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53 Cards in this Set

  • Front
  • Back

Pain

What the person feels and how the person perceives how it feels

Analgesic

Pain-reducing

Pain Management and Pain Relief are what in nursing practice

Essential Elements

In addition to assessing pain what does the nurse do?

Monitors pain management


Evaluates level of pain relief


Advocates for the patient


Educates the patient about treatment options

What is a motor, sensory, emotional response to a subjective feeling

Pain

Pain may arise from what types of factors

Thermal/heat injury


mechanical injury


Chemical injury


Ischemic pain

Nociceptors

Free endings of afferent nerve fibers- sensory neurons that are sensitive to noxious thermal, mechanical or chemical stimuli

Nociception

Process by which the sensation of tissue injury is conducted from Peripheral to CNS

What are the 4 steps in Nociception

Transduction


Transmission


Modulation


Perception

Transduction

When nociceptors detect pain stimuli and convert electrochemical response into an electrical impulse

Neurotransmitters

Chemicals that transmit signals across synapses from one neuron to another

Transmission

Electrical signal transmitted through an afferent nerve to the spinal cord and brain

Two types of afferent nerve fibers

A-delta Fibers


C fibers



A-delta fibers

Large-diameter myelinated fibers with rapid conduction of signals = sharp, acute pain

C fibers

smaller, unmyelinated fibers with slow conduction of signals = diffuse, dull, longer-lasting pain



Perception

Recognition of pain occurs when the brain translates the afferent nerve signals as pain



Pain Threshold

low intensity at which the brain recognizes the stimulus as pain

Pain Tolerance

intensity or duration of pain that a patient is able or willing to endure

Modulation

Once pain is recognized the brain can change the perception of it it by sending inhibitory input to the spinal cord to impede the transmission.

Endogenous Opioids

release of natural analgesic neurotransmitters when the brainstem activates descending nerve fibers to send signal back to the spinal cord

Enkephalins

Influence the perception of pain and associated emotional aspect

Beta-endorphins

Act on the central and peripheral nervous systems to reduce pain

Dynorphins

modulators of pain that may stimulate pain or reduce it, depending on which receptors are activated

3 Theories that influenced nonpharmacologic and pharmacologic pain management

Pattern Theory


Gate Control Theory


Neuromatrix Theory

Pattern Theory

When a signal is carried along large-diameter nerve fibers (touch fibers) that may inhibit a signal carried by thin fibers (pain fibers)

Gate Control Theory

Why thought and emotions influence pain perception

Neuromatrix Theory

Each person has a genetically controlled network of neurons that is unique and affected by that person's physical, psychological, cognitive and life exper

Acute Pain

pain that lasts less than 6 months

Chronic Pain

persists longer than 6 months

Nociceptive Pain

MOST common type of pain.


Stimulated in response to trauma, inflammation, tissue damage

Nociceptive pain orginates from what two locations?

Visceral and Somatic Locations

Visceral pain

Arise from organs of the body- appendicitis, pancreatitis, inflammatory bowel disease

Somatic Pain

injury to skin, muscles, bones, joints- sunburn, lacerations, fractures

Referred Pain

Originates in one area but hurts in another area

Radiating Pain

Extends from the source to an adjacent area of the body

Neuropathic Pain

nerve injury, and pain continues even after painful stimuli is gone

Phantom Pain

Brain continues to receive messages from the area of an amputation

Psychogenic Pain

Pain perceived by an individual but has no phys

SOCRATES

S: Site


O: Onset


C: Character


R: Radiation


A: Associations


T: Time source


E: Exacerbating or relieving factors


S: Severity



Pain Level

1-3 is mild pain


4-7 is moderate pain


8-10 is severe pain

Elevated pulse and BP indicates

Acute Pain

Decrease BP and pulse indicate

Chronic Pain

Assessment to pain

Pain History/Assessment


Physiologic Response to Pain


Behavioral/Psychological Response to pain

Factors Influencing Pain

Age, Gender, Morphology, Disabilities, Culture, Ethnicity, Religion

Nonpharmacologic pain management and alternative and complementary therapies

Used for patients with Mild Pain who do not want to use medication to control pain

Two Therapeutic Strategies to manage pain

Multimodal analgesia


Preemptive Analgesia

Multimodal Analgesia

Use of more than one means of controlling pain

Preemptive Analgesia

Administration of medications before a painful event to minimize pain

Non-opioid Analgesics

Drugs that do not contain narcotics used to treat mild to moderate pain

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Nonnar

Opioid Analgesics

Effective agents for relief of moderate to severe pain. Narcotic drugs bind to opioid receptors

Types of Opioid Analgesics

Agonist Analgesics


Agonist-antagonist Analgesics

Patient-Controlled Analgesia (PCA)