Funds Week 9

  1. What Is Pain
    • Unpleasant sensory/emotional experience
    • Can have destructive effects
    • Can warn of potential injury
    • A multidimensional experience
  2. Classification of Pain
    • Superficial
    • Visceral
    • Somatic
    • Radiating/referred
    • Phantom
    • Psychogenic
  3. Classification of Pain
    • By Cause
    • Nociceptive
    • Neuropathic
    • By quality
    • By duration
    • Acute
    • Chronic
    • Intractable
  4. Physiology of Pain
    • Transduction: activation of nociceptors by stimuli
    • Transmission: conduction of pain message to spinal cord
    • Pain Perception: recognizing and defining pain in cortex
    • Pain Modulation: changing pain perception
  5. Factors That Influence Pain
    • Past experience with pain
    • Emotions
    • Developmental stage
    • Sociocultural factors
    • Communication skills
    • Cognitive impairments
    • Other illnesses contributing to pain
  6. Assessing Pain
    • Includes
    • Obtaining a complete pain history
    • (e.g., onset, location, aggravating/alleviating factors)
    • Nonverbal signs of pain
    • Elevated pulse/blood pressure
    • Crying, moaning
    • Grimacing
  7. Assessing Pain Scales
    • Visual Analogue Scale (VAS)
    • Numeric Rating Scale (NRS)
    • Simple descriptor scale
    • Wong-Baker Faces Pain Rating Scale
  8. The nurse is assessing the confused client. In trying to determine the client’s level of pain, the nurse should
    • a. be aware that confused clients don’t feel as much pain due to their confusion
    • b. observe the client carefully for changes in behavior or vital signs
    • c. ask the client’s family how much pain the client normally has
    • d. use only pain scales that feature numbers or "faces" the client can point to
  9. Pain Management
    Non Pharma
    • Cutaneous stimulation
    • Based on "gate control" theory
    • TENS
    • PENS
    • Acupuncture
    • Acupressure
    • Massage
    • Use of heat and cold
    • Contralateral stimulation
  10. Pharmacological Measures For Pain
    • Nonopioid analgesics
    • NSAIDs
    • Acetaminophen
    • Opioid analgesics
    • Includes IV, IM, transdermal, and epidural forms
    • Client-controlled analgesia pumps
  11. Mr. Zenobia's chronic cancer pain has recently increased, and he asks the home health nurse what can be done. In relationship to his long-acting morphine, which of the following is an appropriate response by the nurse?
    a. "If you take more morphine, it will not change your pain relief."b. "I'll call the physician and ask for an increased dose."c. "The amount you are taking now is all I can give you."d. "I'm worried if we increase your dose that you will stop breathing."
  12. Special Nursing Considerations
    • Managing pain in the elderly
    • Managing pain in clients with addictions
    • Use of placebos
  13. Sleep Versus Rest
    • Sleep
    • Cyclical states/altered consciousness
    • Decreased motor activity/perception
    • Selective response to external stimuli

    • Rest
    • Mild to no activity
    • Relaxation; stress-free
    • Leads to feeling refreshed
  14. Benefits of Sleep
    • Increases mental performance
    • Improves learning
    • Helps the storage of long-term memory
    • Restores energy
    • Improves ability to cope
    • Strengthens the immune system
  15. Terms to Know
    • Circadian rhythm
    • Internal clock
    • 24-hour day-night sleep/wake pattern
    • Affects overall level of functioning
    • Reticular activating system
    • Stages of sleep
    • NREM
    • REM
    Light sleep and slowing brain and body processes are associated with which stage of NREM sleep?
    • a. I
    • b. II
    • c. III
    • d. IV
  17. Factors Affecting Sleep
    • Age
    • Lifestyle factors
    • Physical activity
    • Food and alcohol
    • Medications
    • Caffeine
    • Sleep habits

    • An illness
    • Environmental factors
    • Temperature and humidity
    • Noise and light
    • Nonoxious odor
    • Comfort of bedding
  18. Common Sleep Disorders
    • Insomnia
    • Inability to fall or remain asleep or go back to sleep
    • Circadian disorders
    • Abnormality in sleep/wake times
    • (e.g., jet lag, working night shift, rotating shifts)
  19. The nurse is caring for a hospitalized client who normally works the night shift at his job. The client states, "I don’t know what is wrong with me. I have been napping all day and can’t seem to think clearly." The nurse’s best response is
    • "You are sleep deprived, but that will resolve in a few days."
    • "You are experiencing hypersomnia, so it will be important for you to walk in the hall more often."
    • "There has been a disruption in your circadian rhythm. What can I do to help you sleep better at night?"
    • "I will notify the doctor and ask him to prescribe a hypnotic medication to help you sleep."
  20. Common Sleep Disorders
    • Restless Leg Syndrome
    • Uncontrollable movement of legs during sleep/rest
    • Hypersomnia
    • Excessive sleeping (especially during daytime)
    • Sleep-related or disease-related
    • Can be related to depression
  21. Common Sleep Disorders
    • Sleep Apnea
    • Periodic breathing cessation for at least 10 seconds during sleep
    • Narcolepsy
    • Chronic disorder caused by the brain’s ineffectiveness in regulating sleep-wake cycles normally
    • Uncontrollable episodes of sleep during the day
  22. Common Sleep Disorders
    • Parasomnias
    • Sleepwalking/talking
    • Bruxism
    • Night terrors
    • REM sleep behavior disturbances
    • Enuresis
Card Set
Funds Week 9
Fundamentals PPT Week 9