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Health Assessment
Ch 10 Test 2
42
Nursing
Undergraduate 3
09/13/2011

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Term
Nociceptive Pain
Definition
Develops when nerve fibers in the periphery and CNS are functioning and intact. Starts outside of the nervous system.
Term
Four Phases of Nociceptive Pain
Definition
1)Transduction
2)Transmission
3)Perception
4)Modulation
Term
Transduction
Definition
First phase in nociceptive pain. Occurs when a noxious stimulus in the form of traumatic or chemical injury, burn, incision, or tumor is in periphery. Injured tissues release substance P, histamine, prostaglandins, serotonin, bradykinin.
Term
Transmission
Definition
Second phase in nociceptive pain. Pain impulse moves from spinal cord to brain. Opioid receptors in spine can stop signal, but if not, pain impulse moves to the brain via fibers within spinothalamic tract to thalamus.
Term
Perception
Definition
Conscious awareness of painful sensation. Cortical structures like the limbic system account for emotional response to pain. Somatosensory areas can characterize the sensation. Only when noxious stimuli are interpreted in these higher cortical structures can this sensation be "pain"
Term
Modulation
Definition
Neurons from brainstem release neurotransmitters that block the impulse. Neurotransmitters (serotonin, norepinephrine, neurotensin, GABA, that produce an analgesic effect.
Term
Nociceptors
Definition
Specialized nerve endings that are designed to detect painful sensations from the periphery and transmit them to the CNS.
Term
Nociceptors Location
Definition
Skin, CT, Muscle, and thoracic, abdominal, and pelvic viscera
Term
Nociceptors stimulation
Definition
directly by trauma or injury or secondarily by chemical mediators that re released from the site of tissue damage.
Term
Neuropathic Pain
Definition
Pain that does not adhere to the typical predictable phases in nociceptive pain. Implies an abnormal processing of the pain message from injury to nerve fibers. Difficult to treat.
Term
Conditions that may cause neuropathy
Definition
Diabetes Mellitus, Herpes Zoster, HIV/AIDS, sciatica, trigeminal neuralgia, phantom limb pain, chemotherapy, stroke, MS, tumor
Term
Conditions that may cause neuropathy
Definition
Diabetes Mellitus, Herpes Zoster, HIV/AIDS, sciatica, trigeminal neuralgia, phantom limb pain, chemotherapy, stroke, MS, tumor
Term
Neuropathic Pain
Definition
Pain that does not adhere to the typical predictable phases in nociceptive pain. Implies an abnormal processing of the pain message from injury to nerve fibers. Difficult to treat.
Term
Sources of Pain
Definition
Visceral
Deep Somatic Pain
Cutaneous Pain
Psychogenic
Referred
Term
Visceral Pain
Definition
originates from internal organs - organ injury, tumor, ischemia, distention, or severe contraction - autonomic responses like vomiting, nausea, pallor, diaphoresis
Term
Deep Somatic Pain
Definition
blood vessels, joints, tendons, muscles, bone - injury from pressure, trauma or ischemia
Term
Cutaneous Pain
Definition
Skin surface and subcutaneous tissues - superficial injury with a sharp, burning sensation
Term
Chronic/Persistent
Definition
Pain >6 months, does not stop when injury heals, level of pain intensity usually does not correspond with phys. findings. origin-abnormal processing of pain fibers from peripheral or central sites.
Term
Acute Pain
Definition
Short term, self limiting, predictable trajectory, dissipates after injury heals. Incident pain is acute type that happens when certain movements take place.
Term
Infants
Definition
-same pain capacity of adults
-by 20 weeks gestation, pain is felt
-inhibitory neurotransmitters are insufficient-preterm infant more sensitive to pain
Term
Aging adult and pain
Definition
No evidence suggests that age desensitizes people to pain. People with dementia still experience pain.
Term
Gender differences in pain
Definition
Men tend to not show they are in pain
Women are 2-3 times more likely to have migraines during childbearing years.
6 times more likely to have fibromyalgia
May be a gene that makes difference in pain perception.
Term
Pain
Definition
unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage. Pain is always subjective
Term
Initial Pain Assessment
Definition
eight questions concerning location, duration, quality, intensity, and aggravating/relieving factors
Also questions about the manner of expressing pain and effects of pain that impair one's quality of life.
Term
Brief Pain Inventory
Definition
asks patient to rate pain of 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 patient to rank a list of descriptors in terms of their intensity and to give an overall intensity rating to his or her pain.
Term
Pain rating scales
Definition
unidimensional and are intended to reflect pain intensity
Numeric, Descriptor, Faces, etc.
Term
Children and rating pain
Definition
>2 can report pain and point to location
4-5 y/o can be introduced to rating scales (Oucher)
Term
Joint pain exam
Definition
-note size and contour
-measure circumference of involved joint for comparison with baseline
-check active or passive range of motion
Term
Acute Pain Behaviors
Definition
-autonomic responses
-guarding, grimacing, vocalizations, agitation, restlessness, stillness, diaphoresis, or change in vital signs
Term
Cardiac Acute Pain Responses
Definition
Tachycardia
Elevated blood pressure
Increased myocardial oxygen demand
Increased cardiac output
Term
Pulmonary Acute Pain Responses
Definition
Hypoventilation
Hypoxia
Decreased cough
Atelectasis
Term
Gastrointestinal Acute Pain Responses
Definition
Nausea
Vomiting
Ileus
Term
Renal Acute Pain Responses
Definition
Oliguria
Urinary retention
Term
Musculoskeletal Acute Pain Responses
Definition
Spasm
Joint stiffness
Term
Endocrine Acute Pain Responses
Definition
Increased adrenergic activity
Term
CNS Acute Pain Responses
Definition
Fear
Anxiety
Fatigue
Term
Immune Acute Pain Responses
Definition
Impaired cellular immunity
Impaired wound healing
Term
Poorly Controlled Chronic Pain Acute Pain Responses
Definition
Depression
Isolation
Limited mobility and function
Confusion
Family distress
Diminished quality of life
Term
Immune Acute Pain Responses
Definition
Impaired cellular immunity
Impaired wound healing
Term
CRIES test for neonates
Definition
measures physiologic and behavioral indicators on a 3-point scale
Crying
Requires 02 for sat >95%
Increased Vital signs
Expression
Sleepless
Term
PAINAD (Pain assessment in advanced dementia)
Definition
-Breathing independent of vocalization
-Negative vocalization
-Facial expression
-Body language
-Consolability
Each is rated from 0-2
Score >4 = need for pain management
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