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Foundations 2000 > Week 9 > Flashcards

Week 9 Flashcards

Pain

1
Q

pain

A

subjective and can be caused by stimuli that are actual or anticipated

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2
Q

acute pain

A

anticipated or predictable end; lasts less than 6 months

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3
Q

chronic pain

A

constant or recurring; lasts longer than 6 months

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4
Q

pain threshold

A

the point at which a stimulus causes the client perceived pain

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5
Q

how much of a stimulus the client is willing to accept

A

pain tolerance

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6
Q

nociceptors

A

specialized nerve endings that detect and transmit pain signals to the brain

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7
Q

somatosensory cortex

A

located in the parietal lobe of the brain is responsible for processing sensory information from the body, including
touch, temperature, pain and proprioception

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8
Q

psychological factors of pain

A
  • mood
  • catastrophizing
  • stress
  • coping
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9
Q

biological factors of pain

A
  • disease severity
  • nociception
  • inflammation
  • brain function
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10
Q

social factors of pain

A
  • culture
  • social environment
  • economic factors
  • social support
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11
Q

pain descriptors

A

aching, throbbing, stabbing, pounding, sharp, gripping, dull, tearing, radiating, cutting, burning, scalding

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12
Q

nociceptive pain

A

felt in the tissue, an organ, a damaged part of the body or a referred pain
* somatic: pain in the skin, bones, joints, muscles or CT
* visceral: pain in the internal organs and referring to other locations in the body
* cutaneous: pain in the skin or subcutaneous tissue
* usually throbbing or aching

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13
Q

neuropathic pain

A

nerve pain that arises from the
somatosensory system, described as intense, burning and shooting
* diabetic neuropathy, phantom limb pain, pain associated with spinal cord injury
* intense, shooting or burning, numbness/pins and needles

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14
Q

disease condition: cancer pain

A

can involve tumor pain, bone pain and treatment associated pains such as chronic post surgical pain, radiation induced pain, neuropathies related to chemotherapy

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15
Q

malpractice

A

negligent act that has been performed by a professional
or trained person

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16
Q

negligence

A

failing to perform in a manner that a reasonable and prudent person should perform

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17
Q

ethics

A

study of moral principles that guide personal or group behavior

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18
Q

beneficence

A

doing good and acting in the best interest of a client by providing care that benefits them

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19
Q

nonmaleficence

A

doing no harm, or the least amount of harm to the client, while trying to achieve the best possible outcome

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20
Q

autonomy

A

independence or freedom, ability to make one’s own decisions

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21
Q

justice

A

treating all clients fairly and equally

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22
Q

morality

A

individual’s principles and their concepts of right and wrong

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23
Q

end of life care barriers

A

pain undertreated or not treated
* patient/family: fear of addiction, belief pain is expected part of illness and dying process, speeding up death
* providers: pain assessments may be inadequate or lacking
* h.c. system: monetary boundaries

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24
Q

palliative care

A

focus is improving quality of life for those with serious illnesses, starting at diagnosis and continuing throughout treatment; symptom relief, pain management

