chapter 36 comfort and pain management

Pasero Opioid-Induced Sedation Scale

1 = awake and alert; no action necessary 2 = occasionally drowsy but easy to arouse; requires no action 3 = frequently drowsy and drifts off to sleep during conversation; decrease the opioid dose 4 = somnolent with minimal or no response to stimuli; discontinue the opioid and consider use of naloxone.

TENS machine

A method of pain relief which uses electrical impulses delivered by a small pack to distract from labour pains

Dopamine

A neurotransmitter associated with movement, attention and learning and the brain's pleasure and reward system.

Seratonin

Affects mood, hunger, sleep, and arousal

What will the nurse place at the bedside of a client receiving epidural analgesia?

Ampule of 0.4 mg naloxone this medication reverses the respiratory depressing effects of opioids when needed and should be readily available

A client with chronic pain uses a machine to monitor his physiologic responses to pain. The unit transforms the data into a visual display and through seeing the pain responses, the client is taught to regulate his physiologic response and control pain through relaxation, imagery, or breathing exercises. This technique for pain control is known as:

Biofeedback is a technique that uses a machine to monitor physiologic responses through electrode sensors on the client's skin. The unit transforms the data into a visual display, and through seeing the pain responses, the client is taught to regulate his physiologic response and control pain through relaxation, imagery, or breathing exercises.

cutaneous pain

Cutaneous stimulation techniques include acupressure, massage, application of heat and cold, and transcutaneous electrical nerve stimulation (TENS).

diffuse pain

Diffuse pain is pain that covers a large area and, usually, the client is unable to point to a specific area without moving the hand over a large surface, such as the client's entire torso

A client is experiencing acute pain following the amputation of a limb. What nursing interventions would be most appropriate when treating this client?

Encourage the use of nonpharmacologic complementary therapies as adjuncts to the medical regimen

A client reports after a back massage that his lower back pain has decreased from 8 to 3 on the pain scale. Which opioid neuromodulator does the nurse know is released with skin stimulation and is more than likely responsible for this increased level of comfort?

Endorphins

Epidural analgesi

Epidural analgesia is being used more commonly to provide pain relief during the immediate postoperative phase and for chronic pain situations.

Endorphins

It is thought that certain measures, such as skin stimulation and relaxation techniques, release endorphins

The nurse recognizes which statement is true of chronic pain

It may cause depression in clients

somatic pain

Pain that originates from skeletal muscles, ligaments, or joints.

Transmission phase of pain

Stage in which stimuli move from the peripheral nervous system to the brain

A client has been admitted to a post-surgical unit with a patient-controlled analgesia (PCA) system. Which statement is true of this medication delivery system

The dose that is delivered when the client activates the machine is preset.

You are a new nurse in an ambulatory care setting. You know that the Joint Commission requires that pain be addressed at each visit. When is the most appropriate time to do so?

When obtaining client vital signs

Modulation phase of pain

he last phase of pain impulse transmission, during which the brain interacts with the spinal nerves to alter the pain experience.

How should the nurse position the head of the bed for a client receiving epidural opioids

he nurse should position the head of the bed so that it is elevated 30 degrees unless contraindicated. Elevation of the client's head minimizes upward migration of the opioid in the spinal cord, thereby decreasing the risk for respiratory depression

neuropathic pain

is experienced days, weeks, or even months after the source of the pain has been treated and resolved

Opioids and opiates can cause?

nausea , sedation and constipation

A client reports severe pain following a mastectomy. The nurse would expect to administer what type of pain medication to this client?

opiod analgestics

visceral pain

pain originating in the internal organs in the thorax, cranium, or abdomen

Perception phase of pain

the point at which a person is aware of pain

Transduction phase of pain

which is the first phase of pain in which injured cells release chemicals such as prostaglandins, bradykinin, histamine, and glutamate.