Shared Flashcard Set

Details

ASMT: Chapter 10
Pain Assessment: The Fifth Vital Sign
70
Nursing
Undergraduate 3
02/07/2011

Additional Nursing Flashcards

 


 

Cards

Term
pain
Definition
highly complex and subjective experirence that originates from the CNS or PNS or both
Term
nociceptors
Definition
designed to detect painful sensation from the periphery and transmit them to the CNS
Term

1. A delta fibers

2. C fibers

Definition
the two primary sensory fibers by which nociceptors carry the pain signal to the CNS
Term
A delta fibers
Definition
  • myelinated fibers
  • larger in diameter
  • transmit the pain signal rapidly to the CNS
  • very localized, short-term, and sharp sensations
Term
C fibers
Definition
  • unmyelinated and smaller fibers
  • transmit the signal slowly
  • sensations are diffuse and aching
  • sensations persist after the initial injury
Term
substantia gelatinosa
Definition
  • a specified area of the spinal cord
  • lamina II
  • receives sensory input from various areas of the body
Term
anterolateral spinothalamic tract
Definition
how pain signals ascend to the brain
Term
how does pain occur?
Definition
on a cellular level
Term
nociception
Definition
the term used to describe how noxious stimuli are typically perceived as pain
Term
what are the four phases of nociception?
Definition

1. transduction

2.transmission

3. perception

4. modulation

Term
transduction
Definition
occurs when a noxious stimulus in the form of traumatic or chemical injury, burn, incision, or tumor takes place in the periphery
Term
what does the "periphery" include?
Definition
the skin, as well as somatic and visceral structures
Term
transmission
Definition
  • the second phase of nociception
  • the pain impulse moves from the level of the spinal cord to the brain
Term
opioid receptors
Definition
block the pain signaling with endogenous or exogenous opioids
Term
perception
Definition
  • third phase of nociception
  • indicates the conscious awareness of a painful sensation
Term
cortical structures
Definition
structures that account for the emotional response to pain
Term
somatosensory areas
Definition
areas that characterize the sensation of pain
Term
when can the noxious stimuli be interpreted as pain?
Definition
when they are in the higher cortical structures
Term
modulation
Definition
  • the fourth phase of nociception
  • the pain message is inhibited
Term
neuropathic pain
Definition
  • indicates a type of pain that does not adhere to typical and predictable manifestations
  • implies an abnormal processing of the pain message
  • most difficult type of pain to assess and treat
  • pain is present long after healing
  • pain cannot be identified through imaging
Term
visceral pain
Definition
  • pain that originates from the larger interior organs 
  • often accompanied by autonomic responses such as vomiting, nausea, pallor, and diaphoresis
Term
deep somatic pain
Definition
pain that comes from sources such as the blood vessels, joints, tendons, muscles, and bone
Term
cutaneous pain
Definition
pain derived from skin surface and subcutaneous tissues
Term
why is sapna the way she is?
Definition
because GAYNESS/LOSER STATUS is a congenital defect
Term
referred pain
Definition
  • pain that is felt at a particular site but originates from another location
  • may originate from visceral or somatic structures
Term
acute pain
Definition
  • short term pain
  • self-limiting
  • often follows a predictable trajectory
  • dissipates after an injury heals 
  • serves a self-protective purpose because it warns the individual of actual/potential tissue damage
Term
chronic pain
Definition
  • pain that continues for 6 months or longer
  • two types: malignant and nonmalignant
  • does not stop after healing
  • outlasts its protective purpose
  • level of pain intensity does not correspond with the physical findings
  • originates from abnormal processing of pain fibers from peripheral or central sites
Term
chronic malignant pain
Definition
  • cancer related pain
  • often parallels the pathology created by tumor cells
  • pain induced by tissue necrosis or stretching of an organ by the growing tumor
  • pain fluctuates within the course of the disease
Term
chronic nonmalignant pain
Definition
pain often associated with musculoskeletal conditions
Term
chronic nonmalignant pain
Definition
  • often associated with musculoskeletal conditions 
  • arthritis, low back pain, fibromyalgia 
Term
what happens at 20 weeks gestation in infants?
Definition
ascending fibers, neurotransmitters, and the cerebral cortex are developed and functioning to the extent that the fetus is capable of feeling pain
Term
inhibitory neurotransmitters are in insufficient supply until when?
Definition
until birth at full term → preterm infant is more sensitive to painful stimuli
Term
what can poorly controlled pain in infants lead to?
Definition

  • poor weight gain
  • learning disabilities
  • psychiatric disorders
  • alcoholism

Term
should pain be expected in older adults?
Definition
no
Term
what are the most common pain-producing pathologies for aging adults?
Definition

  • arthritis
  • osteoarthritis
  • osteoporosis 
  • peripheral vascular disease
  • cancer
  • peripheral neuropathies
  • chronic constipation 
  • angina

