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134 Cards in this Set
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analgesics
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substances that relieve pain
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substances that relieve pain:
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analgesics
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Pain is:
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an unpleasent sensory and emotional experience associated with actual or potential tissue damage
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An unpleasent sensory and emotional experience associated with actual or potential tissue damage is:
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Pain
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acute pain is:
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- a sudden onset
- relatively short duration - mild to severe intensity - steadily decreases in intensity over a period of days/weeks |
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Chronic nonmalignant pain
Chronic benign pain |
- occurs almost daily
- lasts for >6 mos - mild to severe intensity - non-life -threatening causes - not responsive to pain relief methods - may continue for lifespan |
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neuralgia
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Paroxysmal pain that extends along course of one or more nerves
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Paroxysmal pain that extends along course of one or more nerves is:
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Neuralgia
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paroxysmal
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a sudden attack
a sudden spasm |
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a sudden attack
a sudden spasm |
paroxysmal
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Examples of nonmalignant pain:
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- neuralgia
- low-back pain - rheumatoid arthritis - ankylosing spondylitis - phantom limb pain - myofascial pain syndromes |
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- neuralgia
- low-back pain - rheumatoid arthritis - ankylosing spondylitis - phantom limb pain - myofascial pain syndromes |
Examples of nonmalignant pain.
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phantom limb pain
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a form of neuropathic pain that occurs after an amputation with pain sensations referred to an area in the missing portion of the limb
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A form of neuropathic pain that occurs after an amputation with pain sensations referred to an area in the missing portion of the limb
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phantom limb pain
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myofascial pain syndromes
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a group of muscle disorders characterized by pain, muscle spasm, tenderness, stiffness, and limited motion.
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A group of muscle disorders characterized by pain, muscle spasm, tenderness, stiffness, and limited motion.
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myofascial pain syndromes
pertaining to a muscle and its sheath of connective tissue, or fascia. |
pertaining to a muscle and its sheath of connective tissue, or fascia.
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nociceptors
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receptive neurons for painful sensations
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receptive neurons for painful sensations
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nociceptors
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(a)fferent pain pathways
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ascending
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ascending
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(a)fferent pain pathways
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(e)fferent pain pathways
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descending
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descending
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(e)fferent pain pathways
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Physiological responses to pain:
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elevated:
- BP - R rate - Pulse rate - dialated pupils - perspiration - pallor (extreme unnatural paleness |
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Elevated:
- BP - R rate - Pulse rate - dialated pupils - perspiration - pallor (extreme unnatural paleness are examples of: |
Physiolgical response to pain
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colic
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acute abdominal pain
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acute abdominal pain
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colic
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Colic results when:
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- constipation or flatus distends the stomach or intestines
- there is hyperperistalsis (ex. gastroenteritis)\ - something tries to pass through an opening that is too small |
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- constipation or flatus distends the stomach or intestines
- there is hyperperistalsis (ex. gastroenteritis)\ - something tries to pass through an opening that is too small |
symptoms of colic
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ischemic pain
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pain occuring when blood supply is restricted or cut off completely
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pain occuring when blood supply is restricted or cut off completely
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ischemic pain
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gate control pain theory
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recognizes that psychological pain is as important as physiological pain; combines cognitive, sensory, and emotional components to pain; can act to block perception of pain
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recognizes that psychological pain is as important as physiological pain; combines cognitive, sensory, and emotional components to pain; can act to block perception of pain
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gate control pain theory
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transduction
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when a noxious stimulus triggers electrical activity in the endings of afferent nerve fibers (nociceptors)
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when a noxious stimulus triggers electrical activity in the endings of afferent nerve fibers (nociceptors)
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transduction
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transmission
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an impulse that travels
1. from the receiving nociceptors to the spinal cord 2. carried to the thalmua 3. continues to the somatosensory cortex |
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an impulse travels from
1. the receiving nociceptors to the spinal cord 2. carried to the thalmua 3. continues to the somatosensory cortex |
transmission
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perception
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awareness
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modualtion
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CNS pathway that selectively inhibits pain transmission by sending blocking signals back down to the dorsal horn of the spinal cord
