Pain the fifth vital sign

  1. 3 types of pain
    • Acute Pain
    • Chronic cancer pain
    • chronic noncancer pain
  2. Sources of pain that are nociceptive (2 types)
    • somatic pain
    • visceral pain

    there is also neuropathic pain
  3. Attitudes and practices related to pain
    attitudes of health care providers and nurses affect interacts with clients experiences pain
  4. __% of clients are unable to obtain pain relief from codeine and why.
    • 10%
    • they have variation in the gene that codes for the enzyme that converts codeine to morphine
  5. Pain cultural considerations: What are minorities at risk for?
    undertreatment of pain: tolerance, physical dependence, and addiction
  6. Tolerance, dependence and addiction of pain and pain medications
    • Tolerance: adaptation in which exposure to a drug induces change in its effect over time
    • Physical dependence is the adaptation manifested by a drug class - specific withdrawal syndrome
    • Withdrawal symptoms result when dependent use of opioids ceases abruptly
    • Addiction: chronic, neurobiologic disease characterized by 1. impaired control over drug use, 2. compulsive drug use 3. continued use despite harm 4. craving
  7. Define pseudoaddiction
    An iatrogenic syndrome created by the undertreatment of pain, characterized by client behaviors such as anger and escalating demands.
  8. Location of pain (4 types)
    • Localized
    • Projected
    • Radiating
    • Referred
  9. Gate control theory for pain
    • Assumes that a mechanism in the spinal cord permits pain impulses to rise to the brain
    • This theory has helped nurses and health care professionals recognize the holistic nature of pain, resulting in many cognitive and behavior therapies use to help relieve pain.
  10. Pain interventions include (non-opioid analgesics)
    • acetylsalicyclic acid
    • acetaminophen
    • nonsteroidal anti-inflammatory drug (NSAIDs)
  11. Anatomic and physiologic bases for pain: 4 facts
    • Pain Stimuli
    • Pain Fibers and pathways
    • Central nervous system processing
    • inhibitory and facilitatory mechanisms: neurotransmitters, neuromodulators, opioid receptors
  12. Common Opioids include
    Codeine, hydrocodone, oxycodone, morphine, hydromorphone, fentanyl, methadone, tramadol, meperidine
  13. Side effects of opioids:
    • Nausea and vomiting
    • constipation
    • sedation
    • respiratory depression
  14. Routes of administration
    • Patient-controlled analgesia (PCA)
    • Epidural analgesia
    • Intrathecal (subarachnoid) analgesia
  15. Adjuvant Analgesics
    • Antiepileptic drugs
    • Tricyclic antidepressants
    • topical medication
  16. Physical measures as an addition or alternative to drug therapy are:
    • Transcutaneous electrical nerve stimulation
    • application of heat, cold, and pressure
    • therapeutic touch
    • massage
    • vibration
    • physical therapy
  17. Strategies that can be used to relieve pain as adjuncts to drug therapy are: (DIRHA)
    • Distraction
    • Imagery
    • Relaxation Techniques
    • Hypnosis
    • Acupuncture
  18. Invasive Techniques for Chronic Pain
    • Never blocks
    • Spinal cord stimulation
    • surgical techniques: rhizotomy and cordotomy
Card Set
Pain the fifth vital sign
basic patient care pain