NMNC 4310 - EXAM 1

Nursing considerations for heat therapy in pain management?

- CONTRA - area tx c radiation, bleeding, decreased sensation, injured within last 24H - don't use c menthol-containing products (EX) Ben-Gay, Vicks, Icy Hot - cover heat source w towel/cloth before applying to skin

How do you care for pt c Bells Palsy?

- NSAIDs - antiviral - 6mos-yr to recover - oral & eye care

How does a fractured hip present?

- hip pain - leg shortened - externally rotated

special considerations for chronic pain management?

- nonpharmacologic therapy preferred - nonopioid therapy preferred - before starting opioids, establish realistic tx goals for pain + fxn - discuss risks & realistic benefits of opioid therapy - assess frequently for opioid-related risks (overdose, withdrawal syndrome, opioid use disorder)

compression fracture

- occurs when the bone is pressed together (compressed) on itself - crushed fragments

how do you get a spinal cord pt ready to go home?

- rehab - strength building exercise - I&O - nutrition - rf infxn - lung (pneumonia) & kidneys (UTI) - mobility adjuncts - mental health - family support

Which client assessment finding would the nurse document as subjective data? 1 Blood pressure 120/82 2 Pain rating of 5 3 Potassium 4.0 mEg 4 Pulse oximetry reading of 96%

2 Pain rating of 5

Which of the following is the priority nursing diagnosis for a patient diagnosed with a spinal cord injury? 1. Fluid Volume Deficit 2. Impaired Physical Mobility 3. Ineffective Airway Clearance 4. Altered Tissue Perfusion

3. Ineffective Airway Clearance

A patient with a femur fracture presents with SOB and petechiae on the face, the nurse should be concerned for A) DVT B) Fat embolism C) PE D) Stroke

B) Fat embolism

When teaching cast care, the nurse instructs the client to: A) Blow dry the wet cast with a hair drier B) Report changes in sensation or mobility to the area C) Use only soft objects to slide down the cast for scratching D) Cut away the edges of the cast if the skin becomes irritated

B) Report changes in sensation or mobility to the area

Which nursing interventions would the nurse avoid when providing care for a client with a fractured extremity? Keeping the client warm and dry Removing the client's shoes or boots immediately Immobilizing the affected extremity Allowing the client to lie in supine position

Removing the client's shoes or boots immediately

Pain assessment components

location intensity quality associated symptoms management strategies impact expectations breakthrough pain reassessment of pain challenges in assessment

flexion-rotation injury

may result in fracture or dislocation, tearing or shearing of cord

what is modulation in the context of pain?

neurons originating in the brainstem descend to spinal cord & release substances (EX endogenous opioids) that inhibit nociceptive impulses

how do you stabilize the spine after injury?

non-operative - halo traction, collars, clamshell braces TLSO, spinal board, log roll, assess sensation operative - pins, rods, plates

A pediatric client with a past history of chicken pox reports a fever and headache. Which medication would the nurse avoid giving to the client? 1 Aspirin 2 Tetracycline 3 Nalidixic acid 4 Chloramphenicol

1 Aspirin

what is nociceptive pain?

normal processing of stimulus that damages normal tissue or has the potential to do so if prolonged tx - nonpioid + opioid (EX) superficial somatic pain, deep somatic pain, visceral pain

C1-3 spinal nerve function

cough - pt w injury will have apnea & no cough

Pain - interrelated concepts

culture development functional ability mobility tissue integrity fatigue sleep mood + affect spirituality

what are some hip fracture post op complications?

pneumonia skin breakdown muscle wasting bone demineralization

what should you include in pt ed for hip fracture prevention? post op?

prevention - osteoporosis - weight-bearing exercise - home safety evaluation - don't smoke - eat well (calcium + vitamin D) - fluids - prevent kidney stones post op - mobility - safety - raise toilet 90° - don't bend past 90°

Wong-Baker FACES scale

scale c drawings/pictures clinicians use to assess pain in cognitively impaired client

be correct. Which would the nurse include in the client's medication teaching on the administration of aspirin 650 mg every 6 hours as needed for arthritic pain? SATA 1 "Report persistent abdominal pain. 2 "Do not chew enteric-coated tablets." 3 "Take the aspirin with meals or a snack. 4 "See a dentist if bleeding gums develop." 5 "Switch to acetaminophen if tinnitus occurs."