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CNS pathway that selectively inhibits pain transmission by sending blocking signals back down to the dorsal horn of the spinal cord
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modualtion
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endogenous
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developing within
produced internally made by the body |
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developing within
produced internally made by the body |
endogenous
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analgesic
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pain killers
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pain killers
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analgesic
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Pain modulation is controlled by:
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two endogenous analgesic systems:
1. endorphins 2. enkephalins endogenous: produced internally; made by the body |
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endorphins
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- endogenous opiate-like substances
- bind to opioid receptor sites - decrease the perception of pain |
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- endogenous opiate-like substances
- bind to opioid receptor sites - decrease the perception of pain |
endorphins
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enkephalins
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decrease pain perception in the pain pathway
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decrease pain perception in the pain pathway
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enkephalins
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Factors that effect the pain experience:
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1. age
2. previous pain experience 3. drug abuse 4. cultural norms |
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1. age
2. previous pain experience 3. drug abuse 4. cultural norms |
Factors that effect the pain experience
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PQRST
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P- what provokes/alleviates pain?
Q- quality of pain R- region (location) & radiation S- severity (0-10) T- Timing (onset, duration, freqency) |
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P- what provokes/alleviates pain?
Q- quality of pain R- region (location) & radiation S- severity (0-10) T- Timing (onset, duration, freqency) |
PQRST
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pain threshhold
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intensity level where a person feels pain (varies)
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intensity level where a person feels pain (varies)
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pain threshhold
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pain tolerance
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intensity level or duration of pain the client is able or willing to endure
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intensity level or duration of pain the client is able or willing to endure
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pain tolerance
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distraction
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focusing attention on stimuli other than pain
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focusing attention on stimuli other than pain
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distraction
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A-C-T-I-O-N
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A - assess pain at regular intervals
C- choose varoius pain interventions T- treat pain promptly/avoid escalation I- include client-specific considerations in the pain management plan (sultural, spiritual, developmental) O- Optimize pain management plan N- negotiate pain interventions/goals w/client to enhance adherance |
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A - assess pain at regular intervals
C- choose varoius pain interventions T- treat pain promptly/avoid escalation I- include client-specific considerations in the pain management plan (sultural, spiritual, developmental) O- Optimize pain management plan N- negotiate pain interventions/goals w/client to enhance adherance |
A-C-T-I-O-N
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adjuvant medications
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- those drugs used to enhance the analgesic efficacy of opiods
- treat concurrent symptoms that exacerbate pain - provide independent analgesia for specific types of pain |
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- those drugs used to enhance the analgesic efficacy of opiods
- to treat concurrent symptoms that exacerbate pain - to profvide independent analgesia for specific types of pain |
adjuvant medications
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analgesia
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The inability to feel pain while still conscious
an - without algesis - sense of pain |
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The inability to feel pain while still conscious
an - without algesis - sense of pain |
analgesia
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breakthrough pain
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pain that surpasses the level of analgesia
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pain that surpasses the level of analgesia
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breakthrough pain
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ceiling effect
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the dosage beyond which no further analgesia occurs
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the dosage beyond which no further analgesia occurs
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ceiling effect
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tolerance
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requiring larger and larger doses of an analgesic to achieve the same level of pain relief
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requiring larger and larger doses of an analgesic to achieve the same level of pain relief
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tolerance
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Classes of Analgesics:
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1. nonpoids
2. opiods 3. analgesic adjuvants |
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Nonpoids, opiods and analgesic adjuvants are:
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Classes of Analgesics
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nonopiods
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- work in the peripheral NS to block prostandin production
- used in conjunction with opioids |
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- work in the peripheral NS to block prostandin production
- used in conjunction with opioids |
nonopiods
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opiods
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- act in CNS by binding to opiate receptor sites
- pain signal stopped @ spinal cord level |
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- act in CNS by binding to opiate receptor sites
- pain signal stopped @ spinal cord level |
opiods
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Principles of Administering Analgesics:
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- establish and maintain therapeutic serum level
