Chapter 10 Pain Med-Surg

Front 1

This organization defines pain as, " An upleasent sensory & emotional experience associated w/ actual or potential tissue damage, or described in terms of such damage.

Back 1

IASP

Front 2

One of the 5-dimensions of pain that involves the transmission of the nociceptive stimuli of pain

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Physiogical

Front 3

One of the 5-dimensions of pain that involves the actual location intensity.

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Sensory

Front 4

One of the 5-dimensions of pain that involves that actual suffering emotion.

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Affective

Front 5

One of the 5-dimensions of pain that involves the persons reaction to pain along with how the react to it.

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Behavioral

Front 6

One of the 5-dimensions of pain that involves the person's attitudes, beliefs, eval, & goals towards pain.

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Cognition

Front 7

Inflammation & the subsequent release of chemical mediatiors increases the likelihood of transduction. This increased susceptibility is called...

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Sensitization

Front 8

A chemical in the distant terminals of the PAN that will sensitize it & dialate nearby blood vessels, w/ subsequent production of edema & release of histamine from mast cells.

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Substance P

Front 9

Neurons that project from the periphery to the spinal cord are also refered to as this.

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First order neurons

Front 10

Large fibers that are enclosed within the myelin sheaths, allowing them to conduct impulses at a rapid rate.

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A-Fibers

Front 11

The smallest fibers that are unmyelinated, which conduct at the slowest rate.

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C-Fibers.

Front 12

Part of nociceptive pain, characterized as aching or throbbing that is well localized, arises from bone, joint, muscle, skin or connective tissue.

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Somatic Pain

Front 13

Part of neuro-pathic pain that can be centrally or peripherally generated

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Deafferentation

Front 14

Part of nociceptive pain, which can result from stimuli such as a tumor involvement, or obstruction, arises from interal organs such as bladder or intestine.

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Viceral Pain

Front 15

Pain that has sudden onset w/ a duration of <3months. Severity is mild to severe, whereas the cause can generally be indentified.TX includes analgesics for symptom control & underlying causes. Diminishes over time.

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Acute Pain

Front 16

Part of the pain assessment that includes the onset & duration.

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Pattern

Front 17

Pain that persists for longer periods, often defined as longer than 3 months, which usually waxes & wains over time.

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Chronic

Front 18

Examples of this kind of pain include dressing changes, position changes, movement, eating & catherization. Fast acting drugs are used to treat this sort of pain.

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Breakthough Pain

Front 19

Part of the pain assessment that includes the location of pain that assists in identifying the possible causes of pain & determining it's tx.

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Area

Front 20

The increased response to "NOXIOUS" stimuli (i.e. not sensitization)

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HYPER-algeisa

Front 21

Painful responsed to normally innoucuous sitmuli.

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Allodynia

Front 22

Prolonged pain after the original noxious stimulus ends

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Persistent Pain

Front 23

The spead of pain to uninjured tissue.

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Referred Pain

Front 24

Part of the pain assessement that determines the severity of pain, which provides a reliable measurement used in detertmining the type of tx, as well as the evaluation of tx effectiveness.

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Intensity

Front 25

Part of the pain assessement that refers to the quality or char. of pain. This insturment captures the Qual-itative & affective components of pain.

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Nature

Front 26

Pain that can be described as sharp, arching, throbbing & cramping. (i.e. is it Neurceptive or Nociceptive)

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Nociceptive Pain

Front 27

Basic Principle of the pain tx where the patient must always be believed.

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Frist Principle

Front 28

Basic Principle of the pain tx
where every patient deserves adequate pain management established by JACHO

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Second Principle

Front 29

Basic Principle of the pain tx
where tx itself must be based on the patient's goals.

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Third Principle

Front 30

Basic Principle of the pain tx
where tx plans should be combined with drugs & non-drug therapies.

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Fourth Principle

Front 31

Basic Principle of the pain tx where a multi-disciplinary approach is necessary to address all dimensions of pain.

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Fifth Principle

Front 32

Basic Principle of the pain tx
where all therapies must be evaluated to ensure that they are meeting patient's goals.

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Sixth Component

Front 33

This type of teaching should be the cornerstone to the tx plan, involving these two groups of people.

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Patient & Family

Front 34

A type of dosage that are provide for opioids & are important because there is no upper limit.

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Equianalgesic Dose

Front 35

Analgesic scheduling should focus on this in conjuction to ongoing control of pain, rather than providing analgesics only after the patient's pain become severe.

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Prevention

Front 36

When pain is around 1-3
non-opioids(e.g asprin) NSAIDS & aceteminophen are used. This is used for what intensity of pain.

