Asch Ch. 23 Severe Pain Ppt

Front 1

Pain =

Back 1

what the person says it is
also
multidimensional & subjective

Front 2

Pain has sensory-discriminative (_____) components and affective-motivational (______) components.

Back 2

physical

emotional

Front 3

The _______ dimension of pain encompasses pain’s location, intensity, and quality.

Back 3

sensory

Front 4

Stimulation of the ________ system produces an emotional response to the physical stimulus of pain.

Back 4

limbic

Front 5

Inhibition of pain and transmission of painful stimuli occur in various regions of the _______.

Back 5

brain

Front 6

_______ substances such as endogenous opioids, serotonin, norepinephrine, and gamma-aminobutyric acid (GABA) are released into nerve _______.

Back 6

Inhibitory

synapses

Front 7

Inhibitory substances bind with receptors on primary _____ and dorsal horn neurons to prevent further _______ of painful stimuli.

Back 7

afferent

transmission

Front 8

________ pain is caused by the activation of the delta and C nociceptors in response to painful stimuli, such as injury.

Back 8

Nociceptic

Front 9

_______ pain is the term used to represent pain in which the underlying pathology is abnormal processing of stimuli in the peripheral or central nervous systems.

Back 9

Neuropathic

Front 10

______ pain, meaning the immediate phase of response to an insult or injury,
results from tissue damage.

Back 10

Acute

Front 11

______ pain may persist well beyond actual tissue injury and healing.

Back 11

Chronic

Front 12

____ nociceptors are fast traveling myelinated fibers and respond to mechanical stimuli (sharp, stinging, etc.)

Back 12

Delta

Front 13

___ nociceptors are un-myelinated slow response fibers. They respond to chemical or thermal stimuli (dull burning or aching pain)

Back 13

C fibers

Front 14

Pain that is "real" and has to do with tissue damage is termed...

Back 14

Nociceptic pain

Front 15

Pain that results from injury to peripheral receptors (impairment of NS) and follows a kind of pattern is termed

Back 15

Neuropathic pain

Front 16

Where are nociceptors found?

Back 16

Skin, muscles, connective tissue, etc.

Front 17

What is the Narcotic analgesic prototype drug?

Back 17

Morphine

Front 18

Opiate agonists, mixed agonist-antagonists, and antagonists based on their activity at opioid receptors are all within what category of Pain relievers?

Back 18

Narcotic Analgesics

Front 19

Sensation of pain begins in ____ neurons called ______

Back 19

afferent

nociceptors

Front 20

After enkephalon is released, ___ ____ is released and the person will sense pain.

Back 20

Substance P

Front 21

What is Substance P?

Back 21

A neurotransmitter that is released in response to pain

Front 22

The ____ has the greatest control over nociceptor functioning

Back 22

brain

Front 23

Pain receptors are found on ___ plates of ____ neurons

Back 23

peripheral

afferent

Front 24

How do narcotic agonists/opium agonists work?

Back 24

They inhibit or block something from happening (ie. morphine)

Front 25

How do opioid/narcotic antagonists work?

Back 25

They counteract what the narcotic agonists or opium agonists effect- and reverse it's action (ie. narcan)

Front 26

What is the major adverse effect or morphine?

Back 26

RESPIRATORY DEPRESSION

Front 27

Is it recommended to give morphine SQ?

Back 27

No, it is very irritating to the tissues

Front 28

Most HAZARDOUS effects of morphine

Back 28

excessive CNS depression; (respiratory depression, apnea, circulatory depression, cardiac arrest, shock, and coma)

Front 29

Most FREQUENT adverse effects of morphine

Back 29

respiratory depression, apnea, bradycardia, light-headedness, dizziness, sedation, N/V, and sweating

Front 30

Why should lifespan and gender be assessed when administering morphine?

Back 30

Older people may need dose reduction adjustments

Front 31

What is the desired outcome for a nursing diagnoses of Ineffective Breathing Pattern, Hypoventilation, related to respiratory depression caused by morphine?

Back 31

Desired outcome: the patient maintains effective breathing despite respiratory depression.

Front 32

What is the desired outcome for a nursing diagnoses of Constipation secondary to activity of morphine?

Back 32

Desired outcome: the patient remains free of constipation.

Front 33

What is the desired outcome for a nursing diagnoses of Urinary Retention related to indirect anticholinergic effects of morphine on the urinary sphincters?

Back 33

Desired outcome: the patient maintains normal urinary output.

Front 34

What is the desired outcome for a nursing diagnoses of Risk for Injury related to orthostatic hypotension or sedation secondary to morphine effects?

Back 34

Desired outcome: the patient remains free of injury.

Front 35

When administering morphine, be sure to assess____ rate, ____, and ____ prior to and during therapy.

