Pain/comfort Nursing Lecture

Front 1

what are the four components of the pain process?

Back 1

transduction, transmission, perception, and modulation

Hint 1

think of it as TTPM

Front 2

what is transduction?

Back 2

activation of pain receptors

Front 3

what are the components of the transduction phase?

Back 3

Nociceptors which are specialized pain receptors that transmit pain.

Front 4

what are the four neurotransmitters of the transduction phase?

Back 4

Brodykinen, Prostaglandin, Substance P, Serotonin

Front 5

what does the transmission phase do?

Back 5

conducts along pathways (A and C delta fibers)

Hint 5

think of the alphabet

Front 6

describe the A and C delta fibers

Back 6

A: sharp and localized
C: dull and aching

Front 7

what does the perception phase do?

Back 7

awareness of the characteristics

Hint 7

what do you perceive?

Front 8

what does the modulation phase do?

Back 8

inhibition or modifys pain

Front 9

Pain is classified according to...

Back 9

Duration, location (source), mode of transmission, and etiology

Hint 9

think about when you are in pain

Front 10

what is acute pain?

Back 10

rapid onset, varies in intensity, protective in nature, sympathetic nervous system responses

Front 11

what is sympathetic?

Back 11

fight or flight, increase heart rate, respiration, blood pressure

Hint 11

what does it do?

Front 12

what is parasympathetic?

Back 12

rest and digest, decrease HR, RR, BP

Hint 12

Opposite of sympathetic

Front 13

what is chronic pain?

Back 13

lasts beyond normal healing period, may be limited, intermittent, or persistent, may experience period of remission, may have anger

Hint 13

opposite of acute

Front 14

what is chronic malignant pain?

Back 14

cancer pain

Hint 14

what does malignant mean?

Front 15

IMPORTANT:
what are the sources of pain?

Back 15

neuropathic and nociceptive

Front 16

what is neuropathic?

Back 16

results from an injury or abnormal functioning of CNS

Hint 16

just use word parts and you'll get it

Front 17

what are the 3 parts of Nociceptive?

Back 17

cutaneous, somatic, visceral

Front 18

what are some common pain syndromes?

Back 18

complex regional, postherpeptic neuralgia, phantom limb, trigeminal neuralgia, diabetic neuropathy

Front 19

what is cutaneous pain?

Back 19

superficial, skin or subcutaneous tissue

Hint 19

think about the layers of the skin

Front 20

what is deep somatic pain?

Back 20

diffuse or scattered, originates in ligament, bones, blood vessels, and muscles

Front 21

what is visceral pain?

Back 21

poorly localized, originates in body organs in the thorax, cranium, and abdomen

Front 22

what is referred pain?

Back 22

when pain originates in one part of body but is perceived in an area distant from it's origin

Hint 22

ex: arm hurts during a heart attack

Front 23

what is intractable pain?

Back 23

when pain is resistant to therapy and persists despite a variety of interventions

Hint 23

kind of like chronic pain

Front 24

what are some responses to pain?

Back 24

physiologic (involuntary), behavioral (voluntary), affective (psychological)

Hint 24

what are you going threw when in pain?

Front 25

what is the physiological response like?

Back 25

moderate and superficial, increase HR, RR, BP, blood glucose, pupil dilation, muscle tension

Hint 25

what are you going threw physically?

Front 26

what is the behavioral response like?

Back 26

grimace, moaning, crying, moving away from stimuli

Hint 26

what are you doing?

Front 27

what is the affective response like?

Back 27

exaggerated wheeping, withdrawal, anger, fear

Hint 27

how do you cope?

Front 28

what is the transmission phase?

Back 28

pain sensation is conducted from the site of injury along pathways to the spinal cord & higher centers

Front 29

how do you define perception of pain?

Back 29

when a person becomes aware that pain is present

Front 30

IMPORTANT:
what is a pain threshold?

Back 30

the lowest intensity of a stimulus that causes the person to recognize pain

Hint 30

women apparently have lower of these than men

Front 31

what is modulation?

Back 31

process by which the sensation of pain is modified

Hint 31

had it earlier, think!

Front 32

what does the modulation phase have in it?

Back 32

neuromodulators, endorphins and enkephalins

Hint 32

think of chemicals in body

Front 33

what are neuromodulators?

Back 33

endogenous opioid compounds naturally present in brain and spinal cord

Front 34

what are endorphins and enkephalins?

Back 34

naturally present opioid neuromodulators that are capable of altering the sensation of pain

Hint 34

these are the workers while the neuromodulator is the boss

Front 35

what is transduction?