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Mild Pain: Step 1 Drugs

Front 37

When pain is of this intesity, from 4-6, but persistant despite non-opioid therapy this step of drugs are used in the form of opioids. (e.g. Codeine, Oxycodone)

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Mild/Moderate: Step 2 Drugs

Front 38

Morphine is an example of this, which binds to the receptor & causes analgesia.

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Opioid Agonist

Front 39

Narcan is an example of this, where it binds to the receptor; but blocks other effects of opioid receptor activation, such as respiration depression & sedation. Doesn't produce analgesia.

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Opioid Antagonist

Front 40

Binds weakly on the mu & kappa receptors which decrease their analgesic efficacy. Currently have limited availability & low clinical value.

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Partial Opioid Aganoist

Front 41

When pain intensity is between 7-10, this step level of drugs are used because they are potent & have no analgesic ceiling. (eg. Morphine, hydromorphine, methadone).

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Step 3 Mu Angonist

Front 42

This drug is the standard of comparison for all other opioid drugs.

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Morphine

Front 43

Side effects for this step level drug include constipation, nausea, vomiting, sedation, respiratory depression & pruritus. (Repeat Question)

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Step 3

Front 44

The most common opioid side effect.

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Constipation

Front 45

This symptom is often a side effect in opioid naive patients. Can be relieved by Reglan.

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Nausea

Front 46

Drugs used in conjuntion w/ opioids & non-opioids. Sometimes referred to as CO-Analgesics. 1)They can enhance opioids & nonopioids, 2)possess own analgesic properties, 3)counteracts side effects of other analgesics.

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Adjuvant Analgesics

Front 47

Generally the administration route of choice for persons with a functioning GI.

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Oral

Front 48

For this route pain relief typically occurs w/in 5-7 minutes after administration

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Sublingual/Buccal

Front 49

Aduvant drugs that enhance the descending inhibitory syst. by preventing cellular reuptake of Nor-epinepherin & serotinin. Resultin higher levels inhibit nociceptive signals in CNS

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Antidepressants

Front 50

Adjuvant drugs which fall in the same class as gabapentin, tegretol & clonazepam, stablize the membrane of the neuron & prevent NEURO-pathic pain transmission. Prophylactic for headaches.

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Anti-Seizure Agents

Front 51

Common side effects of this type of adrenergic agonists are orothstatic hypotension, sedation & dry mouth.

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Alpha 2

Front 52

Aduvant drug that decrease edema & inflammation, & sometimes tumors. Side effects include GI bleeding, impaired healing fluid retention, muscle wasting, osteoporis & susceptibility to infection.

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Corticosteroid

Front 53

Adjuvant drugs which is an anesthetic used to interrupt neuropathic pain signals to the brain. Side effects include paresthisas & seizures in high doses. Also can effect cardiac conductivity causing arrhythmias & myocardial depression. (i.e. what kind of anesthetic)

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Local Anesthetic

Front 54

A common non-drug therapy for pain thought to provide relief by activating mechanoreceptors in the muscles

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Vibration

Front 55

Involves the delivery of an electric current through electrodes applied to the skin surface over the painful region, at trigger point, or over a peripheral nerve.

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TENS Unit

Front 56

Stimulates deeper peripheral tissues through the insertion of a needle to which a stimulator is attached near a large peripheral or spinal nerve.

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PENS Unit

Front 57

Through this type of management, the nurse acts as planner, educator, patient advocate, interpreter & supporter of patient & family.

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Collaborative

Front 58

Barrier to Effective Pain Management that occurs with chronic exposure to drugs, char. by the need for increased opioid do to maintain same degree of analgesia.

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Tolerence

Front 59

Barrier to Effective Pain Management manifested by a withdrawl syndrome that occurs when blood levels of the drug are abruptly decreased.

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Physical Dependence

Front 60

Barrier to Effective Pain Management which involves a complex neurobiological condition char. by a drive to obtain & take substances for other than their prescribed therapeutic value.

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Addiction

Front 61

The issue involving medical & nursing curricula having spent little time teaching about pain & symptom management or providing adequate skills.

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Education

Front 62

This rule states that if an unwanted consequence (i.e. hastened death) occurs as a result of an action taken to achieve a moral good (i.e. pain relief), then the action is justified.

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Rule of Double Effect

Front 63

A common problem in the elderly & is often associated w/significant physical & psych disability.

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Chronic Non-Malignant Pain

Front 64

Often results in depression, sleep disturbances, decrease mobility, increased hospitaliztion & social role dysfuntion.

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Chronic Pain

Front 65

The use of this drug class is associated w/high frequency of serious GI bleeding.

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NSAIDS