PAIN

how are we keeping patients safe in the hospital in regards to pain?

- fall risk - call bell - assessing respiratory function

what is the maximum amount of ibuprofen a patient can receive per day?

1800-2400 mg

what is the hospital daily limit of tylenol?

4000mg/24 hours

What is the maximum amount of ibuprofen given per dose?

800mg

Which cues reflect psychological responses to pain?

Anger Anxiety Irritability Hopelessness

Which cues reflect verbal responses to pain?

Crying Moaning Screaming

what type of pain scales are there?

FLACC scale, Wong-Baker scale, numeric scale

WHAT ORGANS ARE AFFECTED BY IBUPROFEN?!?!?

KIDNEYS AND STOMACH

What ORGAN IS AFFECTED BY TYLENOL?! ?!?!?!?

LIVER

what is ketorolac?

NSAID

Which statement provides an accurate description of pain?

Pain is subjective

Match each theory of pain to it's description Theory -sensations relay a unique sequence of signals to the brain - a mechanism in the spinal cord determines if pain signals reach the brain - the central nervous system is responsible for the pain sensation Theory of Pain - Pattern Theory - Neuromatrix Theory - Gate Control Theory

Pattern Theory - sensations relay a unique sequence of signals to the brain Gate Control Theory - a mechanism in the spinal cord determines if pain signals reach the brain Neuromatrix theory - the central nervous system is responsible for pain sensation

what are examples of idiopathic pain?

TMJ, migraine headache, fibromyalgia

what conditions is acute pain associated with?

acute injury/trauma, surgery, childbirth

what type of pain is transient with fast onset, short duration and identifiable cause?

acute pain

What are physiologic factors of pain?

age, fatigue, genes, neurologic function

What is the International Association for the Study of Pain definition of pain?

an unpleasant, subjective sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage

what type of drug is tylenol?

analgesic, antipyruetic

what types of pathologies is chronic pain associated with?

arthritis, fibromyalgia, neuropathy

How does gender affect cultural factors with pain perception?

beliefs related to gender associate acknowledgement of pain with weakness and lack of honor amongst men

what might cause idiopathic pain?

biological, psychological, physiological

what does ibuprofen increase?

bleeding risk

what type of pain is an exacerbation of pain even though background pain is controlled?

breakthrough

based on the density of nociceptors throughout the body, which condition would the nurse expect to require the MOST analgesia?

burn

What intervention would you perform if a patient has breakthrough pain?

call the physician for a breakthrough order

what can chronic pain lead to with daily life?

can lead to disability, affect quality of life

what type of pain is persistent and can affect quality of life or cause disability?

chronic pain

what is idiopathic pain?

chronic pain with no identifiable cause or pain that remains beyond healing from a medical condition or injury

what are the side effects of opioids?

constipation, dizziness/confusion, urinary retention, nausea, pruritis (itching)

what type of factor influencing pain would acknowledgment of pain as a weakness for men?

cultural

What are examples of opioids as discussed in class?

dilaudid, fentanyl, oxycodone, morphine

what describes characteristics of an individual's pain experience?

each person's pain experience is unique

Who should not touch the PCA?

family members

what is referred pain?

felt in a location of the body other than where it originated

What are cultural factors that may affect pain perception ?

gender, age, education, race, ethnicity, familial factors

which cues reflect behavioral responses to pain?

grimaces, clenched teeth

what is the nociceptor density in the skin?

highest density, extremely sensitive to pain

immune cells release which neurotransmitter during the inflammatory response?

histamine

What type of pain continues to occur after an injury has healed?

idiopathic pain

How do familial factors affect cultural aspects of pain perceptions?

in families where independence and productivity are valued, an individual experiencing pain may attempt to endure the pain rather than seek care to maintain the expected family or work role

What are the signs and symptoms of pain in a nonverbal patient?

increased respiration, grimacing, agitation

what characteristics are associated with chronic pain?

intermittent pain potentially causes disability

where are the lowest density nociceptors located?

internal organs

why would we not use tylenol in cancer patients?

