrelieved acute pain on the renal and urologic system

constipation
anorexia
paralytic ileus

6

harmful effects of unrelieved acute pain on the musculoskeletal system

immobility
weakness and fatigue

7

harmful effects of unrelieved acute pain on the neurologic system

confusion
impaired ability to think, reason, and make decisons

8

harmful effects of unrelieved acute pain on the immune system

infection

9

what is the physiologic dimension of pain

genetic, anatomic and physical determinants of pain influence how painful stimuli are processed, recognized and described

10

what is the affective dimension of pain

emotional responses to pain include anger, fear, depression and anxiety
negative symptoms may interfere with quality of life

11

what is the cognitive dimension of pain

beliefs, attitudes, memories, and meaining attributed to pain influence the ways in which a person responds to pain

12

behavioral dimensions of pain

observable actions

13

sociocultural dimension of pain

age and gender influence
families
culture affects pain expression, medication use, coping methods

14

what is suffering

suffering is a state of distress associated with loss and a profound sense of insecurity

15

what is nociception

the physiologic process by which information about tissue damage is communicated to the CNS

16

what is the main idea of transduction

involves the conversion of a noxious mechanical, thermal. or chemical stimulus into a an electrical signal called an action potential

17

what chemicals are released from noxious stimuli and cell damage

prostaglandins, bradykinin, serotonin, substance p, histamine

18

what cells are involved in transduction

mast cells and macrophages

19

what types of neurons is the action potential sent from in transduction

from myelinated A fibers and unmyelinated C fibers

20

what is peripheral sensitization

the increased sensibility to nociception following an initial wound or noxious stimuli

21

what enzyme plays an important role in peripheral sensitization

cyclooxygenase

22

how do you stop pain at the transduction level

drugs that stabilize the neuronal membrane and inactive peripheral sodium channels inhibit production of the nerve impulse

23

Why did the cookie cry

because his mom was a wafer soo long!

24

what is transmission

is the process by which pain signals are relayed from the periphery to the spinal cord and then to the brain

25

where do the primary afferent fibers terminated when transmitting

in the dorsal horns

26

what does the dorsal horn do

it integrates and modulates the periphery

27

what are the three segments of transmission

1- transmission along the peripheral nerve fibers to spinal cord
2- dorsal horn processing
3- transmission to the thalamus and the cerebral cortex

28

what are dermatones

are areas on the skin that are innervated primarily by a single spinal cord segment

29

what is central sensitization

is increased sensitization and hyperexcitability of neurons in the CNS

30

what is allodynia

the epxerience of significant pain from touch or tactile stimulation in and around the area of tissue or nureve injury

31

what can untreated acute pain lead to

acute pain can lead to chronic pain through the process of central sensitization

32

what is neuroplasticity

the process that allow neurons in the brain to compensate for injury and adjust their responses to new situations or changes in their environment

33

what does central sensitization of the dorsal horn result in

1 hyperalgesia
2 painful responses to normally innocuous stimuli
3 prolonged pain after the original noxious stimuli ends
4 the extension of tenderness or increased pain sensitivity outside of an area of injury to include uninjured tissue

34

what is referred pain

location of pain reported by the person with an injury or a disease involving visceral organs

35

how do fibers from the dorsal horn enter the brain

through the spinothalamic tract and the spinoreticular tract

36

what are some ways to target pain in the transmission stage

opioid analgesics

37

what is perception

occurs when pain is recognized, defined, and assigned meaning by the individual experiencing the pain

38

what is the reticular activating system responsible for in the perception stage of pain

for warning the individual to attend to the pain stimulus

39

what is the somatosensory system responsible for

responsible for localization and characterization of pain

40

what is the limbic system responsible for in the perception stage of pain

for emotional and behavior responses to pain

41

what is the cortical structure responsible for in the perception stage of pain

crucial to constructing the meaning of pain

42

what is modulation

involves the activation of descending pathways that exert inhibitory or facilitatory effects on the transmission of pain

43

what type of drugs exert their effects on modulation of pain

antidepressants

44

what is nociceptive pain

normal processing of stimulus that damages normal tissue or has the potential to do so if prolonged

45

what is neuropathic pain

abnormal processing of sensory input by the peripheral or central nervous system

46

what is the treatment of nociceptive pain

typically a nonopioid or an opioid

47

what is the treatment of neuropathic pain

typically includes adjuvant analgesic

48

what causes nocicpetive pain

damage to the somatic or visceral tissue

49

characteristics of superficial pain

sharp burning prickly

50

characteristics of deep pain

deep aching throbbing

51

what causes viceral nociceptive pain

activation of nociceptors in the internal organs and body cavities- respond to inflammation, stretching, and ischemia

52

what are the signs and symptoms of neuropathic pain

described as numbing, hot, burning, shooting, stabbing, sharp, or electric shock-like
it is sudden intense, short lived or lingering

53

what are common causes of neuropathic pain

trauma, inflammation, metabolic disease, alcoholism, infections of the nervous system, tumors, toxins, and neurologic diseases

54

what is differentation pain

pain that results from loss of afferent input secondary to either peripheral nerve injury or CNS injury

55

what is sympathetically maintained pain

pain that is associated with dysregulation of the autonomic nervous system

56

what cause central neuropathic pain

is caused by CNS lesions or dysfunction

57

onset of acute pain

sudden

58

onset of chronic pain

gradual or sudden

59

duration of acute pain

less than 3 months or as long as natural healing to occur

60

what is the duration of chronic pain

longer than 3 months- may start as an acute injury but continues past normal time for recovery

61

cause of acute pain

generally can identify a precipitating event- surgery or illness or trauma

62

cause of chronic pain

may not be known, original cause of pain may differ from mechanisms that maintain pain

63

course of acute pain

decrease over time and goes away as recovery occurs

64

course of chronic pain

typically pain does not go away
periods of remission and exacerbation

65

typical physical and behavioral manifestations of acute pain

may vary but can reflect sympathetic nervous system activation
- ^ HR, RR, BP
- diaphoresis
- pallor
anxiety
agitation confusion
urinary retention

66

typical physical and behavior manifestations of chronic pain

predominantly behavioral manifestations
- flat affect
decreased physical activity
fatigue
withdrawal from social interaction

67

what is breakthrough pain

pain in patients who have a baseline of pain that is mild to moderate but fairly controlled

68

what is end- of - dose failure

pain that occurs before the expected duration of specific analgesic

69

why did the bicycle fall over

because it was two tired

70

what is sciatica

pain that follows the course of the sciatic nerve- it may originate from muscles or joints around the back or from compression or damage to the sciatic nerve