Fundamentals Of Nursing 100

Front 1

Acupressure

Back 1

Point on the hand that influences nerve pathways to the face and head

Front 2

Acute pain/ transient

Back 2

•Protective,identifiable, short duration, limited tissue damage or emotional response

Front 3

Chronic/Persistent pain

Back 3

(Non-cancer)-not protective, no purpose,may or may not have identifiable cause, >6 months, constant or recurring

Front 4

•Chronic/Episodic pain

Back 4

occurs sporadically over extended periods of time

Front 5

Adjuvants

Back 5

Co- analgesics, medication that enhances analgesics

Front 6

Analgesics

Back 6

Most common and effective method of pain relief

Front 7

Three types of analgesics:

Back 7

Nonopioids

Opiods

Adjuvants

Front 8

Nonopioids:

Back 8

Acetaminophen (tylenol)

NSAIDS (non-steroidal anti-inflammatory drugs)

Front 9

Opiods:

Back 9

Narcotics:

Morphine

Codeine

Fentanyl

Oxycodone

Hydrocodone

Front 10

Biofeedback

Back 10

Non pharmacological pain relief using electrodes

Front 11

Breakthrough pain

Back 11

Transient worsening of pain that occurs spontaneously or unpredictably related to cancer

Front 12

Cutaneous stimulation

Back 12

Skin stimulation using massage, warm bath, cold application

Front 13

Transcutansous electrical nerve stimulation (TENS)

Back 13

electrical nerve stimulation

Front 14

Epidural analgesia

Back 14

Regional anesthesia that treats post op pain, labor and delivery pain, chronic cancer pain

Front 15

Idiopathic pain

Back 15

Chronic pain that has unidentifiable cause

Front 16

Local anesthesia

Back 16

anesthesia used locally subcutanesouly or intradermally to numb a body part

Front 17

Regional anesthesia

Back 17

injection or infusion to block a group of sensory nerve fibers

Front 18

Perineural infusions

Back 18

Anesthesia through catheter

Front 19

Patient controlled analgesia (PCA)

Back 19

Allows patients to self administer opioids

Front 20

Transduction

Back 20

Stimuli converts into electrical energy. The pain-producing stimulus sends an impulse across a sensory peripheral pain nerve fiber (nociceptor)

Example: (slapping table)

Front 21

Transmission

Back 21

Cellular damage that results in release of neurotransmitters

beginning the transmission of pain

Front 22

Perception

Back 22

Point where patient is aware of pain

When it is received in the brain

Front 23

Modulation

Back 23

Inhibition of the pain impulse

inhibitory neurotransmitters are released

Front 24

Multi-modal analgesia

Back 24

medications are combined to target different areas in peripheral or central pain pathways

Front 25

Neurotransmitters

Back 25

Either excite during transmission or inhibit during modulation

Front 26

Examples of Neurotransmitters

Back 26

Prostaglandins

Bradykinin

Substance P

Histamine

Seratonin

Front 27

Prostaglandins:

Back 27

Increase sensitivity to pain

Front 28

Bradykinin

Back 28

Binds to receptors on peripheral nerves

increases pain stimuli

Front 29

Substance P

Back 29

Found in dorsal horn pain neurons

Needed to transmit pain impulses to brain

Causes vasodilation and edema

Front 30

Histamine

Back 30

Causes capillary dilation and and increased capillary permeability

Front 31

Seratonin

Back 31

Released from brain stem and dorsal horn to inhibit pain transmission

Front 32

Neuromodulators (inhibitory)

Back 32

Natural supply of morphine like substance in body

Activated by stress and pain

Located within brain, spinal cord, gastrointestinal tract

Front 33

Nociceptor

Back 33

Sensory peripheral pain nerve fiber

Front 34

Pseudoaddiction

Back 34

Pain not properly relieved by pain management

(doctor shopping)

Front 35

Pain is a ___________ and is _________ in nature

Back 35

symptom

subjective

Front 36

Transduction converts painful stimulus into electrical impulses that travel from the __________ nerve to the __________ cord at the _________ horn.

Back 36

peripheral

spinal

dorsal

Front 37

During transmission, the pain message is sent to the brain via the ___________ tract, which is a bundle of nerve fibers that run up the ________ cord

Back 37

Spinothalamic

Spinal

Front 38

Two types of peripheral nerve fibers conduct painful stimuli:

Back 38

A-delta fibers

C fibers

Front 39

Stepping on a nail, person feels sharp, localized pain, or first pain is which fiber?

After a few seconds the whole foot aches is second pain, or which fiber?

Back 39

A fibers

C fibers

Front 40

•Chemical synapses involve transmitter chemicals (_____________) that signal post_______ cells.

