Basic Nursing Ch 31: "Pain Management"

analgesic
a medication to reduce or eliminate pain
cutaneous stimulation
stimulation of the skin to relieve pain, such as with a TENS
epidural infusion
type of nerve block anesthesia in which an anesthetic is intermittently or continuously injected into the lumbosacral region of the spinal cord
exacerbation
increase in the severity of a disease or its symptoms
guided imagery
a relaxation technique in which a patient concentrates on an image in the mind in order to reduce awareness of pain
local anesthesia
the loss of sensation to a localized body part
neurotransmitter
substances that affect the sending of nerve stimuli
nociceptors
receptors that respond to harmful stimuli
opioid
an analgesic that is used for severe pain
pain
subjective, unpleasant sensation caused by noxious stimulation of sensory nerve endings
patient-controlled analgesia (PCA)
device that allows the client to control the delivery of IV or subQ pain medication in a safe, effective manner through a programmable pump
perception
person’s mental image or concept of elements in their environment, including information gained through the senses
placebo
dose forms that contain no pharmacologically active ingredients
reaction
component of the pain experience that may include both physiological and behavioral responses
reception
nervous system receptors receive painful stimuli and transmit them through peripheral nerves to the CNS
remission
partial or complete disapperance of symptoms
synapse
the point of contact between two neurons
threshold
the point at which a person first becomes aware of a painful stimulus
transcutaneous elecrical nerve stimulation (TENS)
a form of stimulation of the skin that uses a mild electrical current passed through external electrodes
qualitative pain
subjective pain; pain that can be described
quantitative pain
objective pain; pain that can be measured
Gate-Control theory of pain
The theory that pain is a product of both physiological and psychological factors that cause spinal gates to open and relay patterns of intense stimulation to the brain, which perceives them as pain.
adjuvant
an additive with no analgesic effect, but enhances the effectiveness of pain control
modality
method of treatment, such as surgery, chemotherapy or irradiation
cutaneous pain
pain that originates in the skin or subcutaneous tissue
somatic pain
sharp, localized pain originating from muscle, bone, joints, tendons, or blood vessels
visceral pain
poorly localized, dull or diffuse pain that arises from the abdominal organs, or viscera
phantom pain
perceived sensation of pain from an amputated limb
psychogenic pain
pain with no known physical cause; likely has a psychiatric or emotional cause
referred pain
pain that is felt at a place in the body different from the injured or diseased part where the pain would be expected
radiating pain
pain felt at the site of tissue damage and in nearby areas
non-opioid
an analgesic that is effective in treating mild to moderate pain
A-delta fibers
fast, myelinated peripheral nerve fibers that send sharp, localized, and distinct sensations
C fibers
slow, unmyelinated peripheral nerve fibers that relay impulses that are poorly localized, visceral, and persistent
afferent pathways
sensory pathways
efferent pathways
motor pathways
substance P
an excitatory neurotransmitter that transmits pain impulses from the periphery to higher brain centers
excitatory neurotransmitters
neurotransmitters that enhance the transmission of a painful impulse by sending electrical impulses across the synaptic cleft between two nerve fibers
inhibitory neurotransmitters
decrease neuron activity without directly transferring a nerve signal through a synapse
are endorphins inhibitory or excitatory neurotransmitters
inhibitory
autonomic nervous system
The part of the peripheral nervous system that controls the glands and the muscles of the internal organs (such as the heart). Its sympathetic division arouses; its parasympathetic division calms.
neuroplasticity
the ability of the brain to change both the structure and function of nerves or cells involved in trauma
what physical changes can substance P produce
vasodilation and edema
serotonin
an excitatory neurotransmitter that inhibits pain transmission
prostaglandin
an excitatory neurotransmitter that increases sensitivity to pain
endorphins, enkephalins, and dynorphins
inhibitory neurotransmitters that cause analgesia when they attach to opiate receptors in the brain
how are endorphins activated
activated by stress and/or pain
bradykinins
inhibitory neurotransmitters tha increase pain stimuli by binding to receptors on peripheral nerves
bias
overestimating or underestimating the level of pain a patient is having
precipitating factor
a specific event or condition that aggravates pain
relieving factor
a patient’s way of effectively relieving pain
pseudesthesia
a sensation occuring in the absence of the appropriate stimuli; an imaginary sensation.
neuropathic pain
abnormal processing of pain message (no stimuli); burning, shooting in nature
localized pain
pain in one area that gets worse with movement / touch
diffuse pain
pain that is all over or in many areas
numerical rating scale (NRS)
a pain scale in which a pt rates their pain on a line scale from 0 to 10
verbal descrptor scale (VDS)
a pain scale in which a pt rates their pain along a line with three to six word descriptors equally spaced along the line
visual analog scale (VAS)
a pain scale in which a pt rates their pain by marking a point on a line that shows a continuum of intensity with labeled endpoints
critical care pain observation tool (CCPOT)
a tool that attempts to quantify pain of patients in intensive care
FACES Pain Rating Scale
a pain scale for children in which a pt rates their pain by slecting one of six cartoon faces depicting varyin levels of pain
Oucher pain scale
a pain scale in which a pt rates their pain on two seperate scales; a 0-100 scale for older children and a 6-picture photographic scale on the right for younger children
concomitant symptoms
symtoms that occur with pain and usually increase pain intensity
types of concomitant symptoms
nausea, headache, dizziness, urge to urinate, constipation, depression, and restlessness
task-oriented touching
touch that occurs as a nurse performs a task for a patient, such as taking BP or assisting in ambulation
caring touch
touch that occurs as a nurse shows care, such as holding a patient’s hand during a procedure
distraction
reducing a patient’s awareness of pain by directing their attention to something else
progressive relaxation
a pain-distracting technique that uses a combination of controlled breathing exercises and a series of contractions and relaxation of muscle groups
what are the three types of analgesics
nonopioid, opioid, and adjuvants
NSAID stands for . . .
nonsteroidal antiinflammatory drug
examples of nonopioid analgesics
acetaminophen, aspirin, and NSAIDs
how do NSAIDs work
by inhibiting the synthesis of prostaglandins
how do opioids work
by binding to receptor sites in the nervous system
examples of opioid analgesics
codeine, morphine, fentanyl, oxycodone, Darvon, Dilaudid
example of NSAID
Toradol
ATC stands for . . .
around the clock
opioid dependence
the appearance of symptoms of withdrawal when the opioid is reduced abruptly or reversed with an opioid antagonist
opioid addiction
psychological dependence on an opioid
cross-tolerance
the development of tolerance to the therapeutic and adverse effects of pharmacologically related drugs
PCA stands for . . .
patient-controlled analgesia
patient-controlled analgesia
a drug-delivery system that allows patients to administer pain medications when they want them, without repeated injections
epidural analgesia
a form of local anesthesia for the treatment of postoperative, traumatic, chronic noncancer, and cancer pain`
rescue dose
an additional bolus dose of pain medication to combat flares of cancer-related pain
pain modulation
hindering the transmission of pain by release of inhibitory neurotransmitters that produce an analgesic effect
what is the most common type of pain
nociceptive pain