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51 Cards in this Set
- Front
- Back
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Pain |
an unpleasant sensory and emotional experience associated with actual or potential tissue damage.
1.) Physical and emotion experience 2.) A symptom (irritable, loss of sleep, impaired 3.) warning system (injury to body) |
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What is not an actual outcome of growing old? |
Pain |
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Purpose of Pain |
Mainly protective or warning Motivates us to seek medical help |
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Origin of Pain
CUTANEOUS (SUPERFICIAL) |
involves skin or subcutaneous tissues. Example: Paper cut |
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Deep Somatic |
diffuse or scattered- originates in tendons, ligaments, bones, blood vessels and nerves. Example: Sprain, arthritis, Bone Cancer |
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Visceral |
poorly localized- originates in body organs. Example: Thorax cranium, abdome. Example: Stretching of tissues, ischemia, muscle spasms. (Deepest pain) "Gut" (Liver cancer, bowel cancer) |
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Causes of pain
Physical |
Broken bone (visible) |
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Psychogenic |
physical cause for pain can't be identified. Psychological Example: Headache, back pain, stomach pain, nervier pain. |
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Types of Pain |
Actue 3-6 months sudden slow onset subsides as healing takes place |
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Chronic Pain |
lasts 6 months or longer limites normal functioning
Can make a person become Depressed Anger Withdraw from social society |
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Intractable |
Highly resistant to relief Can't take it away Example: Cancer |
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Radiating (Location in body) |
Felt at source of pain extends to nearby tissues, cardiac pain (Chest-Left shoulder and down arm)
Example: pain that spreads |
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Referred |
felt in a part of the body considerably removed from tissue causing pain. Example Kidney (along thigh)
Example: Women- Abdominal pain due to heart attack, upper epigastric area |
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ETIOLOGY |
pain can be classified by etiology (cause) burn post herpetic neuralgia |
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1 in 6 americans have? |
Chronic pain |
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Neurophatic |
Damgage to nervers. Result of peripheral or central nervous system. Ex: Diabetes with feet |
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Phantom pain |
Pins & needles Examples: HIV, chemotherapy (burning sensation) |
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Causalgia |
persistent, serve burning sensation of skin. Redness and inflammation |
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Postherpetic neuralgia |
Damage of nerve from virus
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Phantom limb pain |
amputated either surgically or traumatically
Pain varies may be severe |
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Thalamic Syndrome |
(Tham. Brain) neurological disorder that develops when the central nervous system the brain & spinal cord is damaged (post stroke) |
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Trigeminal Neuralgia |
Nerve disorder that causes a stabbing or electric shock-like pain in part of the face (along trigeminal nerved) |
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Musculoskeletal pain syndrome |
Chronic pain healed long ago, achy still |
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Myofascial pain syndrome |
connective tissue (Cutaneous) |
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Intervertebral Disc Syndrome |
Back pain (Cutaneous) |
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Arthritis |
Cutaneous |
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Headache |
visceral |
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Cancer pain syndrome |
Visceral |
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Nociepetion |
the process of pain perception The signals go through 4 stages before pain is understood. |
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Transduction |
tissue in injury stimulate peripheral nerver fibers that transmit pain (nocireceptors) |
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Transmission of pain |
from peripheral nerves Spinal cord- corten brain |
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Pain Messengers |
A-delta fibers
First pain impulses from acute FAST Ex: Bump your knee
C fibers
Slow transmit pain impulses. |
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GATE CONTROL THEORY |
describes the mechanism of pain sensation. |
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Application of applying GATE CONTROL THEORY |
1. TEACHING- Actives, relaxing 2. Distraction- drawing patient attention away from pain 3. Touch- massage, calming affect, guiding, imagery 4. Other methods- Imagery, relaxation techniques |
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Perception |
patient becomes conscious of pain |
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Modulation |
brain stem sends signals back down spinal cord |
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When patient feels pain "GATE IS WHAT? |
Gate is open, when they get relief it closes gate. |
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Pain sensation |
stimuli patient perceives as pain |
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Pain reaction |
pain stimulates "fight" or flight" pain fibers become sensitive that can intensity and spread. |
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Pain threshold |
Least amount for a person to label a sensation as pain |
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Pain tolerance |
The "max amount and duration of pain an individual is willing to endure |
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Development factors |
Newborn- perceives pain as difficult Toddler- can't identify pain Preschoolers- can describe, identity and locate source of pain. School age child- Brave- rationalize pain Adolescents- may be reluctant to acknowledge pain "giving it" Adult- response vary, related to behaviors learned in childhood. May be gender based. Old adult- may bel report pain. |
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45-80 % older adults |
have sufficient pain in nursing home |
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Assessment of pain |
Location Onset and duration Intensity 0-10 Quality Associated characteristics Behavioral responses Facial expressions- grimaces Verbal expressions Affective responses
How does pain interfere with clients life Perception of pain and meaning to person Adaptive mechanisms use to cope with pain |
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Nursing Measures |
Touching, rubbing, assage, quiet room, TV
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Medical measures |
medications, accupressure, TENS, heat and cold |
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Opiod (Narcotic) Analgesics |
Visceral Morphine Dilaudid Demerol
Actions- acts in CNS
USES- MOD-SERVE PAIN
SIDE EFFECTS most common in constipation most dangerous in respiratory depression |
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Nonopioids |
Acetaminophen- Tylenol
Analegesic, can cause liver failure
Uses- Mild to moderate |
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NSAIDS |
non-sterioidal anti-inflammatory drugs,
Can cause GI bleeding, NO aspirin while taking this medicine cause cause kidney damage |
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Opioid/nonopioid Combinations |
Lortab ( affects CNS and peripheral nerve pathways)
Treats moderate to server pain |
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Adjuvant Analgesics |
co-analgesic meds that have properties to assist in controlling pain when combined with an analgesic.
Examples: Valium, Muscle Relaxers, Anti-depressants |