1 "Report persistent abdominal pain. 2 "Do not chew enteric-coated tablets." 3 "Take the aspirin with meals or a snack.

The nurse is preparing a teaching plan for a patient who is being discharged following a total hip replacement. The nurse would include which part of the following content as a part of the teaching plan? Select all that apply A. Avoid low, cushioned chairs B. Use a device that raises toilet seat C. Avoid bending greater than 90 degrees D. Turn at the waist to reach objects E. Do not cross the legs

A. Avoid low, cushioned chairs B. Use a device that raises toilet seat C. Avoid bending greater than 90 degrees E. Do not cross the legs

What are the of the characteristics of Acute Pain? SATA A. Has a protective effect B. Lasts more than 3 to 6 months C. Usually has identifiable cause D. Dramatically affects quality of life E. Viewed as a disease F. Eventually resolves with or without treatment

A. Has a protective effect C. Usually has identifiable cause F. Eventually resolves with or without treatment

what is neuropathic pain?

Abnormal processing of sensory input by PNS/CNS tx - adjuvant analgesics (EX) central pain (dysfunction of CNS), peripheral neuropathies, deafferentation pain (loss/altered input - phantom limb pain, spinal cord injury pain), sympathetically maintained pain (secondary to ANS dysfunction - phantom limb pain, complex regional pain syndrome)

hyperextension injury

spine extended too far forward anteriorly

what is included in primary prevention for spinal cord injuries?

sports & outdoors education safety equipment

When giving discharge instructions for cast care the nurse includes: A) keep the arm hanging down to improve circulation B) use a coat hanger to itch in the cast C) use a hair drier to help dry it after it has got wet. D) Keep the hand at the level of the heart

D) Keep the hand at the level of the heart

An expected outcome of cast application that the nurse evaluates is: A) Skin irritation at the cast edges B) Decreased cap refill C) Tingling and numbness distal to the cast D) Slight edema, soreness, and limitation of range of motion

D) Slight edema, soreness, and limitation of range of motion

A patient complains of tingling and numbness in his right leg following application of a long leg cast. The patient's discomfort is most likely the result of: A. Reduced venous return B. Bone healing C. Arterial insufficiency D. Nerve compression

D. Nerve compression

flexion injury

Forward dislocation Ruptured posterior ligaments

T5 spinal nerve function

GI motility

Which assessment findings alert the nurse that the client who has a spinal cord injury is developing autonomic hyperreflexia (autonomic dysreflexia)? Hypertension and bradycardia Flaccid paralysis and numbness Absence of sweating and pyrexia Escalating tachycardia and shock

Hypertension and bradycardia

The nurse finds the client on the floor, crying for help, with signs of a hip fracture. Which action would the nurse take first? Administer pain medication. Place the affected extremity in traction. Immobilize the affected extremity. Notify the primary health care provider on call.

Immobilize the affected extremity

The nurse is providing care to a client. Which nursing action has the highest priority when the nurse is moving a client with a neck and spinal cord injury during the assessment process? Removing the cervical spine collar Monitoring for autonomic dysreflexia Implementing the logrolling technique Administering the prescribed pain medication

Implementing the logrolling technique

Which item in the plan of care for a client with paraplegia would the nurse question? Change the client's bed position hourly. Use supportive devices to maintain body alignment. Instruct the client to do active leg exercises. Perform passive leg exercises several times daily.

Instruct the client to do active leg exercises.