- Pain is much easier to control when anticipated or @ mild intensity - titrate analgesic regiment until desired effect achieved |
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- establish and maintain therapeutic serum level
- Pain is much easier to control when anticipated or @ mild intensity - titrate analgesic regiment until desired effect achieved |
Principles of Administering Analgesics:
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titrate-
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the process of determining the concentration necessary to achieve the desired result
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the process of determining the concentration necessary to achieve the desired result
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titrate-
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mixed agonist-antiagonists
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a coupound that blocks opioid effects on the receptor type while producing opioid effects on a second receptor site
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a compound that blocks opioid effects on the receptor type while producing opioid effects on a second receptor site
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mixed agonist-antiagonists
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Patient controlled analgesia (PCA)
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a device that allows the client to control the delivery of intravenous, epidural, or subcutaneous pain medication in a safe, effective manner through a programmable pump
-locks once maximum dose is reached |
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a device that allows the client to control the delivery of intravenous, epidural, or subcutaneous pain medication in a safe, effective manner through a programmable pump
-locks once maximum does is reached |
Patient controlled analgesia (PCA)
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Requirements for using PCA:
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- cognitive ability to understand how to use
- physical ability to push the button |
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- cognitive ability to understand how to use
- physical ability to push the button |
Requirements for using PCA:
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epidural analgesia
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the administering of opioid via a catherter that terminates in the epidural space (the space outside the dura mater that protects the spinal cord)
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the administering of opioid via a catherter that terminates in the epidural space (the space outside the dura mater that protects the spinal cord)
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epidural analgesia
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intrathecal analgesia
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refers to the adminstration of the drug directly into the subarachnoid space
intra - in, within thecal - sheath within the sheath |
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refers to the adminstration of the drug directly into the subarachnoid space
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intrathecal analgesia
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transdermal analgesia
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opioid adminstration via a patch
-only drug available via this route is FENTANYL |
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opioid adminstration via a patch
-only drug available via this route is FENTANYL |
transdermal analgesia
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local anethesia
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topical anethesia
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topical anethesia
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local anethesia
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relaxation techniques
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variety of methods used to decrease anxiety and muscle tension
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variety of methods used to decrease anxiety and muscle tension
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relaxation techniques
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progressive muscle relaxation
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a strategy in which muscles are alternately tensed and relaxed
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a strategy in which muscles are alternately tensed and relaxed
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progressive muscle relaxation
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reframing
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a technique that teaches clients to monitor their negative thoughts and replace them with more positive ones
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a technique that teaches clients to monitor their negative thoughts and replace them with more positive ones
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reframing
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distraction
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focuses one's attention on something other than the pain
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guided imagery
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using one's imagination to provide a pleasant substitute for the pain
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humor
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laughter
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biofeedback
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a method that may help the client in pain to relax and relieve tension
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cutaneous stimulation
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involves stimulation the skin to control pain
- hot - cold |
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involves stimulation of the skin to control pain
- hot - cold |
cutaneous stimulation
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cryontherapy
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cold application that induces local vasocontriction and numbness altering the pain
-contraindicated where vasocontriction may increase symptoms - 20-20 rule |
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cold application that induces local vasocontriction and numbness altering the pain
-contraindicated where vasocontriction may increase symptoms |
cryontherapy
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Cold should be limited to:
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20 minute intervals
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Acupressure/massage
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- blocks pain transmission through nerve stimulation
- promotes relaxation |
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- blocks pain transmission through nerve stimulation
- promotes relaxation |
Acupuncture/massage
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Mentholated rubs
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- ointments or lotions containing menthol
- alters sensation/provide conterirritation to the skin - provides a distraction |
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- ointments or lotions containing menthol
- alters sensation/provides conterirritation to the skin - provides a distraction |
Mentholated rubs
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Trans-cutaneous electrical nerve stimulation (TENS)
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the process of providing low voltage electrical current to the skin through cutaneous electrodes.
