Term
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Definition
| whatever the patient says it is , existing whenever and where ever he or she says it does. |
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Term
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Definition
| Acute pain usually has a rapid onset and lasts for some of the body's healing period |
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Term
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Definition
| Chronic pain may be intermittent, but lasts beyond the normal healing period. May be periods of remission in between periods of pain. |
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Definition
| a deep pain that originates in tendons, ligaments, bones, nerves... |
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Term
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Definition
Neuropathic pain results from an injury or abnormal functioning of peripheral nerves in the CNS. Pain related to an injury or illness of a body part may be refered to another part of the body.
Example:
bladder pain my be experienced in the inner thighs |
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Term
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Definition
| nociceptive pain is transmitted by peripheral nerve fibers called nociceptors |
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Term
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Definition
Gate Control Theory describes transmission of painful stimuli and recognizes a relationship between pain and emotions.
pain travels through small diameter nerve channels to the brain but can be interrupted by larger nerve channels that can block the pain signals. These interruptions might be pleasurable sensations such as a warm compress of massage. This effectively "closes the gate" |
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Term
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Definition
modulation is the process where the sensation of pain is inhibited or modified.
example: endorphins are capable of binding to pain production sights and blocking the transmission of pain. |
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Term
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Definition
endorphins are produces at nueral synapses at various points in the CNS pathway.
They are powerful pain-blocking chemicals that have a prolonged analgesic effect and produce euphoria. |
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Term
| Patient's "rights" in regards to pain |
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Definition
Patients have:
- the right to appropriate assessment and management of their pain.
- ongoing assessment of pain as well as nature and intensity.
- regular reassessment of pain
- staff must be competent in assessment
- policies and procedures for prescription of pain medications
- pain must be managed so as not to hinder rehabilitation.
- pt's and families need education in pain management. |
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Term
| common misconceptions of pain |
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Definition
pain misconceptions:
- the doctor ordered pain meds for me which I will be given routinely
- if I ask for pain meds, I will become addicted to the medication
- sometimes it is better to put up with the pain than to deal with the side effects of pain medication.
- I should be able to controal my pain, it is immature to talk about my pain.
- it is better to wait until the pain gets really bad before I ask for help/meds.
- I don't want to both anyone.
- it's natural to have pain after surgery. after a few days, it will be better. |
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Term
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Definition
Different Pain Scales
-Wong-Baker FACES pain rating scale
- Pain Distress Scales:
- simple descriptive
- 0-10 pain distress scale
- Visual Analog Scale (VAS) |
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Term
| Components of a Pain Assessment |
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Definition
Pain Assessment:
- pt's description
- duration of pain
- location of pain
- quantity/insensity
- quality of pain
- chronology of pain
- aggravating factors
- alleviating factors
- physiological indicators of pain
- behavioral responses
- effect on ADL |
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Term
| Nonpharmacological pain relief measures |
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Definition
Nonpharmacological pain relief
- distraction
- humor
- music
- imagery
- relaxation
- cutaneous stimulation
- acupuncture
- hypnosis
- biofeedback
- therapeutic touch |
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Term
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Definition
accupuncture:
needles inserted into specific part of the body to produce insesitivity to pain. Explained with Gate Control Theory.
Includes PENS and TENS. |
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Term
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Definition
| Percutaneous Electrical Nerve Stimulation is a form of acupuncture with needle probes combined with electro-stimulation |
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Term
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Definition
Adjuvant drugs are used to enhance the effects of opioids by providing additional pain relief and reduce opioid side-effects
- corticosteroids
- anticonvulsants
- antidepressants |
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Term
| Narcotic Pain Meds Side-effects |
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Definition
side-effects of narcotics (opioids):
- sedation (w/ respiratory depression)
- nausea
- constipation |
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Term
| Biggest concern with dosing of opioids (narcotics) |
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Definition
| The biggest concern with the dosing of narcotics is respiratory depression. |
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Term
| Dosing Narcotics in older patients |
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Definition
Dosing narcotics (opioids) in the elderly:
Because of risk of increased toxicity, avoid use of:
- meperidine (Demerol)
- propoxyphene (Darvon products)
- pentazocine (Talwin)
- indomethacin (Indocin)
Avoid IM injections whenever possible because of diminished muscle, fat stores, and circulation, which can effect bioavailability.
administer analgesics on a schedule rather than PRN |
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Term
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Definition
Addiction is a pattern of compulsive opioid use for means other then pain control.
Fewer than 1% of patients with pain become addicted to opioids. |
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Term
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Definition
| Dependence is a phenominon where the body becomes accustomed to the opioid and suffers withdrawal symptoms is opioid is suddenly removed or rapidly decreased. |
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Term
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Definition
| Drug tolerance occurs when the body becomes accustomed to the opioid and needs a larger dose each time for pain relief. |
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Term
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Definition
Patient Controlled Analgesic
A PCA is a portable infusion pump with a button for the pt to push to activate it to deliver pain medication. |
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Term
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Definition
Epidural Analgesia is administered through a catheter that is inserted int he midlumbar region into the epidural space between the walls of the vertebral canal and the dura matter.
because of the location of the catheter, the medication acts directly on the opiate receptors in the spinal chord for faster relief of pain with smaller dosage. |
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Term
| nursing care for a pt. with an epidural analgesic |
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Definition
nursing care for epidural analgesic:
- keep 0.4mg of naloxone available at the bedside in syringe to reverse effects if needed.
- label tubing and pump "for epidural infusion only"
- assess and record sedation level and resp. status every 4 hours for the first 24hrs.
- HOB 30 degrees
- Record pain level and med effectiveness
- monitor I&O - bladder distention
- assess motor strength q4h
- assess for side effects (itchy, N&V)
- assess insertion site |
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Term
| most important concern for Pt. on PCA? |
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Definition
| the most important concern for a patient on a PCA is respiratory depression. This is reversed by Naloxone. |
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Term
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Definition
| Around The Clock medication often used for pt's with chronic/constant pain such as with cancer pain. |
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