Chp 43 Pain Management

Front 1

PAIN IS A LEADING PUBIC H____ PROBLEM

Back 1

HEALTH

Front 2

CARING FOR PTS WITH PAIN REQUIRES RECOGNITION THAT PAIN CAN AND SHOULD BE RE______

Back 2

RELIEVED

Front 3

PAIN INVOLVES PHYSICAL, EMOTIONAL, AND CO______ COMPONENTS

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COGNITIVE

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TRANSDUCTION CONVERTS ENERGY PRODUCED BY THESE STIMULI INTO ELEC____ ENERGY. PAIN STIMULUS SENDS AN IMPULSE ACROSS A SENSORY PERIPHERAL NERVE FIB))))) OR NOCIEPTOR INITIATING AN ACTION POTENTIAL.

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ELECTRICAL
FIBER

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AFTER TRANSDUCTION, TRANSMISSION BE____

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BEGINS

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CELLULAR DAMAGE CAUSED BY THERMAL, MECHANICAL, OR CHEMICAL STIMULI RESULTS IN THE RELEASE OF EXCITATORY NEUROTRANSMITTERS SUCH AS PROST______, BRADYKININ, SUBSTANCE P, AND HISTAMINE. CREATE INFLAMMATORY SOUP SPREADING PAIN MESSAGE.

Back 6

PROSTAGLANDIN

Front 7

NERVE IMPULSES RESULTING FROM PAINFUL STIMULUS TRAVEL ALONG AFFERENT OR SENS____ PERIPHERAL NERVE FIBERS

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SENSORY

Front 8

2 TYPES OF PERIPHERAL NERVE FIBERS CONDUCT PAIN IMPULSES: FAST MYLENATED A-______FIBERS AND THE VERY SLOW UNMYLENATED C FIBERS.

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DELTA

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A FIBERS SEND IMPULSES SHARP, LOCALIZED AND DISTINCT SENSATIONS THAT SPECIFY THE SOURCE OF PAIN AND DETECT ITS IN_______

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INTENSITY

Front 10

C FIBERS RELAY IMPULSES THAT ARE POORLY LOCAL----- BURNING AND PERSISTENT.

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LOCALIZED

Front 11

SOMATOSENSORY CORTEX IDENTIFIES THE LOCATION AND INTEN____ OF PAIN.

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INTENSITY

Front 12

NEUROREGULATORS- PROSTAGLANDINS- FROM THE BREAKDOWN OF PHOSPH_____ AND MAKES MORE SENSITIVE TO PAIN

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PHOSPHOLIPIDS

Front 13

NEUROREGULATORS-BRADYKININ- RELEASED FROM PLASMA, INCREASES PAIN STIM____, BINDS TO CELLS THAT PRODUCE PROSTAGLANDIN.

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STIMULI

Front 14

NEUROREGULATORS-SUBSTANCE P FOUND IN THE PAIN NUERONS OF DORSAL HORN. NEEDED TO TRANSMIT PAIN IMPULSES FROM PERIPHERY TO HIGHER PAIN CENTERS; CAUSES VASO______ AND EDEMA.

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VASODILATION

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NEUROREGULATORS- HISTAMINE= PRODUCED BY MAST CELLS CAUSING CAPILLARY DIL_____ AND INCREASES CAPILLARY PERMEABILITY.

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DILATION

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NEUROREGULATORS= SEROTONIN= RELEASED FROM THE BRAINSTEM AND DORSAL HORN TO INHIBIT PAIN TRANS+++++

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TRANSMISSION

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NEUROREGULATORS= INHIBITORY NEUROMODULATORS- NATURAL SUPPLY OF MORPHINE- LIKE SUBSTANCES IN THE BODY; ACTIVATED BY STRESS AND P____. LOCATED WITHIN THE BRAIN, SPINAL CORD, AND GI TRACT. CAUSE ANALGESIA WHEN THEY ATTACH TO OPIATE RECEP++++ IN THE BRAIN. PRESENT IN HIGHER LEVELS IN PEOPLE WHO HAVE LESS PAIN THAN OTHERS WITH A SIMILAR INJURY.

Back 17

PAIN
RECEPTORS

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NOCICEPTIVE PAIN- NORMAL PROCESSING OF STIMULI THAT DAMAGES NORM----- TISSUES OR HAS THE POTENTIAL IF LONGER. RESPONSIVE TO OPIODS OR NON.

