Pain (Basics In Nursing)

Front 1

(def)

a compulsive, uncontrollable dependence on a chemical substance, habit, or practice to such a degree that either the means of obtaining or ceasing use may cause severe emotional, mental, or physiologic reactions.

Back 1

addiction

Front 2

(def)

a stress management technique that brings under conscious control bodily processes normally thought to be beyond voluntary command

Back 2

biofeedback

Front 3

(def)

a condition in which successive increases in the dosage of a drug are required to maintain a given therapeutic effect

Back 3

drug tolerance

Front 4

(Def)

developing from within

Back 4

endogenous

Front 5

(def)

one of the three groups of endogenous opioid peptides; elaborated by the pituitary gland and other brain areas; acts on the CNS and PNS to reduce pain

Back 5

endorphins

Front 6

(def)

a center of perceived responsibility for one's behavior; people in this group tend to believe that real power resides in forces outside themselves and determines their life

Back 6

external locus of control

Front 7

(def)

a center of perceived responsibility for one's behavior; people in this group tend to believe that they can control events related to their life

Back 7

internal locus of control

Front 8

(def)

type of pain that originates in the skin

Back 8

cutaneous pain

Front 9

(def)

pain that is not relieved by ordinary medical, surgical, and nursing measures; this pain is often chronic and persistent and can be psychogenic in nature

Back 9

intractable pain

Front 10

(pain)

pain felt by a patient in a limb that has been removed

Back 10

phantom limb pain

Front 11

(def)

a functional pain that does not have any known organic cause

Back 11

physchogenic pain

Front 12

(def)

pain felt away from the point of origin

Back 12

Referred pain

Front 13

(def)

pain originating in one area of the body which extends to a different, unrelated region

Back 13

radiating pain

Front 14

(def)

pain originating within a tissue, such as skin, muscles, bone, or connective tissue

Back 14

somatic pain

Front 15

(def)

pain originating in an organ, such as the kidney or heart

Back 15

visceral pain

Front 16

(def)

a pain management technique that allows the client to take an active role in managing pain

Back 16

PCS (Patient-controlled Analgesia)

Front 17

(def)

the maximum amount and duration of pain that an individual is willing to endure

Back 17

pain tolerance

Front 18

(def)

the amount of pain stimulation a person requires before feeling pain

Back 18

pain threshold

Front 19

(def)

a pain receptor

Back 19

nociceptor

Front 20

(def)

state of focused attention that encourages changes in attitudes, behaviors, and physiologic reactions

Back 20

Guided imagery

Front 21

(def)

substance dependence in which there is evidence of tolerance, withdrawal, or both

Back 21

physiologic dependence

Front 22

(def)

any form of treatment that produces an effect in the client because of its intent rather than it's chemical or physical properties

Back 22

placebo

Front 23

(def)

a noninvasive, nonanalgesic pain control technique that allows the client to assist in the management of acute and chronic pain; device applies electric impulses to the nerve endings

Back 23

Transcutaneous electrical nerve stimulation (TENS unit)

Front 24

What is pain (as nurses should understand it)?

Back 24

".....whatever the person experiencing it says it is, existing whenever the person says it does...."

Front 25

Is pain subjective or objective?

Back 25

Subjective - the patient's self-report of pain is the most reliable indicator of pain

Front 26

List the chain of transmission beginning with the stimulus of pain to the perception of pain.

Back 26

Pain stimulus ---> nociceptors (pain receptors) ---> moves along sensory afferent neurons ---> picked up by spinothalamic tract neurons in the spinal cord ---> sent to the brain (specifically the thalamus, cerebral cortex, and limbic structures ---> pain is perceived

Front 27

Describe the Gate Control Theory.

Back 27

Theory states that there is a gating mechanism at the spinal cord level of the CNS that affects the transmission of pain to the conscious awareness

Front 28

Gate Control Theory:

What is the effect on pain awareness when the gate is closed?

Back 28

Pain awareness decreases or disappears

Front 29

Gate Control Theory:

What is the effect on pain awareness when the gate is open?

Back 29

Pain perception increases and pain results

Front 30

Gate Control Theory:

Is there activity in large or small nerve fibers when the gate is closed?

Back 30

large nerve fibers

Front 31

Gate Control Theory:

Is there activity in large or small nerve fibers when the gate is open?

Back 31

small nerve fibers

Front 32

Gate Control Theory:

What type of nerve impulses (inhibitory or facilitory) are sent from the brainstem when the gate is closed? What about when it is open?

Back 32

Gate closed = brainstem sends inhibitory impulses

Gate open = brainstem sends facilitory impulses

Front 33

What are 2 examples of situations that may increase pain perception?

Back 33

- Monotonous Environment
- Fear

Front 34

What are 3 examples of situations that may decrease the perception of pain?

Back 34

- Knowledge
- Distraction
- Skin Stimulation

Front 35

What are 6 endogenous pain mediators? Note whether each is a chemical substance or a neurotransmitter.

Back 35

- Bradykinin (chemical substance)
- Histamine (chemical substance)
- Prostaglandins (neurotransmitter)
- Acetylcholine (neurotransmitter)
- norepinephrine (neurotransmitter)
- Substance P (neurotransmitter)

Front 36

What are 3 endogenous pain inhibitors?

Back 36

- Serotonin
- Endorphins
- Enkephalins

Front 37

What are examples of activities that may increase endorphins?

Back 37

- skin stimulation
- exercise
- carbohydrates

Front 38

Why is the experience of pain considered a benefit?

Back 38

It functions as an alert system within the body, letting the person know when something is wrong

Front 39

Do pain mediators inhibit or allow the experience of pain?