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Noninvasive pain interventions:
Cognative-Behavioral Interventions: |
1. Trusting nurse-client relationship
2. Relaxation 3. Reframing 4. Distraction 5. Guided Imagery 6. Humor 7. Biofeedback 8. Hot/Cold Applications 9. Acupressure/Massage 10. Mentholated Rubs 11. TENS 12. Exercise 13. Psychotherapy 14. Positioning |
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1. Trusting nurse-client relationship
2. Relaxation 3. Reframing 4. Distraction 5. Guided Imagery 6. Humor 7. Biofeedback 8. Hot/Cold Applications 9. Acupressure/Massage 10. Mentholated Rubs 11. TENS 12. Exercise 13. Psychotherapy 14. Positioning |
Noninvasive pain interventions:
Cognative-Behavioral Interventions: |
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Invasive Pain Interventions:
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1. Nerve block
2. Neurosurgery 3. Radiation Therapy 4. Acupuncture |
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1. Nerve block
2. Neurosurgery 3. Radiation Therapy 4. Acupuncture |
Invasive Pain Interventions:
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Acupuncture
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the insertion of small needles into the skin at specific (hoku) sites
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the insertion of small needles into the skin at specific (hoku) sites
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Acupuncture
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nerve block
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the process of injecting a local anesthetic or neurolytic agent into the nerve
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the process of injecting a local anesthetic or neurolytic agent into the nerve
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nerve block
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neurolytic (lysis)
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a chemical agent that causes destruction of the nerve and creates an interruption in the pain signal
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a chemical agent that causes destruction of the nerve and creates an interruption in the pain signal
neuro- nerve(s) lytic - (lysis) destruction; abatement of symptoms |
neurolytic (lysis)
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neurosurgery
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- implatation of electrical stimulation devices that sends impulses to NS
- some stimulate the brain or spinal cord |
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- implatation of electrical stimulation devices that sends impulses to NS
- some stimulate the brain or spinal cord |
neurosurgery
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radiation therapy
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used as a palliative measure for pain relief in clients with cancer
- relieves both metastic pain and pain caused by tumors at the primary cancer site - aimed specifically at the cause of the clients pain - smallesst dose is used to minimize side effects |
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The Joint Commission Standards
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- recognize clients right for assessment and pain management
- assess pain in all clients - record results of assessment - educate providers in pin assissment and management - determine competency in pain assessment and management - establish poicies and procedures that support appropriate prescription and ordering - ensufe pain does not interfere with rehabilitation - educatte clients and families about pain management - include clients need for symptom management in discharge planning - collect data to minitor effectiveness of pain mangement |
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- recognize clients right for assessment and pain management
- assess pain in all clients - record results of assessment - educate providers in pin assissment and management - determine competency in pain assessment and management - establish poicies and procedures that support appropriate prescription and ordering - ensufe pain does not interfere with rehabilitation - educatte clients and families about pain management - include clients need for symptom management in discharge planning - collect data to minitor effectiveness of pain mangement |
The Joint Commission Standards
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paroxysmal
paroxysm - |
violent attack. It may be due to the sudden occurrence of symptoms or the acute exacerbation (the abrupt worsening) of preexisting symptoms.
para - during + oxys - sharp or acute |
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violent attack. It may be due to the sudden occurrence of symptoms or the acute exacerbation (the abrupt worsening) of preexisting symptoms.
para - during + oxys - sharp or acute |
paroxysmal
paroxysm - |
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paroxysmal pain
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sudden and acute exacerbation of pain
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sudden and acute exacerbation of pain
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paroxysmal pain
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