Term
what system does Alzheimer's affect?
Definition

limbic system 

 

(does not affect somatosensory cortex)

Term
what are gender differences in pain perception influenced by?
Definition

  • societal expectations
  • hormones
  • genetic make-up

Term
women are 6 times more likely of having what disease?
Definition
fibromyalgia 
Term
what is the most accurate report of pain?
Definition
the self report from the patient 
Term
what are the eight questions of initial pain assessment?
Definition

 

  1. where is your pain?
  2. when did your pain start?
  3. what does your pain feel like?
  4. how much pain do you have now?
  5. what makes your pain better/worse?
  6. how does pain limit your function or activities?
  7. how do you usually behave when you are in pain? how would others know that you are in pain?
  8. what does this pain mean to you? why do you think you are having pain?

 

Term
what are the different components of asking the patient, "what makes your pain better/worse"
Definition

  • behavioral interventions
  • pharmacologic interventions 
  • non-pharmacologic interventions 

Term
how is neuropathic pain described?
Definition
burning, shooting, tingling
Term
how do you describe nociceptive pain?
Definition
aching (localized), cramping (poorly localized), throbbing/aching (somatic sites)
Term
standardized overall pain assessment tools
Definition
useful for chronic pain conditions or particularly problematic acute pain problems
Term
initial pain assessment
Definition
clinician asks patient to answer 8 questions concerning location, duration, quality, intensity, and aggravating/reliving factors 
Term
brief pain inventory
Definition
asks the patient to rate the pain within the past 24 hours using graduated scales (0-10) with respect to its impact on areas such as mood, walking ability, and sleep 
Term
short form mcgill pain questionnaire 
Definition
asks the patient to rank a list of descriptors in terms of their intensity and to give an overall intensity rating to his/her pain 
Term
pain rating scales
Definition
unidimensional; intended to reflect pain intensity
Term
what do pain rating scales indicate?
Definition

  • a baseline intensity
  • track changes
  • gives some degree of evaluation to a treatment modality 

Term
numeric rating scales
Definition

asks a patient to choose a number that rates a level of pain

 

0 = no pain // 10 = most pain

Term
what pain scale do older adults use?
Definition
the descriptor scale
Term
the descriptor scale
Definition

describes pain intensity as:

  • no pain
  • mild pain
  • moderate pain
  • severe pain

Term
what are infants' and children's pain assessment dependent upon?
Definition
behavioral and physiologic cues
Term
at what age do are children able to point to the location of their pain?
Definition
2 years
Term
at what age are children able to use the rating scales (Wong-Baker Scale) to rate their pain?
Definition
4-5 years
Term
what pain scale is used for girls in diverse ethnic groups?
Definition
outcher scale
Term
what exam process can help you understand the nature of the pain?
Definition
the physical exam process
Term
what are the normal findings for joints in a physical examination?
Definition

  • joint motion normally causes no tenderness or pain

Term
what are the abnormal findings for joints in the physical assessment?
Definition
swelling, inflammatio, injury, deformity, diminished ROM, increased pain on palpation
Term
what are the abnormal findings on the muscles and skin when performing the physical assessment?
Definition

  • bruising
  • lesions
  • open wounds
  • tissue damage
  • bulging 
  • change in hair distribution 
  • absent/increased pain sensation

Term
what are the abnormal findings in the abdomen during the physical assessment?
Definition

  • swelling
  • bulging 
  • herniation 
  • inflammation 
  • organ enlargement 

Term
what are the nonverbal behaviors of pain?
Definition
identifies pain using behavioral cues 
Term
which factors influence behaviors with regards to nonverbal behaviors and pain?
Definition

  • nature of the pain (acute vs. chronic)
  • age
  • cultural/gender expectations

Term
nonverbal acute pain
Definition

  • gaurding
  • grimacing 
  • vocalizations (moaning)
  • agitation 
  • restlessness
  • stillness
  • diaphoresis 
  • change in vital signs

Term
nonverbal chronic pain behaviors
Definition

  • difficult to identify because not easily shown by patient
  • sigh frequently
  • bracing, rubbing, diminished activity
  • change in appetite 

Term
what tool is developed for postoperative pain in preterm and term neonates?
Definition
CRIES
Term
CRIES
Definition

  • crying 
  • requires O2 for saturation >95%
  • increased vital signs
  • expression
  • sleepless

Term
reflexive sympathetic dystrophy (RSD) or complex regional pain syndrome (CRPS)
Definition

  • a chronic progressive nerve condition, characterized by burning pain, swelling, stiffness, and discoloration, of the affected extremity
  • affects both men and women 40-60 years old

Term
objective data for RSD/CRPS
Definition

  • swelling
  • disappearance of skin wrinkles
  • cool skin temperature
  • discoloration
  • brittle nails
  • atrophic changes 

Supporting users have an ad free experience!