Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
56 Cards in this Set
- Front
- Back
Discuss the
concept of comfort |
central to the art of nursing.
Each individual has physiological, social, spiritual, psychological, and cultural characteristics that influence how comfort is interpreted and experienced. The context of comfort is the umbrella under which pain and pain management options are viewed. Factors affecting: illness, nutrition, exercise, environment, meds, stress |
|
Explain the pn
mgmt policy by Ca BRN |
1-assess, document, treat pain
2-begin interventions before pain is severe - early 3-pain mgmt should include non-pharmocological means 4-RN uses judgement with PRN schedule |
|
Define:
Addiction |
Physical dependence on med,
has psychological, environmental and genetic etiology. Using med despite negative impact on life. |
|
antagonist
|
blocks receptor - no response
|
|
analgesic
|
medications that relieve
pain |
|
opioid tolerance
|
pt no longer gets same
desired effect of medication must increase dose/amt to get that effect long term use |
|
opioid withdrawl
|
after 2 weeks stop using med:
eyes + nose watery n/v/d hot, diaphoretic irritable, restless |
|
pain threshold
|
how much pain a person
can tolerate level of stimulus that results in perception of pn |
|
agonist
|
fits perfectly on receport
sites - desired effect causes response |
|
Cultural
factors/responses associated with pain |
the meaning that a person
associates with pain effects the experience of pn and how one adapts. Ethnicity- cultural beliefs/values learned behavior gender - females more verbal |
|
Psychological
factors/responses associated with pain |
anixety over pain can lead
to fatigue that begins the pain cycle. pt can't sleep, muscles tense = more pain cycle repeats itself |
|
Physiological
factors/resonses associcated with pain |
age
nervous system pain impulses low to moderate pain continuous, sever, deep pain |
|
geriatric considerations
of pain control and nursing implications |
elderly are vague, tend to deal
with pain more before they speak up. believe that nothing can be done for pain, fear of meds |
|
define pain
and dicuss what is meant by experience of pn |
unpleasant subjective
sensory and emotional experience associated with either actual or potential damage. 5th vital sign. whatever the experiencing person says it is, existing whenever s/he says it does |
|
common
misconcpetions about pain |
drug abusers/alcoholics
overreact to discomfort minor illnesses=less pain than others pain meds lead to addiction chornic pn is psychological |
|
characteristics
of acute pain |
onset is quick
intensity levels vary signs - sympathetic nervous sys duration - less than 6 months has predictable ending |
|
characteristics
of chronic pain |
recurrent, duration - lasts
longer, parasympathetic nervous system involved, uncertain cause/duration, can lead to depression, isoloation |
|
break through
pain |
pain that extends
beyond treated steady chronic pain: incident pain end-of-dose failure pain spontaneous pain |
|
Stages of PAIN:
Transduction |
peripheral pn stimulus
chemical mediators are transducted from action potential to potential for pain Ibuprofin works with prostaglandins so they don't get transduced to pain signal |
|
Transmission
|
substance P
stimuli transferred across synapse by substance P so that it can go to a higher brain function |
|
Perception
|
conscious of pn
pn senstation can treat with distraction guided imagery |
|
Modulation
|
neurons originating in
brainstem descend to spinal cord and release substances -analgesic effectiveness -tricyclic antidepressants |
|
Somatic pain
|
originates from
skeletal muscles, ligaments, joints easy to pinpoint |
|
Visceral pain
|
deep organs, intermittent,
not easily localized. |
|
central pain
|
resulrting from an d/o that
causes CNS damage |
|
referred pain
|
common phenom in visceral pain
because many organs have no pain receptors - pain is felt in part of body separate from source of pain an may assume characteristic |
|
radiating pain
|
place of orgin and going
somewhere else back pn radiating to legs |
|
phantom pain
|
pain experienced in a body
part that has been surgically or traumatically removed |
|
neuropathic pain
|
pain that results from a
disturbance of function or pathologic change in a nerve |
|
organic
|
physiologic reason
|
|
Psychogenic pain
|
psychologic in nature but is
truly real pain - stress, mental health |
|
Gate control theory
of pain transmission and perception |
pain has obligatory emotional