A nurse believes that patients with the same type of tissue injury should have the same amount of pain. This statement reflects a. a belief that will contribute to appropriate pain management. b. an accurate statement about pain mechanisms and expected goals of pain therapy. c. a belief that will not have any effect on the type of care provided to people in pain. d. a lack of knowledge about pain mechanisms, which is likely to contribute to poor pain management.

d. a lack of knowledge about pain mechanisms, which is likely to contribute to poor pain management.

What is included in the diagnosis & care for mobility issues r/t neurological fxn?

diagnosis - genetics, MRI, lumber puncture, muscle biopsy, blood, often a diagnosis of exception tx - symptom control (steroids), comfort measures (pain meds), meds per diagnosis nursing care - muscle weakness, safety, skin integrity, airway, breathing, mental health, often incurable

C4 spinal nerve function

diaphragm - pt w injury can't breathe

psychosocial consequences of pain

fear anger depression anxiety reduced ability to maintain relationships, engage in activities/work r/f substance abuse & addiction

What is halo traction?

immobilizes cervical spine when a cervical fracture occurs

populations at risk for pain

infants + children older adults sex - women race / ethnicity

Nursing considerations for cold therapy in pain management?

- CONTRA - areas tx c radiation, open wounds, poor circulation - cover cold source w cloth/towel before applying to skin - may apply cold above/below painful site or opposite side of body on corresponding site

what is included in post op hip fracture care?

- VS - wound monitoring - abduction pillow - prevents hip rotation - IS - over bed trapeze - watch elbows for skin breakdown (they use them to scooch up in bed)

How do you care for pt c botulism?

- botulinum antitoxin - abx - may req vent - supportive care - nutrition - skin integrity

how do you tx pt w autonomic dysreflexia?

- check clothing/sheets, toenails + soles of feet - sit pt up to lower BP and give you time before veins are damaged - check BP Q5min - ensure good bowel + bladder care - reduce stem when giving enemas - med alert bracelet if previous event

what is a partial cord transection?

- cord isn't completely there may still be some retained sensory-motor function - Hx of injury - stabbing, GSW (gunshot wound) - changes in sensation - improving/deteriorating - movement crosses over and goes to brain, sensation goes directly to brain - (EX) central cord, anterior cord, posterior cord, brown sequard

what is included in secondary prevention for spinal cord injuries?

- deep breathing - PT / OT - mobility - stabilize - if in doubt immobilize - DVT prophylaxis - VS - pain meds - AD prevention - skin integrity

spinal cord injuries

- fix orthopedic issues through surgery spinal cord - no transmission of stimuli to brain - no "ouch" - no transmission of stimuli to muscle - no movement

What is spinal shock?

- lack of sympathetic nerve response (higher up = more problems) - HoTN - bradycardia - temp dysreg - once spinal shock is fixed, it doesn't return - can take wks - physiological reaction to depression of cord below the SCI level - loss of sensorimotor function & flaccid paralysis

What is the most worrisome level of sedation of the POSS scale?

- level 4 - somnolent, minimal/no response to verbal/physical stimulation unacceptable! stop opioid! consider administering naloxone, notify HCP/anesthesiologist, monitor respiratory status & sedation level closely until sedation level is stable

what is autonomic dysreflexia?

- life-threatening emergency in T6 or higher spinal cord injury patients that causes a hypertensive emergency - occurs any time AFTER spinal shock has resolved - S/S - headache, diaphoresis, nausea, nasal congestion, bradycardia

how does skeletal (pins) traction work?

- long term traction - if pt is not an anesthesia candidate (age, comorbidities, renal/liver) - can be wks-mos - reduces muscle spasm - reduces pain & tissue damage

What is botulism?

- nerve paralysis due to toxin buildup - toxin blocks release of acetylcholine in synapse - food poisoning - blood in stool/vomit - giving children honey

what are some surgical procedures for hip fracture repair?

- open reduction procedures - anesthesia required (open = cut open) - pins & plates - hip replacement - rehab, hip joint deterioration, PT/OT

how does Buck's (skin) traction work?