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NORMAL

Front 19

NEUROPATHIC PAIN- ABNORMAL PROCESSING OF SENSORY IN____ BY PERIPHERAL OR CNS. TREATMENT INCLUDES ADUVANT ANALGESICS.

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INPUT

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NOCICEPTIVE PAIN INCLUDES SOMATIC AND VIS_____ PAIN. SOMATIC PAIN COMES FROM BONE, JOINT, MUSCLE, SKIN, OR CONN)))))) TISSUE. USUALLY ACHING AND THROBBING AND WELL- LOCAL_____

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VISCERAL
CONNECTIVE
LOCALIZED

Front 21

VISCERAL PAIN FROM VISCERAL ORGANS SUCH AS GI TRACT AND PAN_____ SOMTIMES DIVIDED INTO 1. TUMOR INVOLVEMENT OF ORGAN CAPSULE THAT WELL LOCALIZED AND ACHING. 2 OBSTRUCTION OF HOLLOW VISCUS WHICH CAUSES INTERMITTENT CRAMPING AND POORLY LOC))))))))) PAIN.

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PANCREAS
LOCALIZED

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NEUROPATHIC PAIN: 2 TYPES: CENTRALLY GENERATED AND PER_______ GENERATED.

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PERIPHERALLY

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NEUROPATHIC PAIN: CENTRALLY GENERATED: DEAFFERATION PAIN; INJURY TO EITHER THE PERIPHERAL OR CEN_____ NERVOUS SYSTEM.

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CENTRAL

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NEUROPATHIC PAIN: SYMPATHETICALLY MAIN____ PAIN: ASSOCIATED WITH IMPAIRED REGULATION OF THE ANS

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MAINTAINED

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NEUROPATHIC PAIN: PERIPHERALLY GENERATED PAIN INCLUDES 1. PAINFUL POLYNEUROPATHIES AND 2. PAINFUL MONO________

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MONONEUROPATHIES

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IDIOPATHIC PAIN IS CHRONIC PAIN IN THE ABSENCE OF AN IDENTIFIABLE PHYSICAL OR PSYCH_____ CAUSE OR PAIN PERCEIVED AS EXCESSIVE FOR AN ORGANIC PATHO+++++ CONDITION.

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PSYCHOLOGICAL
PATHOLOGICAL

Front 27

COMMON BIASES AND MISCONCEPTIONS ABOUT PAIN: PATIENTS WHO ABUSE SUBSTANCES OVERREACT TO DISCOMFORT. T OR F

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F

Front 28

COMMON BIASES AND MISCONCEPTIONS ABOUT PAIN:
PATIENTS WITH MINOR ILLNESSES HAVE LESS PAIN THAN THOSE WITH SEVERE PHYSICAL ALTERATION. T OR F

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F

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COMMON BIASES AND MISCONCEPTIONS ABOUT PAIN: ADMINISTERING ANALGESICS REGULARLY LEADS TO DRUG ADDICTION. T OR F

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F

Front 30

COMMON BIASES AND MISCONCEPTIONS ABOUT PAIN: THE AMOUNT OF TISSUE DAMAGE IN AN INJURY ACCURATELY INDICATES PAIN INTENSITY T OR F

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F

Front 31

COMMON BIASES AND MISCONCEPTIONS ABOUT PAIN: HEALTH CARE PERSONNEL ARE THE BEST AUTHORITIES ON THE NATURE OF A PT'S PAIN. T OR F

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F

Front 32

COMMON BIASES AND MISCONCEPTIONS ABOUT PAIN: PSYCHOGENIC PAIN IS NOT REAL. T OR F

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F

Front 33

COMMON BIASES AND MISCONCEPTIONS ABOUT PAIN: CHRONIC PAIN IS PSYCHOLOGICAL T OR F

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F

Front 34

COMMON BIASES AND MISCONCEPTIONS ABOUT PAIN: PATIENTS WHO ARE HOSPITALIZED WILL EXPERIENCE PAIN T OR F

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F

Front 35

COMMON BIASES AND MISCONCEPTIONS ABOUT PAIN: PATIENTS WHO CANNOT SPEAK DO NOT EXPERIENCE PAIN T OR F

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F

Front 36

RESEARCH SHOWS RN ATTITUDE TOWARD PT'S PAIN AFFECTS PAIN ASSESS____ AND TITRATION OF OPIOD DOSES.

