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49 Cards in this Set
- Front
- Back
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pain leads to anxiety
anxiety leads to tension tension lead to ... |
pain
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if the pt is wound up, what natural body chemical will not allow any pain meds to work regardless?
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norephinepherine will not allow any pain meds to work
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what is pain?
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whatever the patient says it is
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can pain make other health issues worse?
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yes. why you increase the anxiety, then increase immune response, and thus decrease your tolerence.
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who's an autority on the pt's pain?
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the patient is
but pain is very subjective car running over one guys foot will hurt more to him than to someone else |
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what is breakthrough pain
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what that level and OVER that the pt can live with. the breakthrough is pain that the pat is experiencing over and above what they usually can tolerate
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what is idiopathic pain?
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chronic pain where there is no identifial cause both physical or mental (6 months or longer)
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don't confuse an actual diagnosis with pain ex. fibra neualgia. isn't a pain, its a diagnosis, because we know what causes that pain. Idiopathic is more like
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a pain in my back I'm experiencing and no one knows why or can diagnose is.
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intractiable pain is ...
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pain you can't get over
its really severe pain you can't get a hold on like bone pain |
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what is pain threshold? a threshold is in a door way, something you have to step over. so ... here a pain thershold is
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the point you actually FEEL pain. a low threshold means you see a dentist and your teeth start to hurt
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what is pain syndrome?
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SYMPTOMS WHERE PAIN IS THE CRITICAL ELEMENT. EX. shingles someone used to have, they remember that pain
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phantom pain is the whole nerve plexus still works. why
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the leg is gone but that whole nerve network is still there so it still hurts like crazy
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cykogenic pain...
a pain w/ no identifiable explanation ... a chronic pain. So what's referred pain? |
your arm hurts even through your having a heart attack. this is referred pain. Viseral does not have pain BUT they refer pain b/c they are part of that whole nerve dermatom to somewhere else. Referred pain is having pain eating an orange
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what does culture have to do w/ the pain experience?
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what pain is or is not allowed. also its ok for a girl to cry with pain therefore they will get the pain meds first.
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can a nurse give a pt a placebo for pain?
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no. only during a study.
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no forget about pain memory and how that can affect a pain experience someone is having. Is pain the 4 or 5 vital sign?
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yes. pain is the 4 or 5th vital sign
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who needs more pain medicine, the ordinary patient or the drug addict?
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the drug addict will need more pain medicine b/c his threshold is up
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whats the side effect of pain medication?
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constipation.
old people hate this b/c they are already dehydrated anyway. |
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do traditional healers have a thing to do with pain?
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yes
an Indian doing a sand painting to help someone manage pain works. Its psych managed of pain |
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patient's rights w/ pain is mandated. SO, education of family and patient is mandated so therefore we have to consider ehtical, spiritaul etc beliefs. this is a patient's ...
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rights. an important part of care. so we must be assessing all patients so what does this mean to us? that every assessment has to have an assessment to their pain in there.
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characteristics of pain.
Intensity of Pain. use pain scale and don't cue them. we do ask them. what if the patient can't talk? |
facial expressions
guarding the hurt area |
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what are pain assessment questions?
when did the pain start? how long did it last? 1 to 10 how much? look for patterns, why? |
if pain is sudden then goes away, could be a heart attack.
or ischemic attack. another is location. |
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don't say is it stabbing, is it dull, is it sharp or achie, you just say...
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describe your pain
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so, here are 4 things about pain
**************************** 1)intensity 2)timing 3)location 4)........ ******************************* |
quality
of pain 5) and personal meaning. ****************************** I mean how does this affect your life. |
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pain ladder 1 to 10 scale, the 1 to 4 is ...
This is step 1 of NON OPIDIODE ANALGEGELICS ********************** |
mild pain
most places says anything 3 and below is treated with repositioning or a massage or something to get them to relax or treat with a non narcodic like Tylenol THIS IS STEP ONE ... NON PHARMACOLOGICAL KIND OF INTERVENTION. WARM PACKS, REPOSITIONING, MASSAGE, COLD PACKS, VISUALIZATIONS OF FISHING. |
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STEP 2 IS PAIN LEVEL 5 AND 6
**************************** WHAT WOULD WE USE OR DO ON STEP 2 (PAIN LEVEL 5/6?) |
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WE USE A WEAK NARCODIC DRUG FOR PAIN, AND ALONG W/ THAT AN ADJUNCT DRUG. EX: VICODENE A WEAK NARCODIC (ALSO USING STEP ONE TECHNIQUES NON PHARMACOLOGICAL ((THIS STEP ONE IS AN ADJUNCT TO GET THE PT TO RELAX) VICODEN IS TYNELOL AND CODENE) A WEAK NARCODIC, AT A WEAK DOSE +TYLENOL |
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OTHER ADJUNCT AGENTS ARE NOT JUST TYLENOL IV PROFIN OR ADVILL. CAN ALSO BE DRUGS (ESP IF PT HAS NERVE PAIN) COULD BE ...