it is an anti-pyruetic and can mask a fever which may be the first sign of infection

what is the nociceptor density in the joints and tissues?

lower density, less sensitive to pain

what is the nociceptor density in the internal organs?

lowest density, respond only to painful stim

How does ethnicity affect the cultural factors with pain perception?

may attempt to hide cancer pain because it is believed by some to be a punishment of sins of the past

what are nonpharmalogical modalities used for pain control?

med scales

what step of nociception does the brain release analgesic neurotransmitters or endogenous opioids?

modulation

what do we give to a patient overdosing on opioids?

narcan/naloxone

what type of pain is neuropathic?

nerves are injured or impaired

which theory of pain was based on studies of phantom limb pain in amputees and proposes that pain cannot be explained solely by physical factors?

neuromatrix theory

a patient complains of shooting pain in a leg following amputation of the leg. What type of pain is the patient experiencing?

neuropathic pain

what type of pain is psychogenic?

no physical source of pain is evident

what is psychogenic pain?

no physical source, causes an individual to be more responsive than other people to any stimulus that registers as painful

what type of pain is nociceptive?

nociceptors encounter harmful stimuli

What are the different steps of the ladder?

non opioid medications, into opioid medication

How does neuropathic pain present?

numbness, tingling, burning, aching, crushing, stabbing, shooting

what is a life threatening side effect we're looking for when administering opioids?

overdose

what are potential issues related to breakthrough pain?

overuse, misuse and abuse of opioids

you have a nonverbal patient, their assessment shows they are diaphoretic, tachycardic and have an increased respiratory rate. what is your priority to manage for this patient?

pain

when do we give patient's opioids for pain management?

pain scale 4-6, 7-10

what step of nociception does the brain interpret pain signals?

perception

which step of nociception involves translation of nerve signals?

perception

what type of factor influencing pain would the influence of genetics on pain tolerance be?

physiologic

a patient is taking prescribed sedative that affects the patient's pain perception. Which type of influencing factor reflects the patient's experience?

physiological

when is the use of ibuprofen contraindicated?

post op, kidney disease

what type of factor influencing pain would the ability to cope with pain and perceived loss of control be?

psychological

what characteristics describe acute pain?

quick onset, lasts less than three months, linked to injury or trauma

which cultural factors influence meanings and attitudes associated with pain?

race, education

what type of nociceptive pain originates from the source of pain to an adjacent area of the body?

radiating pain

a patient having a heart attack feels pain in the jaw. which type of pain is the patient experiencing?

referred

what type of nociceptive pain originates from internal organs, but is felt in other locations?

referred pain

a patient has suffered burn injuries related to a house fire and is in the burn center for pain control and dressing changes. Which function does pain serve when it is associated with a thermal injury?

response

where are the highest density nociceptors located?

skin

What type of factor influencing pain would presence of a parent to provide support for a child experiencing pain?

social

An individual's attendance at a chronic pain support group reflects which type of influencing factor?

social factor

what type of nociceptive pain originates from skin, muscles, joints and bones?

somatic pain

What are factors that contribute to a hypersensitive nervous system?

stress, anxiety, medication, lack of sleep, poor nutrition

the nurse is providing care for a patient with alzheimer disease. which factors would the nurse consider when conducting a pain assessment on a patient with a cognitive disorder?

the patient is able to experience pain the patient may not be able to express the location of pain

What describes the role played by neurotransmitters when an individual experiences pain?

the release of neurotransmitters is part of the inflammatory response

What step of nociception does injury occur and injured tissues release neurotransmitters?

transduction

which step of nociception involves recognition of a painful stimulus and conversion of the stimulus to an electrical impulse?

transduction

what step of nociception do pain impulses travel to the spinal cord and brain?

transmission

which intervention demonstrates psychological factors that influence pain?

use guided imagery

What type of nociceptive pain originates from organs within the body?

visceral pain

what are the four types of pain?

visceral, somatic, superficial, neuropathic

when would we administer narcan to a patient taking opioids?

when respirations are less than 6