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ASSESSMENT

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MORE EXPERIENCE, HIGHER MOTIVATION, AND PERCEIVED HIGHER PAIN CARE SKILLS USE MORE PT ADVO_____ IN PAIN MANAGEMENT

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ADVOCACY

Front 38

FACTORS INFLUENCING PAIN: PHYSIOLOGICAL, SOCIAL, SPIR____, PSYCHOLOGICAL, AND CULTU____

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SPIRITUAL
CULTURAL

Front 39

FACTORS INFLUENCING PAIN IN OLDER ADULTS WITH AGING MUSCLE MASS DE______, BODY FAT INCREASES, AND PERCENTAGE OF BODY WA____ DECREASES, INCREASES THE CONCENTRATION OF WATER SOLUBLE DRUGS SUCH AS MORPHINE, AND THE VOLUME OF FAT SOLUBLE DRUGS SUCH AS FENTANYL

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DECREASES
WATER

Front 40

FACTORS INFLUENCING PAIN IN OLDER ADULTS : EAT POORLY LEADING TO POOR SERUM AL_____ LEVELS. MORE FREE DRUG AVAILABLE, INCREASING THE RISK OF SIDE EFFECTS OR TOX___ EFFECTS.

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ALBUMIN
TOXIC

Front 41

FACTORS INFLUENCING PAIN IN OLDER ADULTS : A DECLINE OF LIVER AND RENAL FUNCTION OCCURS WITH AGING. THIS RESULTS IN REDUCED METAB____ AND EXCRE____ OF DRUGS.

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METABOLISM
EXCRETION

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FACTORS INFLUENCING PAIN IN OLDER ADULTS : THIS RESULTS IN REDUCED METABOLISM AND EXCRETION OF DRUGS. OLDER ADULTS EXPERIENCE A GREATER PEA___ EFFECT AND A LONGER DUR____

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PEAK
DURATION

Front 43

PHYSIOLOGICAL FACTORS INFLUENCING PAIN: AGE, OLDER ADULTS HAVE DIFFICULTY INTERPRET PAIN; FATIGUE HEIGHTENS PAIN AND DECREASES COP____, GENES, NEUROLOGICAL FUNCTION (FACTORS THAT INTERRUPT PAIN RECEPTION OR PER______

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COPING
PERCEPTION

Front 44

SOCIAL FACTORS INFLUENCING PAIN: ATTENTION (INCREASED ATT_____ INCREASES PAIN), PREVIOUS EXPERIENCE HELPS INTERPRET PAIN, FAM OR SOC SUPPORT MAKES PAIN LESS STRESSFUL, SPIRITUAL FACTORS HELP.

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ATTENTION

Front 45

PSYCHOLOGICAL FACTORS INFLUENCING PAIN: ANXIETY INCREASES PAIN, COPING- INTERNAL VS EXTERNAL LOCI OF CONTROL, AND CULTURE IMPACTS EXP_____ OF PAIN

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EXPRESSION

Front 46

MISCONCEPTIONS ABOUT PAIN IN OLDER ADULTS. OLDER ADULTS MORE LIKELY TO EXPERIENCE PAIN, BUT PAIN IS N___ AN INEVITABLE RESULT OF AGING

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NOT

Front 47

ALTHOUGH THERE IS EVIDENCE THAT EMOTIONAL SUFFERING RELATED TO PAIN IS POSSIBLE LESS IN OLDER THAN YOUNGER PTS, NO DECREASE IN PERCEPTION OF PA___OCCURS WITH AGE OR THAT AGE DULLS SENSITIVITY TO PAIN.

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PAIN

Front 48

OLDER PTS COMMONLY UNDERREPORT PA+++

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PAIN

Front 49

OLDER PTS OFTEN BELIEVE THAT IT IS UNACCEPTABLE TO SHOW PAIN. DISTRACTION AND SL____ TO COPE.

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SLEEP

Front 50

ALZHEIMER AND OTHER COG IMPAIR PTS DO NOT FEEL PA___ AND THEIR REPORTS OF PAIN MORE LIKELY IMPAIRED

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UNDERREPORT PAIN.

Front 51

POSSIBLE SOURCES OF ERROR IN PAIN ASSESSMENT BIAS WHICH CAUSES OVER OR UNDER+_____. VAGUE OR UNCLEAR ASSESS QUEST. USE OF PAIN ASSESSMENT TOOLS THAT ARE NOT EVIDENCE-BASED. LACK OF RELEVANT, COMPL_____, AND ACCURATE INFO. PTS WHO ARE COGNITIVELY IMPAIRED AND UNABLE TO USE PAIN SCALES

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UNDERESTIMATE
COMPLETE