and cognitive components. In addition, pain impulses can be regulated or even blocked by gating mechanisms located along the central nervous system. The theory suggests that pain impulses pass through when a gate is open and that impulses are blocked when a gate is closed. Closing the gate is the basis for pain-relief interventions |
|
differentiate between
pain tolerance and pain threshold |
Tolerance: level a person can
put up with, perception of pain, lowers because: emotions, discomfort, fatigue Threshold: point at which person feels pain, raise pain threshold with: diversion, empathy, sympathy, rest, meds, anti-anxiety agents |
|
Expalin comfort
care in r/t pain control outcome |
by providing comfort to
patients you can relieve some of their pain, our job is to provide comfort |
|
different types
of pain rating scalses |
10 point scale - 0=no pain
10=worst pain ever Wong-Baker - faces indicating pain level for non-verbal pt |
|
PRN around
the clock dosing |
Nursing judgement to decide
if paitent needs around the clock medication. one way to maximize pain relief while minimizing drug tox |
|
noninvasive
pain relief measures |
music, reading, games,
meditation, guided imagery, shower/bath, massage, reposition, transcutaneous electrical nerve stimulation TENS - electric current over painful region |
|
Heat / Cold
therapy |
Heat: application of moist or
dry heat to skin, superficial or deep via heating pad, bottle, compress, whirpool Cold: appilaction of moist or dry cold to skin via ice pack, bath, running water. Evidence: cold relieves more pain than heat therapy, works faster than heat, provides longer relief |
|
Morphine
|
SC, IM, PO, IV, PR, Epidural
moderate to severe pain s/e: hypotension, decrease RR, sedation, n/v, constipation, urinary retention, irching, euphoria, disorientation |
|
Meperidine
|
IM, PO, IV, SC
moderate to severe pain s/e: hypotension, decrease RR, sedation, n/v, constipation, urinary retention, irching, euphoria, disorientation |
|
Hydromorphone
|
SC, IM, PO, IV, PR
moderate to severe pain s/e: hypotension, decrease RR, sedation, n/v, constipation, urinary retention, irching, euphoria, disorientation |
|
Hydrocodone
|
PO, PR
moderate to severe pain s/e: hypotension, decrease RR, sedation, n/v, constipation, urinary retention, irching, euphoria, disorientation |
|
Codeine
|
mild to moderate pain
s/e: hypotension, decrease RR, sedation, n/v, constipation, urinary retention, irching, euphoria, disorientation |
|
Aspirin
Acetaminophen non-narcotic |
Aspirin: PO, PR, mild pain,
s/e gastric upset/bleed, platelet aggregation Aceta: PO, PR, mild-mod pain s/e rash n/v |
|
Naloxone (narcon)
|
IV
Complete or partial reversal of opioid-induced respiratory depression - raises BP, HR, RR |
|
Special problems assoc.
with control of chronic and intractable pain |
It is necessary to give
required analgesics on a reg. basis, prescribing analgesics prn is ineffective/causes suffereing, even when pn subsides, client should continue taking med, often a comprehensive tx plan is needed |
|
Assembly Bill 791
|
it is the RNs job to:
assess and treat in a timely fasion/effectively it is a vital sign document |
|
DSCR: developmental
stages of pain |
Infant - avoidance
Toddler - externalizes School age - bravery Adolescent - dramatic Adult - denial Elder - vague |
|
sympathetic
and para-sympathetic nervous system s+s |
Symp: acute pain, fight or
flight, elev HR, RR, pupils dilate, diaphoretic Para: chronic pain, skin dry, HR, RR normal |
|
Durin the trasduction
phase of nociception, which method of pain control is most effective? |
Ibuprofen
|
|
Pin is viewed as a
|
separate disease
|
|
Pain hx
guidelines |
OLDCART
onset, location, duration, character, agg. factors, radiation, treatment previously duration, description |
|
The client is c/o of
L shoulder pn. Your response? a. request the pt to decribe pn b. inquire if pn is throbbing c. ask if pt wants meds d. instruct pt to compete pn questionnaire |
a. request the pt to describe
pain |
|
Which client problem would
be most appropriate for the client experienceing acute physical pain a. ineffective coping b. potential for inj c. alteration in comfort d. altered sensory input |
c. alteration in comfort
|
|
When preparint the plan of
care for the pt in acute pn from post op, the RN should include: a. administer pn meds as soon as time allows b. use non-pharm methods c. apply heat (works faster) d. instruct family give PCA |
a. admin pn meds as soon
as time allows |
|
PCA definition
|
paticnt controlled
analgesia can or cannot have basal rate continuously infused puts pt in charge |