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61 Cards in this Set

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considered to be the 5th vital sign
pain
sever discomfort or uncomfortable sensation with a sudden onset, usually subsides with treatment
Acute Pain
Persistent or recurring pain that contiumes for more then six months.
Chronic Pain (nonmalignant or benign)
Pain that persists beyond normal heling period. Non life threatening
chronic
Stimuli damage tissues or has potential to do so if prolonged
Nociceptive Pain
arises from bone, joint, muscle, skin or connnective tissue. Aching throbbing, well localized
Somatic
arises from panceas, or gi tract.
visceral
tumor aching is
well localized
cramping poorly localized
obstruction
Abnormal processing of sesory input by nervous system
Neuropathic pain
Injury to either peripheral or Cns (phantom)
Deafferentation
dysregularion of autonomic nerfus system
sympathetically maintained
centrally generated
deafferentation
sympathetically maintained
peripherally generated
polyneuropathies
centrally generated
deafferentation
sympathetically maintained
pain along a peripheral nerve (diabetic)
polyneuropathies
nerve root compression, entrapment
mononeuropathies
send pain signal along peripheral nerve fibers iwth neurotransmitters.
nociceptors
cells release prostaglandins (increase pain) potassium bradykinin.
nociceptors
sharp well localized pain after injury
A delta
dull, poorly localized persistent pain after injury
C fiber
Substance P allows impulse to travel to spinothalamic tract
Dorsal horn of spinal cord
motor impulses travel along ? to cause a contraction of muscle near site of stimulation and withdrawl
efferent nerve fibers
when released from the brain, cord, gi tracte this causes analgesia
endorphines and dynophins
WHat released from the brain and dorsal horn, inhibits pain transmission
serotonin
pain impulses ascend to spinal cord to somatosensory and ? cortex
association
dorsal horn of spinal cord, thalamus, limbric system as as what
gate that can be opened to pass pain impulse along or closed to block transmission
if imput dominates from A-beta fibers, gate will
close
what can be done to stimulate mechanoreceptors a beta fiber
nurse ccan massage
release endorphins to close gate by inhibiting substance P release
descending neural pathways
what elicts flight or fight reaction.
Mild to moderate pain
physiological responses to pain are
increased rr hr pallor diaphoresis glucose increase muslce tension pulpil dilation.
sever continuous or deep pain stimulates what
PNS
sever pain results in what to the hr, bp
decreased. irreg breathing nausea and vomiting pallor and weakness
factors influencing pain
age
gender
attention
system that processes emotional reaction to pain, aggravating or relieving it.
Anxiety -limbric
fatigue does what to pain?
intensifies pain and decreases coping
stoicism and self control moaning and crying accepted. communicating it is not.
Mexicans
disgraceful to express pain verbally and may refuse anagesic
japanese
may not complain of pain except to family, or eldest male
chinese
germans and scandinavians handle pain by being
stoic
punishment from god for sinful thinking or behavior, suffering is part of ones fate, sacrament of sixk mandatory
catholic
disease pain and suffering is gods will, and are part of expiating sin. some may not adhere to therapy because of fatalistic views
muslim
believe illness is result of actions in this or previous lifes
budhists
disease pain and suffering is gods will, and are part of expiating sin. some may not adhere to therapy because of fatalistic views
muslim
nonpharmacologial pain relief include
acupressure, relaxation , guided imagery, distration, biofeedback, cutaneous stimulation to close gate, massage ice
a child with reyes syndrome do not use
ASA
side effects of opioids
constipation, sedation, nausea and vomiting
vertigo, faintness when standing, decreased bp and increased sweating are side effects of
Opiod
cancer pain relief, acute pulm adema sever pain
morphine
this type of pain relief can cause hepatic toxicity rash pruritis respiratory depression
morphine
opiods should not be used if Rr is less then
12
pain med perferred for biliary colic, pancreatitis.less apt to release histamine
demerol
do not use this pain med with head injury and increased intracranial pressure because neuro stats masked
demerol (copd)
Do not use this med older adutls impaired renal or liver function
Demerol
dermal patch for cancer pain
transdermal fentanyl
onset is 12-18 hourse will continure giving short term analgesia until onset
transdermal fentanyl
sustained release for chronic pain relief
oxycodones
to be administered atc, not prn
oxycontin
use what? for pruritis
antihistamines
use this for nausea, vomiting
antiementics