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A ANTIDEPRESSENT DRUG LIKE ALOVIL WHICH IS AMITRIPTYLINE SO THEY DON'T GET DEPRESSED, SO THE COMBO DRUG HELPS WITH THE NERVE PAIN AND DEPRESSION
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WHAT KIND OF SIDE EFFECTS COME WITH USING AMITRIPTYLINE?
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ANTICOLENRGIC EFFECTS LIKE DRY MOUTH DRY EYES URINARY RETENTION AND CONSTIPATION. SO YOU GIVE PT A DRUG W/ AN ADJUNCTIVE AGENT THEY WILL NEED FIBER AND FLUIDS
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SO THE PAIN LADDER, 1-4 IS MILD PAIN, 5-6 IS MODERATE AND GETS A WEAK NARCODIC+ADJUVANT DRUG. WHAT IS SEVERE PAIN?
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7-10 IS SEVERE PAIN. YOU USE STRONG NARCOTIC+NON NARCOTIC + ADJUVANT DRUG
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STRONG NARCODIC IS MORPHINE. SO QUIZ QUESTION
**************************** A PT AT STEP 3 (SEVERE PAIN) THEY SAID THEY ARE AT A 8 OR 9 TELL TEACHER THE COMBINATION DRUGS TO PICK ARE... |
STRONG NARCODIC+NON-NARCODIC+ADJUVANT DRUG.
NAME THE DRUGS BUT DON'T WORRY **************************** MORPHINE+TYLENOL+SOMETHING |
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ADJUVANT DRUGS NOW:
WE CAN USE SERATONINE REUPTAKE INHIBITORS (SSRIs) OR TRICYCLICS. what are these? |
antidepressents
they work great b/c they make your brain feel good be careful w/ stuff like Tylenol b/c of liver toxicity |
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there are antidepressent adjunctive agents and also anticonvulsant agents. these are good for :
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neuropathic pain
block abnormal nerve discharge sedation, confusion, nausea,bone marrow depression |
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Tegretol is an anticonvulsant agent. what is it good for?
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neuro pain / blocks abnormal nerve discharge b/c thats what anticonvulsants do, block nerve discharge
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Dilantin and Neurontin:
given in kidney failure (Dilantin is a nasty drug) given for nerve pain. b/c the pt can experience bone marrow stuff so what kind of labs whould we be looking for? |
RBCs and WBCs
Tegretol, you have to have blood levels to make sure this person isn't bc toxic. Tegretol is for convulusions. epilepsy so labs could say below theraputic levels. thats OK b/c were'not giving it for seizures! |
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nonpharmacological mangament:
a electrical gizmo that stimulates a muscle. it changes or closes a gate for pain. it what? |
doesn't let your body recognize the pain. keeps your body too buzy feeling heat or other stuff to recognize pain. Ben gay works this way. hypnosis, massages, distraction, positioning, ice/heat, aromatherapy, exercise, etc
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pain b/f and during surgery.
b/c of lots of tissue manipulation they will ... |
irrigate or infuse directly into a wound to stop pain. apply the analgesia directly to the tissue. your not as sore this way. even when your under in surgery, those receptors are still firing! this method prevents nociciptors from sensitizing central neurons.
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there is the idea of pre emptive analgesia. what is this?
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pre op
peri op (during surgery) eliminate sensory signals generated by surgery prevent nociceptors from sensitizing central neurons |
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intraspinal
epidural require close assessment spinal headache so keep them flat as possible respiratory depression means decreased cardiac output. so what? |
i don't know
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Narcan (naloxone)
reverses effect of opioid analgesics quickly, instantly the pt will be ... |
awake, alert and in pain. so it needs to be quickly avaliable w/ use of narcotic analgesics esp. w/ PCA pumps & Epidural infusions.
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what are 5 things a nurse would see in a cognitive impaired patient w/ a UTI.* ****************************
associated w/ pain |
hostile
pacing guarding change in behavior withdrawl |
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client w/ cancer taking an opiod will become? additive to meds or immune to the drugs effects?
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not additive, wrong term usage
immune? no immunity has nothing to do with it pscy depended? more tolerant to the dosage. |
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elderly cancer patient. would asborption and metablolism of the medication would be slower or faster?
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slower.
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your caring for an adult w/ chronic fatique and back pain unreleived by medication. do you think pt would have a need for a placebo?
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no.
have pain tolerence? yes would have anxiety? yes depression? yes *************************** |
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if someone on a pain level of a 5 on scale of 1 - 10, what kind of drugs would he need?
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weak narcotic + an non narcotic adjunct.
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what is the antidote for a narcotic?
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Narcan
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what is pain?
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whatever the pt says it is
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a pt that is cognitively impaired, how could you first clue the pt is in pain?
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change of behavior like:
withdrawl pacing hostile guarding develop more aggressive behavior ***************************** |
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what is tolerence?
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takes more drugs for it to work
receptors not as receptive to effects of the drug |
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what is addiction:?
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taking the drug to feel good and not to get ride of pain
if you need it for pain you won't b/c addicted |
