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16 Cards in this Set
- Front
- Back
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acute pain |
protective mechanism, less than 6 months, sudden and localized pain that is sharp,. Occasionally radiates. Dilated pupils, identifibale cause, elevated and shallow respirations, diaphoretic |
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chronic pain |
leads to controlling personality -greater than 6 months, alters normal functioning, intermittent or persistsant pain, more difficiulty to ass and treat, leads to depression, cause is not identifiable, describe as dull, aching or difuse pain. periods of remission and exacerbation |
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nociceptive pain |
somatic- superficial (skin and tissues); deep somatic- tendons, ligaments and bone
visceral- body organs, poorly localized (pain radiates) |
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neuropathic pain |
alloodynia
-diabetic neuropathy - burning, stabbing sensations
-trigeminal neuralgia- facial pain, difficiult to control |
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how are pain impulses transported and interpreted? |
1, tranduction 2. transmission 3. modulation 4. perception |
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transduction |
-activation of pain receptors -conversion of painful stimuli to electrical impuulses that travel to the spinal cords -factors that stimulate pain receptors: bacteria (infections), heat (sunburn), impaired blood flow (angina)
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transmission |
-conduction of pain sensations along the pathway -nociceptors stimulated: pain transmitted to spinal cords -small A delta fibers- FAST (skin and muscle ) -Large C nerve fibers- SLOW -most injuries stimulate both |
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modulation of pain |
-regulation or modification of sensation of pain -neuromodulators: edorphins -bind with opiod receptor sites in CNS and though to be produced with pain relief measures
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perception of pain |
includes patients perception/interpretation of pain AND pain threshold (lowest intensity of pain stimulus that causes person to recognize pain) |
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WHO ladder for pain relief |
level 1- nonopiod, adjuvant level 2- opiod for mild to mod pain level 3- opiod for mod to severe pain |
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Adjuvant meds |
antidepresants- promotes sleep and usefeul with neuropathic pain -anticonvulsants - neurontin, tegretol, useful with neuropathic pain -local anesthetics-via catheter to incisional area, patch for localized relief.
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evaluating effectiveness |
-a bialance btwn maximal pain relief and minimal side effects -advocate -use ATC and PRN dosing (around the clock) -benefits: decreased length of stay, increase in mobility, less fear, anxiety, fewer, S/E, need for lower doses |
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kids and pain |
-difficult to understand pain: why does it hurt? -self-report most reliable -observe for s/s pain -pain scale with faces -ok to use optiates (bases on ht/wt) -combination of meds and nonpharmacologic measures most effective (as in true in adults) |
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pain in the elderly |
-no decrease in sensitivity to pain -not true that opioids cause excessive resp depression in older adults -not true that pain is a normal part of aging |
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elderly |
-despite age related changes: older adults need and tolerate same dosing of meds w/o severe SE or sedation -may hesitate to ask for pain med, due to concern r/t addiction and loss of independence -LOC may affect how we assess older adults |
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long term pain control |
oral: oxycontin, morphine trandermal: duragesic (fentanyl), lidocaine (lidoderm) transmucosal: fentanyl lonznege |