Back 35

the conversion of painful stimuli to an electrical impulse through nociceptors

Front 36

what is transmission?

Back 36

occurs as the electrical impulse travels along the nerve fibers and is regulated by nuerotransmitters

Hint 36

right after transduction

Front 37

what is pain tolerance?

Back 37

amount of pain a person is willing to bear

Front 38

what are some substances that increase pain transmission and cause inflammatory response?

Back 38

Substance P, Prostaglandin, Bradykinen, Histamine

Hint 38

their the same as neurotransmitters except for one

Front 39

what are the substances that DECREASE pain transmission and produce analgesia?

Back 39

serotonin and endorphins

Hint 39

here's that one missing from the last card

Front 40

what are the components of etiology?

Back 40

Neuropathic pain, intractable, phantom, and psychogenic

Front 41

what is phantom?

Back 41

often referred to where an amputation is & receptors & nerves are clearly absent but pain is real

Hint 41

do you know what phantom limb syndrome is?

Front 42

what is the gate control theory of pain?

Back 42

model regarding the concept of pain, small diameter nerve fibers conduct excitatory pain stimuli towards brain while large diameters inhibit the transmission of pain impulses

Front 43

nursing measures for the gate control theory?

Back 43

apply heat or ice, massage, acupuncture, electrical stimulation

Hint 43

all may stimulate large nerve fibers that interfere with pain transmission and close the gate to block pain

Front 44

factors affecting pain experience

Back 44

culture, ethnic variables, family, gender, age, religion, environment, anxiety, past pain experience

Hint 44

what has effected you?

Front 45

what are the characteristics of pain in the nursing process?

Back 45

observation, duration, quality, quantity, chronology, aggravating factors, alleviating factors

Hint 45

what should you asses for?

Front 46

what are the physiological response to pain?

Back 46

vital signs, skin color, perspiration (sweat), pupil size, nausea, muscle tension, anxiety

Front 47

what about behavioral response?

Back 47

posture, gross motor activities, facial features, verbal expressions

Front 48

affective response?

Back 48

anxiety, depression, interaction with others, degree to which pain interferes with patients life, adaptive mechanism used to cope, outcomes

Hint 48

remember the 3 components of response to pain?

Front 49

what are the population at risk for undertreatment of pain?

Back 49

infants, children, older adults, clients with substance abuse problem

Front 50

what kind of pain do people over 65 experience?

Back 50

more frequent and twice as long, hearing and visual impairment, multiple drug regimes, dementia

Front 51

how do we asses a cognitively impaired patient?

Back 51

expect that they experience the same pain a verbal patient would so rely on their history of pain, observation of family or caregivers, and medical diagnosis

Hint 51

these people don't have a voice, who's their voice?

Front 52

what's a analgesic?

Back 52

pharmaceutical agent that relieves pain

Hint 52

a drug

Front 53

three classes of drug used for pain?

Back 53

non opioid analgesic, opioid analgesic, adjuvant drugs

Front 54

IMPORTANT:
what are the pharmacologic pain measures?

Back 54

non opioid, opioid, and adjuvant

Hint 54

just listed these

Front 55

what kind of drug is non opioid?

Back 55

acetaminophen and NSAIDS, used for mild to moderate pain

Hint 55

aspirin

Front 56

what kind of drug is opioid?

Back 56

all controlled substances

Front 57

what kind is adjuvant?

Back 57

antidepressants, anticonvulsants, multipurpose drugs

Front 58

what is the sedation scale?

Back 58

1: awake and alert
2: occasional drowsy but easy to arouse
3: frequently drowsy, drifts off during conversation
4: minimal or no response to stimuli

Front 59

ways of managing pain?

Back 59

CAT, humor, music, imagery, relaxation techniques, cutaneous stimulation, acupuncture, hypnosis, biofeedback, therapeutic touch

Hint 59

how do u distract yourself?

Front 60

the 3 parts of the nursing process?

Back 60

diagnosis, outcome identification, implementation

Front 61

what do you do in diagnosis?

Back 61

type of pain, etiologic factors, patients behavior, physiological response

Hint 61

what do you determine?

Front 62

what do you do for outcome identification?

Back 62

demonstrate commitment to assist patient to achieve pain relief

Front 63

how do you implement?

Back 63

establish trust relationship, manipulate factors of pain, initiate relief measure, review additional pain control measure

Front 64

what do you need to teach a patient?

Back 64

pain scale, safety, and diet!