Back 40

neurotransmitter

synaptic

Front 41

•Sensation of pain regulated or modified by substances called ______________

Back 41

neuro-modulators

Front 42

Endogenous

Back 42

made inside us

Front 43

Endogenous opioid compounds

Analgesic activity alters the perception of pain

Back 43

Neuro-mudulators

Front 44

A protective ________ response also occurs with pain reception. ________ fibers send sensory impulses to the spinal cord, where they synapse with spinal motor neurons. _______ _______ travel via a reflex arc along efferent (motor) nerve fibers back to a peripheral muscle near the site of stimulation, thus bypassing the brain.Contraction of the ________ leads to protective withdrawal from the source of pain.

Back 44

reflex

A-delta

Motor Impulses

muscle

Front 45

Pain impulses pass through when a gate is open and are blocked when a gate is closed

Back 45

Gate-Control Theory of Pain

Front 46

The gates can be _________, _________, or ________ processes

Back 46

Physiological

emotional

cognitive

Front 47

Closing the gate is a the basis for ___________ pain relief interventions

Back 47

nonpharmacological

Front 48

Inferred Pathological Process

Back 48

Nociceptive vs. neuropathic

Front 49

100 times more potent than morphine and provides analgesia for 48-72 hours

Back 49

Transdermal fentanyl

Front 50

•Patients with chronic pain need to be given medications on a regular ________ basis.

Back 50

ATC

(around the clock)

Front 51

•Long-acting or controlled-release medications are very successful in managing all types of chronic pain. You can manage most chronic pain by using ______ or _______ medications.

Back 51

oral

patch

Front 52

Transmucosal fentanyl is used for _________ pain

Back 52

breakthrough

Front 53

Normal processing of stimuli that damages normal tissues or has the potential to do so

Back 53

Nociceptive pain

Front 54

Pain that is aching, throbbing, usually well localized

Back 54

Somatic

Visceral

Front 55

Pain that is felt more in bones, joints, muscle, connective tissue

Back 55

Somatic

Front 56

Pain that is felt more in internal organs (tumor, obstruction)

Back 56

Visceral

Front 57

Abnormal processing of sensory input by peripheral or CNS

(centrally or peripherally generated)

Back 57

Neuropathic pain

Front 58

Neuropathic pain example:

Back 58

Diabetic neuropathy (tingling, pain, numbness)

Herpesoster (shingles)

Front 59

Factors influencing pain

Back 59

•Physiological••Social••Psychological••Cultural

Front 60

___________ has established specific guidelines for assessing patients with acute and cancer pain. The focus is on planning successful pain management interventions before a patien thas pain. Because it involves a collaborative approach, the pain treatment flow chart offers a useful conceptual approach to the control of acute pain.

Back 60

AHRQ

The Agency for Healthcare Research and Quality

Front 61

5 Vital signs

Back 61

Heart rate

Blood pressure

Respiration rate

Body temperature

Pain

Front 62

Characteristics of pain:

Back 62

•Onset and duration

•Location

•Intensity-(Pain Scales)

•Quality-(Sharp, Dull, Diffuse, Shifting)

•Pattern-(Acute, Chronic, Episodic,Persistent)•Relief measures

•Contributing symptoms

•Effects of pain on the patient

Front 63

Routine clinical approach to pain assessment and management:

A
B
C
D
E

Back 63

•A: Ask about pain regularly. Assess pain systematically.

•B: Believe patient and family in their report of pain and what relieves it.

•C: Choose pain control options appropriate for the patient, family, and setting.

•D: Deliver interventions in a timely, logical, and coordinated fashion.

•E: Empower patients and their families. Enable them to control their course tot he greatest extent possible.

Front 64

4 tools for assessing pain:

Back 64

•VerbalDescriptor Scale (VDS)

•Wong-BakerFaces Scale (FACES)

•NumericRating Scale (NRS)

•VisualAnalog Scale (VAS)

Front 65

Ranges pain on a scale between mild, moderate and severe

Back 65

Verbal descriptor scale (VDS)

Front 66

Shows various facial expressions. Works well with the pediatric population

Back 66

Wong-Baker Scale (faces)

Front 67

Which pain scale tool?

Patients designate a point on the scale corresponding to their perception of the pain's severity at the time of assessment

ex. no pain ----------- unbearable pain

Back 67

Visual analog scale

Front 68

Which pain scale tool?

Number of 1-10 from no pain to severe pain, how bad is the pain?

Back 68

Numerical rating scale

Front 69

Level of pain a person is willing to accept

Back 69

Pain tolerance

Front 70

Non-pharmacological pain relief examples:

Back 70

•Relaxation,guided imagery

•Biofeedback•Distraction,music

•Cutaneous stimulation

Massage,transcutaneous electrical nerve stimulation (TENS), heat, cold, acupressure

•Herbals

•Reducing pain perception