Back 39

They allow the experience of pain to occur

Front 40

(def)

pain stimulus due to tissue damage or pressure

Back 40

Mechanical Stimulus

Front 41

(def)

pain stimulus due to inflammation secondary to the exposure of secretions OR a lack of a necessary chemical

Back 41

Chemical

Front 42

(def)

pain stimulus due to the increased sensitivity to nerve endings secondary to the loss of skin layers

Back 42

Thermal

Front 43

Mechanical, Chemical, or Thermal Stimuli?

Puncture wound

Back 43

Mechanical

Front 44

Mechanical, Chemical, or Thermal Stimuli?

inflammation due to gastric ulcer

Back 44

Chemical

Front 45

Mechanical, Chemical, or Thermal Stimuli?

Pain due to lack of oxygen to the heart

Back 45

Chemical

Front 46

Mechanical, Chemical, or Thermal Stimuli?

Pain due to exposed nerve ending at the site of an injury

Back 46

Thermal

Front 47

True/False:

You should check for pain every time you check vital signs.

Back 47

True

Front 48

As a nurse, what 4 things should you be aware of within yourself that may influence YOUR judgment about a patient's pain?

Back 48

1. The nature of the illness (remember that everyone has different pain thresholds, do not judge)
2. Meaning of illness (it is not for you to decide if a person deserves pain treatment)
3. Personal experiences
4. Professional experiences

Front 49

What 8 things should you specifically assess for regarding pain?

Back 49

1. Onset, duration
2. Location
3. Quality (Sharp, dull, throbbing, stabbing, etc.)
4. Intensity (0-10)
5. Aggravating Factors
6. Accompanying Signs & Symptoms
7. Relief Measures
8. CAUSE of pain

Front 50

What are 6 different pain scales?

Back 50

- numeric rating scale
- Verbal rating scale
- Face Scale (Wong-Baker Scale)
- Body Diagram
- Questionnaire
- Behavioral Scale (assessment by the nurse)

Front 51

What pain scale would you use for a young child or a person who doesn't speak the nurse's language?

Back 51

- Wong-Baker Scale (face scale)

Front 52

At what point should you give a pain medication to a patient?

Back 52

at the onset of pain

Front 53

True/False:

You should never wake a client to give a pain medication.

Back 53

FALSE

Front 54

Acute or Chronic Pain?

Sudden

Back 54

Acute

Front 55

Acute or Chronic Pain?

Insidious

Back 55

Chronic

Front 56

Acute or Chronic Pain?

Sharp

Back 56

Acute

Front 57

Acute or Chronic Pain?

Poorly localized

Back 57

Chronic

Front 58

Acute or Chronic Pain?

localized to one area

Back 58

Acute

Front 59

Acute or Chronic Pain?

Dull, ragging pain

Back 59

Chronic

Front 60

Acute or Chronic Pain?

ANS response usually present

Back 60

Acute

Front 61

Acute or Chronic Pain?

ANS response usually not present

Back 61

Chronic

Front 62

What does the mneumonic "PQRST" stand for?

Back 62

P= Precipitating/alleviating factors
Q= Quality
R= Radiation
S= Severity
T= Timing

Front 63

Acute or Chronic Pain?

Crying or moaning present

Back 63

Acute

Front 64

Acute or Chronic Pain?

Depression, self-focused behavior

Back 64

Chronic

Front 65

Why are ANS responses not usually seen with chronic pain?

Back 65

the body adapts to the prolonged condition of pain

Front 66

What are 3 ANS responses you may see in a client that is experiencing acute pain?

Back 66

- VS change (increasing BP, P, and R)
- Dilated pupils
- diaphoresis

Front 67

Acute or Chronic Pain?

Anxiety may be present

Back 67

Acute

Front 68

What is secondary gain?

Back 68

a benefit received from a negative situation (ex. in pain so relatives visit more often)

Front 69

Acute or Chronic Pain?

Depression, withdrawn

Back 69

Chronic

Front 70

True/False:

Culture influences a person's expression of pain.

Back 70

True

Front 71

True/False:

Children/Elderly don't feel as much pain as adults.

Back 71

False - expression of pain may change, but the experience is the same

Front 72

True/False:

Most people do NOT become addicted when receiving pharmacologic pain therapy.

Back 72

True - less than 1% of people receiving pain therapy become addicted

Front 73

What are 3 examples of comfort measures we can give patients?

Back 73

- adequate rest
- quiet environment
- position changes

Front 74

What are 3 examples of cutaneous stimulation measures that may reduce pain?

Back 74

- back rubs/massage
- application of heat/cold (* need dr. order)
- TENS unit (* need dr. order)

Front 75

What are 6 distractions/cognitive measures that may reduce pain?

Back 75

- muscle relaxation
- diversional activities
- guided imagery
- biofeedback
- hypnosis
- yoga

Front 76

How do anticonvulsants treat chronic pain?

Back 76

- inhibit transmission of nerve impulses

Front 77

How do benzodiaepines treat chronic pain?

Back 77

enhances muscle relaxation, decreases anxiety

Front 78

How do antidepressants help control chronic pain?

Back 78

inhibits the reuptake of serotonin, norepinephrine, dopamine

Front 79

True/False:

Physical symptoms MUST be present for a nursing diagnosis of pain.

Back 79

FALSE - self-report by the client is all that is needed.

Front 80

What are examples of nursing diagnoses that may be related to pain?

Back 80

- acute/chronic
- anxiety
- constipation
- impaired mobility
- self-care deficit
- sleep pattern disturbance
- social isolation