Nursing Care of Patients Experiencing Acute and Chronic Pain – Flashcards
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Pain stimulating chemicals substances;(5)
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Histamine Bradykinin Acetylcholine Potassium Prostaglandins
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Pain controlling substances(3)
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Enkephalins Endorphins Serotonin
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Pain categories:(4)
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Duration, etiology, type, location
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Duration:(4)
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Acute Chronic non-malignant Chronic intermittent Cancer-related
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Etiology:(3)
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biologic, chemical, physical ( mechanical)
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Type: superficial deep somatic- localized- referred- projected(phantom)- intractable- cancer-related- breakthrough-
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muscles, nerve pain, appendicitis, visceral any of the category pain that occurs in a certain area and felt in another area, still perceiving pain and still needs to be addressed, pain so severe that it is resistant to all kinds of treatment, nothing is relieving the pain, malignant pain, can be chronic or acute and can be intermittent pain that occurs between medication
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Acute Pain;(7)
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Mild to severe Sympathetic nervous system responses (observable) Related to tissue injury Resolves with healing Restless and anxious Reports of pain Pain behavior
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Chronic Pain(3)
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Mild to severe Adaptation response Parasympathetic nervous system responses
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Cancer Related pain;(4)
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Progression of cancer Treatment Acute or chronic Need large dose of pain med
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Consequences of pain: Acute(7)
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Postop complications Slow recovery Poor outcomes Respiratory Cardiovascular Endocrine Immune system
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consequences of pain chronic(4)
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Disability Depression Anger Fatigue
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Addiction-
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Compulsion characterized by behaviors that include impaired control over drug use, compulsive use, continued use despite harm and craving mostly for its psychic effects
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dependence(5)
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Opioids taken over a long period of time with abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist. Not necessarily an addiction. Physical - drug class specific withdrawal syndrome Psychological - emotional craving for drug effect Prevent occurrence of withdrawal symptoms
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Tolerance(2)
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Decreased sensitivity to analgesic properties of opioid with need for increasing doses to maintain same level of pain relief Adequate pain relief no longer obtained
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Factors influencing pain response(7)
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Neuronal Psychological Past experience Cultural Gender Age Support
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Adaptation response:***(6)
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Vital signs may be normal Facial expression may not be changed Shifting away or guarding frequently Reporting pain only if asked directly Sleepiness is increased Physical activity is decreased
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Assessment:pain (10)
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Triggers/relief Associated s/s Intensity Location Onset and duration Quality Personal meaning Allergies Threshold Tolerance
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Pain Assessment: PQRST
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P= provoked (what brought about pain) Q= quality R= region/radiation S= severity T= timing
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Objective signs: pain assesment (5)
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Sympathetic Parasympathetic Verbal Non-verbal Adaptation response
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Types of Analgesics: Opioids;(2)
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Morphine Codeine
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Non-opioid Analgesics;(3)
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Salicylate Acetaminophen Nonsteroidal Anti-inflammatory Drug (NSAID
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Adjuvants;(2)
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Anticonvulsants Antianxiety
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Negative effects of drugs: Acetaminophen Aspirin(2) NSAIDS(3)
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Liver damage Auditory problems Decreases serum level of NSAIDS Increase sodium retention GI bleeding and irritation Take with food or milk
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Pain management:(6)
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Reduce anxiety Prevention PCA Medications Opioids NSAIDS Placebos Adjuvant Anesthetic agents Blocks Non-pharmcological Surgery-Chordotomy, Implantable electrical stimulation Acupuncture Non-invasive
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Adverse Effects of Opioid Analgesics:(6)
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Respiratory Depression Constipation GI upset Cutaneous Effects Orthostatic hypotension Urinary Retention
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Non-invasive techniques:(11)
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Massage Contralateral stimulation TENS Acupressure Relaxation Breathing Therapeutic touch Distraction Hypnosis Heat and cold application Diathermy
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Nursing Diagnoses:(9)
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Pain as etiology of other nursing diagnoses; Ineffective Airway Clearance Hopelessness Ineffective coping Ineffective health maintenance Self Care Deficit Deficient Knowledge Impaired Physical Mobility Disturbed Sleep Pattern
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