- pulls bone - applies tension to reduce muscle spasm & assists in realigning bones - tape applied to skin up to knee - weights pull leg & apply tension to hip + femur - reduced muscle spasm - reduced pain & trauma to surrounding tissue - skin care & keep it swinging

how do you assess the effectiveness of pain management?

- self-report - achievement of pain management goals - activity level - assessing for ad fx - sedation level, ventilation (capnography, mental status, respiration rate + depth)

What is Brown-Sequard syndrome?

- side of lesion - hypertonic paralysis, spastic paralysis & loss of vibration & proprioception (position sense) & fine touch - opposite side - loss of pain & temp sensation - image to half cord - often penetrating injury - Tx symptoms - depends on level, supportive care, rehab

what are some risks with skeletal traction?

- skin breakdown - pin infxn - muscle wasting r/t immobility - lengthy recovery if at all - bone demineralization

What is Bell's palsy?

- unknown cause - maybe viral? - Ipsilateral facial paralysis w inability to close affected eye - acute onset over 1-2 days, progressively worsening weakness over 3 weeks, recovery in 6 months - dx - CT & MRI (mostly to rule out other conditions) - Unilateral facial nerve paralysis - Hyperacusis (paralyzed stapedius muscle) - differentiated from stroke bc BP only affects face

After surgery, a child experiences intense pain and an analgesic is prescribed. Which would the nurse consider when administering the analgesic? 1 Even though children do not like medicine, analgesics will make them more comfortable. 2 Pain is not felt as strongly by children as by adults; therefore analgesics are not needed as frequently. 3 Children should rarely receive analgesics because they could cause addiction or respiratory depression. 4 Children do not need analgesics because they quickly return to playing or sleeping when they are distracted.

1 Even though children do not like medicine, analgesics will make them more comfortable.

Which rational supports administering the medication pregabalin to a client with acquired immunodeficiency syndrome (AIDS)? 1 To reduce neuropathic pain 2 To reduce cognitive difficulty 3 To reduce swallowing difficulty 4 To reduce muscle and joint paln

1 To reduce neuropathic pain

A patient with a spinal cord injury at the T1 level complains of a severe headache and an "anxious feeling." Which is the most appropriate initial reaction by the nurse? 1. Try to calm the patient and make the environment soothing. 2. Assess for a full bladder. 3. Notify the healthcare provider. 4. Prepare the patient for diagnostic radiography.

2. Assess for a full bladder.

Which of the following signs or symptoms in a patient who is opioid-naïve is of greatest concern to the nurse when assessing the patient 1 hour after administering an opioid? 1. Oxygen saturation of 95% 2. Difficulty arousing the patient 3. Respiratory rate of 12 breaths/min 4. Pain intensity rating of 5 on a scale of 0 to 10

2. Difficulty arousing the patient

A new medical resident writes an order for oxycodone CR 10 mg PO q2h prn. Which part of the order does the nurse question? 1. The drug 2. The time interval 3. The dose 4. The route

2. The time interval

A patient with a spinal cord injury (SCI) is admitted to the unit and placed in traction. Which of the following actions is the nurse responsible for when caring for this patient?Select all that apply. 1. modifying the traction weights as needed 2. assessing the patient's skin integrity 3. applying the traction upon admission 4. administering pain medication 5. providing passive range of motion

2. assessing the patient's skin integrity 4. administering pain medication 5. providing passive range of motion

The patient is admitted with injuries that were sustained in a fall. During the nurse's first assessment upon admission, the findings are: blood pressure 90/60 (as compared to 136/66 in the emergency department), flaccid paralysis on the right, absent bowel sounds, zero urine output, and palpation of a distended bladder. These signs are consistent with which of the following? 1. paralysis 2. spinal shock 3. high cervical injury 4. temporary hypovolemia

2. spinal shock

Which instruction would the nurse provide to an older client using ice-and heat to treat pain from back strain? Select all that apply. One, some, or all responses may be correct. 1 Switch positions every 4 hours. 2 Use a heating pad for the first 24 hours. 3 Apply for 30-minute time intervals. 4 Place the ice pack directly to injury site. 5 Take ibuprofen every 4 hours PAN.

