Basic Nursing Ch 31: "Pain Management" – Flashcards
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analgesic
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a medication to reduce or eliminate pain
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cutaneous stimulation
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stimulation of the skin to relieve pain, such as with a TENS
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epidural infusion
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type of nerve block anesthesia in which an anesthetic is intermittently or continuously injected into the lumbosacral region of the spinal cord
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exacerbation
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increase in the severity of a disease or its symptoms
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guided imagery
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a relaxation technique in which a patient concentrates on an image in the mind in order to reduce awareness of pain
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local anesthesia
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the loss of sensation to a localized body part
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neurotransmitter
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substances that affect the sending of nerve stimuli
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nociceptors
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receptors that respond to harmful stimuli
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opioid
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an analgesic that is used for severe pain
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pain
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subjective, unpleasant sensation caused by noxious stimulation of sensory nerve endings
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patient-controlled analgesia (PCA)
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device that allows the client to control the delivery of IV or subQ pain medication in a safe, effective manner through a programmable pump
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perception
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person's mental image or concept of elements in their environment, including information gained through the senses
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placebo
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dose forms that contain no pharmacologically active ingredients
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reaction
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component of the pain experience that may include both physiological and behavioral responses
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reception
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nervous system receptors receive painful stimuli and transmit them through peripheral nerves to the CNS
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remission
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partial or complete disapperance of symptoms
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synapse
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the point of contact between two neurons
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threshold
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the point at which a person first becomes aware of a painful stimulus
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transcutaneous elecrical nerve stimulation (TENS)
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a form of stimulation of the skin that uses a mild electrical current passed through external electrodes
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qualitative pain
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subjective pain; pain that can be described
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quantitative pain
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objective pain; pain that can be measured
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Gate-Control theory of pain
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The theory that pain is a product of both physiological and psychological factors that cause spinal gates to open and relay patterns of intense stimulation to the brain, which perceives them as pain.
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adjuvant
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an additive with no analgesic effect, but enhances the effectiveness of pain control
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modality
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method of treatment, such as surgery, chemotherapy or irradiation
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cutaneous pain
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pain that originates in the skin or subcutaneous tissue
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somatic pain
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sharp, localized pain originating from muscle, bone, joints, tendons, or blood vessels
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visceral pain
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poorly localized, dull or diffuse pain that arises from the abdominal organs, or viscera
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phantom pain
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perceived sensation of pain from an amputated limb
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psychogenic pain
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pain with no known physical cause; likely has a psychiatric or emotional cause
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referred pain
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pain that is felt at a place in the body different from the injured or diseased part where the pain would be expected
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radiating pain
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pain felt at the site of tissue damage and in nearby areas
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non-opioid
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an analgesic that is effective in treating mild to moderate pain
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A-delta fibers
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fast, myelinated peripheral nerve fibers that send sharp, localized, and distinct sensations
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C fibers
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slow, unmyelinated peripheral nerve fibers that relay impulses that are poorly localized, visceral, and persistent
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afferent pathways
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sensory pathways
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efferent pathways
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motor pathways
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substance P
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an excitatory neurotransmitter that transmits pain impulses from the periphery to higher brain centers
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excitatory neurotransmitters
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neurotransmitters that enhance the transmission of a painful impulse by sending electrical impulses across the synaptic cleft between two nerve fibers
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inhibitory neurotransmitters
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decrease neuron activity without directly transferring a nerve signal through a synapse
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are endorphins inhibitory or excitatory neurotransmitters
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inhibitory
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autonomic nervous system
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The part of the peripheral nervous system that controls the glands and the muscles of the internal organs (such as the heart). Its sympathetic division arouses; its parasympathetic division calms.
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neuroplasticity
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the ability of the brain to change both the structure and function of nerves or cells involved in trauma
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what physical changes can substance P produce
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vasodilation and edema
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serotonin
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an excitatory neurotransmitter that inhibits pain transmission
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prostaglandin
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an excitatory neurotransmitter that increases sensitivity to pain
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endorphins, enkephalins, and dynorphins
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inhibitory neurotransmitters that cause analgesia when they attach to opiate receptors in the brain
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how are endorphins activated
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activated by stress and/or pain
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bradykinins
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inhibitory neurotransmitters tha increase pain stimuli by binding to receptors on peripheral nerves
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bias
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overestimating or underestimating the level of pain a patient is having
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precipitating factor
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a specific event or condition that aggravates pain
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relieving factor
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a patient's way of effectively relieving pain
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pseudesthesia
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a sensation occuring in the absence of the appropriate stimuli; an imaginary sensation.
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neuropathic pain
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abnormal processing of pain message (no stimuli); burning, shooting in nature
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localized pain
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pain in one area that gets worse with movement / touch
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diffuse pain
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pain that is all over or in many areas
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numerical rating scale (NRS)
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a pain scale in which a pt rates their pain on a line scale from 0 to 10
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verbal descrptor scale (VDS)
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a pain scale in which a pt rates their pain along a line with three to six word descriptors equally spaced along the line
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visual analog scale (VAS)
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a pain scale in which a pt rates their pain by marking a point on a line that shows a continuum of intensity with labeled endpoints
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critical care pain observation tool (CCPOT)
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a tool that attempts to quantify pain of patients in intensive care
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FACES Pain Rating Scale
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a pain scale for children in which a pt rates their pain by slecting one of six cartoon faces depicting varyin levels of pain
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Oucher pain scale
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a pain scale in which a pt rates their pain on two seperate scales; a 0-100 scale for older children and a 6-picture photographic scale on the right for younger children
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concomitant symptoms
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symtoms that occur with pain and usually increase pain intensity
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types of concomitant symptoms
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nausea, headache, dizziness, urge to urinate, constipation, depression, and restlessness
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task-oriented touching
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touch that occurs as a nurse performs a task for a patient, such as taking BP or assisting in ambulation
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caring touch
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touch that occurs as a nurse shows care, such as holding a patient's hand during a procedure
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distraction
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reducing a patient's awareness of pain by directing their attention to something else
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progressive relaxation
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a pain-distracting technique that uses a combination of controlled breathing exercises and a series of contractions and relaxation of muscle groups
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what are the three types of analgesics
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nonopioid, opioid, and adjuvants
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NSAID stands for . . .
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nonsteroidal antiinflammatory drug
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examples of nonopioid analgesics
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acetaminophen, aspirin, and NSAIDs
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how do NSAIDs work
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by inhibiting the synthesis of prostaglandins
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how do opioids work
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by binding to receptor sites in the nervous system
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examples of opioid analgesics
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codeine, morphine, fentanyl, oxycodone, Darvon, Dilaudid
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example of NSAID
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Toradol
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ATC stands for . . .
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around the clock
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opioid dependence
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the appearance of symptoms of withdrawal when the opioid is reduced abruptly or reversed with an opioid antagonist
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opioid addiction
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psychological dependence on an opioid
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cross-tolerance
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the development of tolerance to the therapeutic and adverse effects of pharmacologically related drugs
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PCA stands for . . .
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patient-controlled analgesia
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patient-controlled analgesia
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a drug-delivery system that allows patients to administer pain medications when they want them, without repeated injections
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epidural analgesia
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a form of local anesthesia for the treatment of postoperative, traumatic, chronic noncancer, and cancer pain`
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rescue dose
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an additional bolus dose of pain medication to combat flares of cancer-related pain
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pain modulation
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hindering the transmission of pain by release of inhibitory neurotransmitters that produce an analgesic effect
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what is the most common type of pain
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nociceptive pain
