MSII Chapt 15 Pain PP notes.txt

  1. McCaffery�s definition of pain
    Pain is whatever the person experiencing it says it is and exists whenever he says it does
  2. Nociceptors
    receptors that activate the afferent pathways; unable to adapt to repeated stimuli so they continue to fire until the stimuli are removed
  3. What can inhibit pain?
    Endorphins and enkephalins that can have an opioid effect by blocking or diminishing pain perception
  4. What can decrease endorphin levels?
    Prolonged stress and pain, prolonged use of morphine and alcohol
  5. What can increase endorphin levels?
    Brief stress and pain, laughing, exercise, sex, acupuncture, TENS, massive trauma
  6. Factors that cause the gate to open include
    tissue damage, monotonous environment, and fear of pain
  7. What can close the gate?
    Stimulation of large-diameter fibers through massage, position change, and heat or cold applications; distraction, guided imagery, preparatory information
  8. What physical factors affect pain?
    Pain threshold, pain tolerance, age, physical activity, surgery and anesthesia
  9. Pain threshold
    Point at which stimulus causes sensation of pain
  10. What lowers pain threshold?
    Anger, fatigue, anxiety, insomnia, depression and uncontrolled pain
  11. Pain tolerance
    Intensity of pain that a person will endure
  12. What is the most painful surgery?
    Upper Abdomen
  13. What psychological factors affect pain?
    Culture, religion, past experiences, anxiety, situational factors
  14. Because the brain interprets pain as a stressor, it activates the
    sympathetic NS
  15. What are predictable responses to acute pain?
    Increased heart rate, respiratory rate, and BP
  16. Cause of acute pain is
    known, treatable, and temporary
  17. Acute pain
    follows the normal pathway for pain from nociceptor activation to the brain
  18. Chronic pain
    persistent, recurs for > 6 months; neuropathic because it follows an abnormal pathway
  19. Unusual sensations of chronic pain
    burning, shooting pain and abnormal sensations that occur when there is no pain stimulus present; cause may be unknown
  20. What purposes do pain serve?
    Chronic-no useful purpose; acute warns of tissue damage and trauma
  21. Sympathetic nervous system adapts
    so HR, BP and R may be normal; nurse may underestimate severity and undermedicate
  22. Most chronic pain is
  23. When should pain be assessed?
    On admission and on a regular basis
  24. Six steps of pain
    Accept pt report, determine status of pain, describe pain, examine site of pain, identify coping methods, document findings and evaluate interventions
  25. How should pain be described?
    Location, quality, intensity, aggravating and alleviating factors
  26. Physical interventions
    physical comfort measures, environmental control, stimulation techniques
  27. Psychological interventions
    anxiety reduction, distraction, relaxation and imageryn
  28. Nonpharmacological interventions
    increase tolerance and threshold
  29. Hot and cold
    heat< 30 minutes and don�t put on abdominal pain or malignancy; cold<15 minutes and don�t put on people taking vasoconstriction and heart disease
  30. Nonopioid analgesics affect
    PNS, have ceiling effect on analgesia
  31. Opioid analgesics affect
  32. Examples of opioid agonists
    codeine, methadone, dilaudid, Demerol, morphine, fentanyl
  33. Examples of opioid agonist antagonists
    nubain, puprenex, stadol, talwin
  34. Side effects of opioids
    constipation, sedation, nausea, respiratory depression, confusion, hypotension, dizziness, urinary retention
Card Set
MSII Chapt 15 Pain PP notes.txt
MS II Test 3 Chpt 15 Pain PP notes