Term
| 4 phases of pain transmission |
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Definition
Transduction - pain starts with noxious stimuli causes release of chemicals causing inflammation (prostaglandin, histamine, glutamate) create a stimuli that is transmitted.
Transmission - noxious stimuli transmitted up spinal cord to thalamus which acts as relay station and transmits stimuli to high brain levels where it is perceived cognitively and emotionally.
Perception - Cognitive perception is result of painful stimuli, emotional perception is influenced by patient history, experience of pain, experience with similar injuries.
Perception
Modulation |
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Term
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Definition
| pain caused by a stimuli which does not ordinarily cause pain . Often associated with neuropathic pain |
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Term
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Definition
| increased response to a stimulus that is normally painful (can be caused by a patient that is in withdrawal) |
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Term
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Definition
| when a neuron that mediates nociception in the dorsal horm is repeatedly stimulated, its rate of discharge dramatically increases with time as does the perception of pain that the patient cognitively perceives is increased the barrage of pain signals can actually cause altered morphology within the spinal cord (neuroplasticity) with a resultant continued discharge persisting when the painful stimuli stops. |
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Term
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Definition
| When a person is taking drugs purely for psychological effects not because they are taking them for pain |
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Term
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Definition
| state of adaption exposure to a drug resulting in decrease of drugs effect over time. Usually occurs within ten days. WHen it occurs, it may increase requirement of opioid to give them the same effect |
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Term
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Definition
| adaptation to a drug creating withdrawal with abrupt cessation can occur in as little as ten days |
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Term
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Definition
| drug seeking behavior doesn't always mean that they don't have pain. |
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Term
| 5 typical under treated populations |
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Definition
elderly (people are fearful of giving htem opioids because of side effects)
pediatric ( have a hard time communicating pain)
confused
non english speaking
patients with a history of alcohol or drug abuse. |
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Term
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Definition
tachycardia
elevated bp
sweating
dilated pupils
anxiety |
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Term
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Definition
heart rate WNL
BP WNL
absent
Pupils WNL
Depression |
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Term
| physiologic component of pain |
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Definition
| depends on intensity of stimulus, duration of stimulus and quality of stimulus, this is combined with psychological component which is what the patient believes about the apin. |
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Term
| Psychological Component of pain |
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Definition
| Meaning of pain, coping of pain, fatigue, resources, anxiety and depression |
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Term
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Definition
Palliative Factors - what makes pain better vs. worse
Quality of Pain - descriptors of the pain
Radiation of pain
Severity of Pain - record intensity of pain on scale 0-10 gives you the idea of patients baseline to determine if interventions were sucessfull
Temporal Factors - what is making pain wrose. |
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Term
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Definition
#1 Patients Self Report
#2 assume pain is present when pathological cause is present
#3 nursing observations of pain behaviors, does not reflect pain intensity,
#4 surrogate reporting
#5 attempt an analgesic trial |
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Term
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Definition
musculoskeletal pain
arises from tissues such as skin, muscle, joins bones
described as sharp localized, intermittent and increased by movement. |
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Term
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Definition
| deriving from internal organs of the body, poorly localized feels like an ache or cramp and is continuous pain. |
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Term
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Definition
| pain from peripheral nervous system 9between periphery and spinal cord or from the central nervous system between the spinal cord and brain. can be caused y nerve degeneration, pressure, inflammation or infection. |
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Term
| Two kinds of drugs used to treat somatic pain |
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Definition
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Term
| Three kinds of drugs used to treat visceral pain |
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Definition
NSAIDS
opioids
antispasmodics |
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Term
| 5 kinds of neuropathic pain drugs |
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Definition
alpha adrenergic agents
SSRI's
Tricyclic
membrane stabilizer
NMDA inhibitors |
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Term
| 6 examples of nursing interventions for pain |
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Definition
positioning
relaxation
ice and heat
unresolved psychosocial issues
distraction
increase patient control of pain |
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Term
| 2 symptoms of opioid withdrawl |
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Definition
Irritability
autonomic hyer-activiy (GI, urinary, sweating) |
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Term
| Range frequency orders of opioids |
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Definition
| 2 tabs every 3 hours PRN pain |
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Term
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Definition
| 2-6 mg every three hours prn |
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Term
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Definition
Respiratory Depression
Sedation
Urinary Retention
Constipaton
Pruritis (morphine creates histamine response)
Emetic Effects
Delirium |
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Term
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Definition
| peripheral nervous system |
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Term
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Definition
| mediate postaglandin production, decreases inflammatory process, |
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Term
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Definition
full mu agonists
Mixed agonist - antagonists |
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Term
| Alpha Adrenergic Blocker Action |
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Definition
Decrease sympathetic outflow from CNS
Useful for sympathetically mediated pain
may be used to assist patients in opioid withdrawal
may be used for neuropathic pain |
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Term
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Definition
| used for neuropathic pain |
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Term
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Definition
| block reuptake of serotonin |
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Term
| tricyclic antidepressants action |
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Definition
| block reuptake of serotonin, dopamine, and norepinepherine at the CNS |
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Term
| Membran stabilizers (anticonvulsants) action |
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Definition
stabilize the nerve membrane
prevent an action potential from occurring |
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Term
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Definition
| nmda receptor in the dorsal horn of the spinal cord mediates neurogenic hyperalgesia and may block neuropathic pain |
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Term
| What do corticosteroids do? |
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Definition
inhibit prostaglandins
Decrease edema |
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Term
| What are corticosteroids indicated for... |
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Definition
| acute nerve compression, visceral distention, increased intracrainial pressure. |
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Term
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Definition
| decrease visceral spasm and inhibit GI secretions |
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Term
| indications for antispasmodics |
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Definition
| indicated for GI and Bladder spasm |
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Term
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Definition
| decrease muscle tension adn contractions |
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Term
| Indication of muscle relaxants |
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Definition
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Term
| universal safe dose of opioids |
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Definition
| no universal safe dose, must evaluate each patient individually. |
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