Pain 10
Wha is inflammatory pain?
- a subtype of nociceptive pain that results from the release of pro inflammatory cytokines at the site of tissue injury. - present in acute pain (bruises or infection) and chronic pain (rheumatoid arthritis)
What are coanalgesics?
- antidepressants - anticonvulsant - sodium channel blocked - NDMA receptor antagonists - Antispasmodic skeletal muscle relaxants -anti-spastic agent
What is visceral pain?
arises from visceral organs, such as the GI tract and bladder: well or poorly localized bowel obstruction, gallbladder pain, appendix
What is cancer-related pain?
- Pain associated with malignancy that can result from the disease itself of damage to secondary tissue - Pain secondary to direct tumor involvement of bone, nerves, viscera, or soft tissue
What is chronic pain?
- Pain continues for 6 months or longer despite efforts to diagnosis and treat original condition/injury - Peripheral and central sensitization of pathways occurs
What are the medications used for pain management?
- nonopiod analgesics - acetaminophen - non steroidal anti-inflammatory drus - opioids - morphine and congeners; fentanyl and congeners - dual- mechanics analgesics - opioid antagonist- naloxone
What is breakthrough pain?
- transient, moderate to severe pain that occurs in patients whose pain is otherwise well controlled - true this type of pain is characterized as brief, lasting minutes to hours, and can interfere with ADLs
Neuropathic central pain is best described as: A. diabetic feet B. Migraine headache C. Bone pain D. GI pain
B. Migraine headache
Patient complains fo pain from a migraine. How would the practitioner classify this type of pain? A. Central neuropathic pain B. Peripheral neuropathic pain C. Inflammatory Pain D. Somatic nociceptive pain
A. Central neuropathic pain
Osteoarthritis is most effectively treated with the following: A. Demerol 5 mg IM B. Tylenol 650 mg PO C. Morphine 2 mg IV D. Gabapentin 300 mg po
B. Tylenol 650 mg PO
Ms. Smith reports her pain is 5 on a scale of 1 to 10. The most appropriate initial medication to treat her pain is? A. Tylenol 650 mg PO B. Naloxone 0.2mg IV C. Toradol 30 mg IM D. Morphine 2 mg IV
C. Toradol 30 mg IM moderate pain go for IM
Mr. James reports his pain is 2 on a scale of 1 to 10. the most appropriate medication to initially treat his pain is? A. morphine 2 mg iv B. Demerol 50 mg IM C. Tylenol 650 mg PO D. Naloxone 0.2 mg IV
C. Tylenol 650 mg PO
Acute inflammatory pain is best described as? A, Migraine headache b. arthritis c. wound pain d. diabetic feet
C. Wound Pain
Mrs. Horner reports her pain is 10 on a scale of 1 to 10. The most appropriate initial medication to treat her pain is? A. Tylenol 650 mg po B. gabapentin 300 mg C. morphine 2 mg IV D. Naloxone 0.2 mg IV
C. morphine 2 mg IV use opioid for severe pain
Diabetic neuropathy pain is best treat by? A. Tylenol 650 B. Toradol 30 mg IM C. Morphine 2 mg IV D. Gabapentin 300 mg PO
D. Gabapentin 300 mg PO
Mrs. Holcomb has neuropathic pain. The APRN prescribes medication based on which of the following? A. morphine is recommended for neuropathic pain B. Analgesics that block nociceptive receptors are recommended for neuropathic pain D. medications that increase concentration of GABA are recommended for neuropathic pain
D. medications that increase concentration of GABA are recommended for neuropathic pain
A practitioner conducting a pain assessment asks the patient "is the pain consistent or intermittent?" What character of pain is the practicer assessing? A. quality b. region C. severity D. temporal pattern
D. temporal pattern
Nociceptive visceral pain is most effectively treated with the following? A. tylenol 650 mg q 6 hours b. naloxone 0.2 mg IV now C. dilaudid 1 mg IV now D. torodol IV
Dilaudid 1 mg
What is the best choice for cancer pains?
Long acting narcotics
What is the recommended order of pain treatment for pain ranked: 1-3/ mild?
NSAID/APA
What is the recommended order of pain treatment for pain ranked: 8-10/ Severe?
NSAID/APA if suspected inflammatory component, usually opioids, co-analgesics
What is the recommended order of pain treatment for pain ranked: 4-7/ moderate?
NSAID/APA, usually opioids, co-analgesics
What are common side effects of opioids?
Respiratory depression, constipation, miosis, hypotension, and bradycardia, itching, nausea and vomitng, sedation
Nociceptive somatic pain is most frequently found in?
bone
What is nociceptive pain?
a result of a nerve receptor stimulation following a mechanical, thermal, or chemical insult
What is pain?
an unpleasant sensory and emotional experience associated with actual or potential tissue damage, od described in terms of such damage. subjective and its intensity varies from patient to patient and form day to day
What is the treatment of choice for inflammatory pain?
anti-inflammatory
What is the only way to treat nociceptor pain?
block the receptors
What is the choice of treatment for visceral pain?
fentanyl, morphine schedule 2 narcotic
What is the choice treatment for neuropathic pain?
gabapentin can prescribe starting at 300mg twice a day
What is the best treatment for somatic pain?
morphine or fentanyl must hit opioids receptors in brain
What is somatic pain?
originating from muscle, bone, joints, tendons, or blood vessels and is often well localized tore ligaments, rupture tendons. bone cancer/fractures, severe burns
What is the most reliable indicator of pain?
self reporting
What is acute pain?
sudden onset, usually subsides once treated, characterized by sharp, localize sensations with identifiable cause, can point right to it
What is neuropathic pain?
pain that arises from abnormal or damaged pain nerves [e.g., phantom limb pain, pain below the level of a spinal cord injury, diabetic neuropathy]; This is not the nerve receptor - usually intense, shooting, burning, or "pins and needles" - peripheral pain: diabetes, neuropathies, shingles. - Central: pain from multiple sclerosis, spinal cord injuries, migraine and post stroke syndrome
What is chronic non cancer pain?
persistent pain seen in patients no affected by cancer, examples are osteoarthritis and fibromyalgia.