Back 35

respiratory rate, pain, and constipation

Front 36

To correctly assess pts pain the nurse should use a _____ _____ _____.

Back 36

pain assessment tool

Front 37

Pain Assessment:
P
Q
R
S
T

Back 37

Provoking factor?
Quality?
Radiate?
Severity?
Time?

Front 38

Mild Narcotic Agonists: Prototype drug?

Back 38

codeine

Front 39

codeine, hydrocodone, and propoxyphene are all....

Back 39

mild narcotic agonists

Front 40

codeine treats what level of pain?

Back 40

mild-to-moderate

Front 41

codeine acts specifically on ____ ____ in the brain to depress ____ reflex.

Back 41

cough center
cough reflex

Front 42

codeine should not be given with other ____

Back 42

narcotics

Front 43

codeine acts at specific _____ receptors in the ____ to produce analgesia, euphoria, and sedation.

Back 43

opioid

CNS

Front 44

What other drugs does codeine interact with?

Back 44

Antihistamines, phenothiazines, barbiturates, tricyclic antidepressants, cimetidine, and alcohol

Front 45

Can codeine cause physical dependency?

Back 45

Yes

Front 46

Codeine: Nursing Diagnoses:
Disturbed Sensory Perception r/t drowsiness and sedation.
What is the desired outcome?

Back 46

Desired outcome: the patient will be protected from injury related to sedation and drowsiness.

Front 47

Codeine: Nursing Diagnoses: Risk for Ineffective Airway Clearance r/t suppression of cough reflex.
What is the desired outcome?

Back 47

Desired outcome: the patient will maintain baseline respiratory function.

Front 48

Codeine: Nursing Diagnoses: Constipation secondary to activity of the drug.
What is the desired outcome?

Back 48

Desired outcome: the patient remains free of constipation.

Front 49

Do not administer condeine to pts who need to ___ or clear their _____.

Back 49

cough

airway

Front 50

When administering codeine, assess ________ function prior to administration.

Back 50

respiratory

Front 51

Narcotic Agonist-Antagonists: Prototype drug: ______ (_____)

Back 51

pentazocine (Talwin)

Front 52

Some narcotic analgesics have mixed opioid effects, being an _____ at some receptors and an ______ at others.

Back 52

agonist

antagonist

Front 53

What does the agonist component of Narcotic Agonist-Antagonists do?

Back 53

it is the component that relieves the pain

Front 54

What does the antagonist component of Narcotic Agonist-Antagonists do?

Back 54

decreases risk of toxicity and drug dependence

Front 55

pentazocine is an _____ to control pain

Back 55

agonist

Front 56

In cases of pentazocine overdosage, _______ is indicated.

Back 56

naloxone

Front 57

Harrison Narcotic Law of 1914

Back 57

Provided regulation regarding the manufacture and distribution of certain drugs (1st fed law towards controlling drug addiction)

Front 58

The 1970 Comprehensive Drug Abuse Prevention and Control Act

Back 58

Established the Drug Enforcement Agency (DEA)

Five categories, known as SCHEDULES, were established

Front 59

Nongovernmental Institutional Controls can be implemented by ____ and other ___ _____

Back 59

hospitals

accrediting bodies

Front 60

CONTROLLED SUBSTANCES ACT:1970

Back 60

Classified Scheduled Drugs

Schedule I - V

Front 61

Schedule I

Back 61

Illegals: highest risk for abuse where danger involved. NOT used medically

Front 62

Schedule II

Back 62

High potential for abuse

Front 63

In order to maintain control on narcotics, nurses must use the "count," what is this?

Back 63

2 nurses count each narcotic and countsheet. All must match what is inside the drawer.

Front 64

_____ can have their own rules and regulations regarding narcotics

Back 64

hospitals

Front 65

The prescribing, dispensing, and storing of controlled substances is subject to _________ control.

Back 65

governmental

Front 66

Procedures are precisely defined by _____ for every step, from manufacture to administration to wasting or discarding.

Back 66

law

Front 67

Nurses are ______ responsible for the drugs they administer.

Back 67

legally

Front 68

Safe drug administration requires a thorough understanding of _______ drug actions and ______ drug reactions.

Back 68

therapeutic

adverse

Front 69

In some clinical settings, _____ are allowed to modify drug regimens.

Back 69

nurses

Front 70

Application of the nursing process to the pharmacologic aspects of patient care is especially important because long-term use of drug therapy is frequently necessary to control ______ _______processes.

Back 70

chronic disease

Front 71

Nursing management of drug therapy may be considered an ______ ________

Back 71

applied science

Front 72

Drug laws and nurse practice acts vary from ____ to _____.

Back 72

state to state

Front 73

Nurses cannot provide drug therapy without proper _________.

Back 73

authorization

Front 74

Nurses are responsible for drug _______ and safe _________.

Back 74

security

administration