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25
hospice care
specialized type of palliative care for nearing the end of life who are no longer seeking curative treatment; emphasis on comfort rather than cure
26
advanced directive
legal document that allows you to communicate your wishes regarding future medical care
27
CMO
comfort measures only
28
end of life care emotional/psych support
active listening, therapeutic communication * addressing anxiety, depression and fear of death * providing comfort through presence and reassurance
29
subjective pain indicators
* pain scale, quantity and quality of pain * location of pain, length of time the pain has been present, what precipitated the pain, what relieves the pain, any radiation of pain, how the client characterizes the pain
30
objective pain indicators
* crying, sweating, restlessness, grimacing, guarding * vital signs, physical assessment findings, laboratory tests, imaging reports, any diagnostic information or tests
31
PQRST
* precipitating cause - what were you doing when the pain started? * quality - describe what your pain feels like * region - how me the location of where you are experiencing pain * severity - on a scale of 1 to 10, how would you rate your pain? (use pain scale) * timing - when did your pain first begin?have you experienced this pain before?
32
numerica rating scale
* most frequently used * rate the intensity of pain * 0: no pain * 10: worst pain the client can imagine * used in clients >8 years old
33
wong baker FACES scale
* widely used with people ages 3 * self-assessment tool must be understood by the patient *NOT to be used by a third person, parents, h.c. professionals, or caregivers, to assess patient’s pain
34
FLACC
* observational pain measurement tool for children 2 months to 7 years and clients who are cognitively disabled * nurse observes patient for 1-5 minutes if awake, >5 minutes if asleep * ccore from 0-10 (10 being high pain)
35
CRIES
* crying, req O2, increased VS, expression, sleeplessness (CRIES) scale * observation scale used for infants who were born at 38 weeks gestation or greater * used primarily for post op pain in infants
36
nonverbal pain scale
* face * activity * guarding * physiologic (VS) * respiratory
37
cultural consideration: pain expression and communication
* some encourage openly express pain, others view it as weakness or endurance * some may hesitate to report pain due to cultural beliefs about suffering. * some expect family to advocate for patient’s pain relief rather than patient speaking up.
38
pain factors to consider
* client’s risk factors * consider medications used for pain management * anxiety and pain can have similar clinical manifestations
39
cultural consideration: beliefs about pain and suffering
* certain religions and cultures may see pain as spiritual growth or a test of faith * stoicism is valued in some cultures, leading patients to underreport pain
40
cultural consideration: use of traditional remedies
* patients may prefer herbal treatments, acupuncture, cupping, or spiritual healing practices alongside or instead of meds * nurses should ask about and respect these practices while ensuring they do not interfere with prescribed treatments
41
cultural consideration: nonverbal cues
* patients may not verbally report pain but exhibit nonverbal signs such as grimacing, guarding, or restlessness. * nurse should assess verbal and nonverbal expressions, especially in patients with limited English proficiency
42
cultural consideration: language barriers
* use professional interpreters to ensure accurate pain assessment * culturally appropriate pain assessment tools, such as the Wong-Baker Faces Scale for patients with limited literacy
43
cultural consideration: attitude towards pain meds
* cultures may be hesitant to take opioids due to fear of addiction or a belief in enduring pain. * some may expect strong meds and express dissatisfaction if pain is not quickly relieved. * educate patients about pain management options and address concerns about addiction or side effects.
44
non-pharm interventions
* positioning * cutaneous stim * cognitive strategies * therapeutic touch
45
types of cutaneous stimulation
* temperature - heat: muscular pain relief - cold: orthopedic injury, decrease swelling - apply for 20-30 minutes at a time to avoid skin or nerve damage * massage & acupressure: decrease pain scores in patients with neuropathic pain * acupuncture: small needles placed temporarily in the skin to minimize pain that are believed to stimulate the CNS * TENS: emits low voltage electrical impulses to the skin over painful areas - extracorporeal shock-wave lithotripsy: uses shock waves to help treat soft tissue injuries
46
pharm interventions
* opioids * patient controlled analgesia (PCA) * non-opioids * sucrose * adjuvant analgesics * corticosteroids * antidepressants: nerve related pain, migraines, arthritis * cannabis * botulinum boxin:
47
opioids
* most common pain med, risk of sedation and depression of respiratory system * assess RR and depth closely, monitor HR and BP * slow position changes to avoid orthostatic hypotension and syncope * nausea, vomiting, constipation * received via PO, IM, IV, PR (rectal) TOP, epidural or spinal anesthesia * some are continuous and other are intermittent or as needed depending on the goals of care, pain levels and reason for pain
48
sucrose
* used in infants who have to undergo painful procedures * sucrose is sugar water that a pacifier is dipped into and helps calm the patient during procedures and interventions
48
patient controlled analgesia (PCA)
often post operatively
48
non-opioids
* can be admin for the treatment of pain by nurse and include local anesthetics, non-steroidal anti-inflammatory meds (NSAIDs), and acetaminophen * pain relieving properties, reduce inflammation and fever * examples: aspirin, naproxen, ibuprofen * contraindicated in surgery and labor because, can increase risk of bleeding * topical meds: lidocaine, capsaicin * useful for arthritis, myalgias, arthralgia, neuralgias, chronic musculoskeletal pain, neuropathic pain
49
adjuvant analgesia
* aid in pain relief by working on underlying pain generators, such as antidepressants, corticosteroids, and botulinum toxin * not specifically labeled as pain meds but properties assist in pain management
50
corticosteroids
* hydrocortisone, cortisone, prednisone: reduce inflammation associated with pain * can cause: increase in BG levels, suppression of immunity (long term use), weight gain, mood swings, elevated BP, sleeplessness
51
antidepressants
* can cause sedation, heart problems, and dry mouth * some may have an increase risk of suicidal thoughts or actions
51
botulinum boxin
* blocks nerve signals that cause muscle contractions to reduce pain * helpful with migraines, neuropathic pain, spasticity
52
cannabis
* not FDA approved but has been legalized for medicinal use in 38 states * helpful in managing chronic pain or cancer related pain
53
role of rn: assessment
* eval pt’s pain using a standardized pain scale (0-10 scale, Wong-Baker Faces Scale) * assess pain characteristics (PQRST) * consider factors influencing pain (med history, culture, emotional state) * monitor for nonverbal signs, especially in pts who have difficulty communicating
54
role of rn: med admin
* verify correct med, dose, route, and time based on the provider’s order * use the rights for medication admin * admin meds per protocol (e.g., IV, oral, IM, or topical) * educate pt about med, including expected and possible side effects.
55
role of rn: monitor and evaluate
* reassess pain levels after med admin (e.g., 30-60 mins oral, 15-30 mins IV) * watch for adverse reactions, such as respiratory depression with opioids * assess for side effects like nausea, drowsiness, constipation, or allergic reactions
56
role of rn: documentation
* record the med, dosage, route, and time * document the pt’s pain level before and after admin * note side effects or adverse reactions
57
role of rn: pt advocacy and education
* teach pt about alternative pain relief methods (heat, relaxation, PT) * address concerns about addiction or tolerance, especially with opioid use * advocate for proper pain management if the pt’s needs are not being met
58
SBIRT
* screening * brief * intervention * referral to treatment

Foundations 2000 (13 decks)

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