Kozier Chap 46 Pain Managment

Front 1

Equianalgesic dosing

Back 1

the relative potency of various opioid analgesics compared to a standard dose of parental morphine. A chart provides doses of approx. equal ablity to releave pain

Front 2

Physical Dependance

Back 2

a state if adaptation and it includes withdraw if abrupt cessation or rapid dose reduction

Front 3

Tolerance

Back 3

a state if adaptation in which exposure to a drug includes changes that result in a diminution of one or more of the drugs effects over time

Front 4

Narrow theraputic index

Back 4

There is not much of a margin for safety between the dose that may produce a toxic or lethal effect and the dose that produces the desired effect

Front 5

Ceiling effect

Back 5

once the maximun analgestic benifit is achieved, more drug will not produce more analgesic, however toxicity may occure

Front 6

Preemptive analgesia

Back 6

the administration of analgesics prior to an invasive or operative procedure. Nurses can also use the approach by providing ATC & supplimenting with PRN doses

Front 7

3 types of opioid

Back 7

Agonist analgesic (pure)
agonist-antagonist analgesic
partial agonist

Front 8

Angonist analgesic

Back 8

Pure opioid, have no ceiling level; EX: morphine

Front 9

Agonist-antagonist analgesic

Back 9

acts like an opioid but can block opioid effects. these have ceiling effect levels that limit doses. Not recommended for use with termally ill clients

Front 10

Partical Agonist

Back 10

have ceiling effect but act like agonist EX: buprenex used in methodone therapies

Front 11

Theraputic serum level

Back 11

a high enough level of a drug in the serum blood to be effective

Front 12

Co-analgesic

Back 12

Drugs that were put on the market for other reasons than pain. Given at lower doses that the usual dose; given in conjuction with an opioid

Front 13

addiction

Back 13

A chronic disease that develps

Front 14

Key strategies to reduce pain

Back 14

Acknowlege and accept the clients pain; Assist support people; reduce misconceptions; reduce fear and anxiety; prevent pain

Front 15

Pain managment

Back 15

alleviating pain or reducing pain to a level of comfort that is acceptable to the client

Front 16

COLDERR

Back 16

Character; Onset; Location; Duration; Exacerbation; Relief; Radiation

Front 17

S 1-2-3-4

Back 17

S=Sleep 1=awake and alert; 2=Drowsy but easliy aroused; 3= freq. Drowsy 4 = somnolent

Front 18

subjective data

Back 18

data that is apparent only to the person affected; can be described or verified by that person

Front 19

Pain Scales

Back 19

Objective data for a subjective experience

Front 20

At what phase of nociceptive pain will a local anesthetic work and why

Back 20

in the transdcution phase of pain by decreasing ion movement

Front 21

at what phase of nociception will asprin or NSAID's work and why?

Back 21

transduction phase by blocking the production of prostaglandin

Front 22

Threhold of pain

Back 22

the amount of pain stimuli that is need for a person to label the sensation as pain. changes very little in the individual; Varies from person to person

Front 23

Tolerance of pain

Back 23

The amount of pain you can take. The maximum amount of pain stimuli that a person is willing to withstand. Varies within the same person, according to the situation

Front 24

Sensitization

Back 24

An increase in sensitivity of a receptor after repeated activation by noxious stimuli

Front 25

acute pain

Back 25

Only last through an expected period of recovery. Pulse RR and B/P all go up

Front 26

Chronic Pain

Back 26

prolonged, reoccuring, persisting; interferes with functioning

Front 27

Ceiling effect

Back 27

once the maximun analgesic benifit is achieved, more drug will not produce any more analgesic; however toxicity may occure

Front 28

Pseudo -addiction

Back 28

"clock watching" caused by undertreatment. client becomes focused on obtaining meds by watching time for next dose. can be distinguished from true addiction because it is resolved whtn pain is treated effectively

Front 29

Wind up phenomenon

Back 29

caused by persistant pain; New nerve growth occurs which intensifies spreads and prolongs the noxious stimuli

Front 30

Narrow thrapuetic Index

Back 30

there is not much of a margin for safety between the dose that causes a toxicity or lethal dose a nd the dose that produces the desired effect

Front 31

Types of mechanical pain stimuli

Back 31

tissue trauma; edema, blockage to a duct, tumor, muscle spasm

Front 32

types of thermal pain stimuli

Back 32

extreme hot or cold; causes tissue distruction

Front 33

types of chemical pain stimuli

Back 33

tissue ischmia (blocked coronary artery) bcause of accumulation of lactic acid.

Front 34

Refered Pain

Back 34

appears in different area than the area of the condition

Front 35

Radiating Pain

Back 35

spreads or extends to other areas

Front 36

Visceral Pain

Back 36

Pain arising form organs or hollow virceral; often is it refered pain - remote from the organ of origin

Front 37

Pain intensity assessment

Back 37

Use a pain scale

Front 38

1-3 on pain scale

Back 38

mild pain

Front 39

4-6 on pain scale

Back 39

moderate pain

Front 40

7-10 on pain scale

Back 40

severe pain

Front 41

Alladynia

Back 41

a painful response to non painful stimuli EX: contact with linens cause pain

Front 42

Hyperalgesia or Hyperpathia

Back 42

a heightened response to painful stimuli EX: severe respons to a paper cut

Front 43

Tolerance to pain

Back 43

the maximum amount of painful stimuli that a person is willing to withstand without seeking avoidance

Front 44

Pain threshold

Back 44

the amount ofpain stimuli that is needed for a person to label the sensation as pain

Front 45

dysethesia

Back 45

an abnormal unpleasant sensation. It mimics Neropathic pain disorder such as pain that follows a stroke or spinal cord injury

Front 46

Transmission phase of nociception

Back 46

The 2nd phase. Pain impulses travel form perpheral to spinal to brainstem to thalmus to somatic sensory cortex where perception occures

Front 47

Modulation

Back 47

the 3rd phase of nociception; the decending system; Neurons from thalmus and brainstem send signals down the dorsal horn

Front 48

Perception phase

Back 48

the final phase of nociception; when the person becomes aware of the pain. It is the sum of all activites of the CNS and gives character and meaning and intensity to pain

Front 49

transduction phase

Back 49

the 1st phase of nociception; Nociceptors are excited by stimuli; that triggers the release of biochemicals

Front 50

Nociceptive pain

Back 50

Pain theat is directly related to tissue damage. may te somatic or visceral has 4 phases

Front 51

what are the 4 phases of Nociceptive pain

Back 51

Transduction; Transmission; Modulation and perception

Front 52

Nociception

Back 52

the physio process of pain perception.

Front 53

meds that work in the transduction phase of pain

Back 53

NSAID's, asprin, tylenol; local anethetic; topical analgesic

Front 54

Meds that work in the transmission phase of pain

Back 54

Opioids, Capsaicin

Front 55

Nociceptors

Back 55

specialized pain receptors

Front 56

Pain meds that work during the modulation phase of pain perception

Back 56

Trycyclie Antidepressants; NMDA antagonist (ketamin dextromethophan can diminish pain signals

Front 57

NSAID's

Back 57

Ibuprofen, acetaminophen asprin

Front 58

Side affects of NSAID's

Back 58

GI bleeding Diminished renal flow; inhibits blood clotting

Front 59

Does a opioid have a ceiling effect?

Back 59

NO

Front 60

Does a NSAID have a ceiling effect

Back 60

Yes

Front 61

Does a NSAID have a narrow theraputic index

Back 61

Yes