3 Apply for 30-minute time intervals.

A client who just returned from a cardiac catheterization reports to the nurse that the pressure bandage on the right groin is tight. Which action would the nurse take? 1 Loosen the dressing slightly. 2 Notify the primary health care provider. 3 Assess the circulatory status of the extremity. 4 Have the client flex the joints of the right leg.

3 Assess the circulatory status of the extremity.

While caring for the patient with spinal cord injury (SCI), the nurse elevates the head of the bed, removes compression stockings, and continues to assess vital signs every two to three minutes while searching for the cause in order to prevent loss of consciousness or death. By practicing these interventions, the nurse is avoiding the most dangerous complication of autonomic dysreflexia, which is which of the following? 1. hypoxia 2. bradycardia 3. elevated blood pressure 4. tachycardia

3. elevated blood pressure

The nurse educates the nursing student on measures to reduce vaccine-related pain in children. Which statement by the student indicates a need for further teaching? 1 "I should use a microneedle." 2 "I should apply topical anesthetics." 3 "I should provide tactile stimulation." 4 "I should give antipyretics to the child.

4 "I should give antipyretics to the child.

A client who has a ureteral calculus is admitted to the hospital with severe flank pain, nausea, and hematuria. Which intervention would the nurse implement first? 1 Strain all urine output 2 Increase oral fluid intake 3 Obtain a urine specimen for culture 4 Administer a prescribed analgesic

4 Administer a prescribed analgesic

The nurse reviews a patient's medical administration record (MAR) and finds that the patient has received oxycodone/acetaminophen (5/325), two tablets PO every 3 hours for the past 3 days. What concerns the nurse the most? 1. The patient's level of pain 2. The potential for addiction 3. The amount of daily acetaminophen 4. The risk for gastrointestinal bleeding

4. The risk for gastrointestinal bleeding

During an 8-hour shift, a client has a 6-oz (180-mL) cup of tea and 360 mL of water. The client vomits 100 mL, and the instilled intravenous (IV) fluids equaled the urinary output. What is this client's fluid balance at the end of this 8-hour period that the nurse must document on the client's intake and output record? 240 mL -340 mL 440 mL 540 mL

440 mL

Which complication would the nurse monitor for in a client on strict bed rest for 3 days? Select all that apply. Atelectasis Hypotension Constipation Pressure injuries Urinary tract infection

Atelectasis

The nurse is caring for a patient treated with IV fluid therapy for severe vomiting. As the patient recovers and begins to tolerate oral intake, which food choice does the nurse understand would be most appropriate? А. Теа B. Dry Toast C. Plain Hamburger D. Hot Coffee

B. Dry Toast

What are the characteristics of chronic pain? SATA A. Has a protective effect B. Lasts more than 3 to 6 months C. Usually has identifiable cause D. Dramatically affects quality of life E. Viewed as a disease F. Eventually resolves with or without treatment

B. Lasts more than 3 to 6 months D. Dramatically affects quality of life E. Viewed as a disease

While in Buck's extension traction, the client may be positioned: A) On the back, with the knees flexed 45 degrees B) On the back, with the buttocks slightly elevated off the bed C) On the back, turning to the unaffected side for 10- to 15-minute periods D) On the back, with the bed tilted toward the side that is opposite the traction

C) On the back, turning to the unaffected side for 10- to 15-minute periods

Your patient is post operative SCFE (Slipped epiphyseal head). The patient develops a fever on day 3. The wound is red and draining. The nurses priority concerned should be for: A) Wound infection B) Growth deficit on that leg C) Osteomyelitis D) The other leg also being impaired

C) Osteomyelitis

A client with a history of spinal cord injury (SCI) reports a severe headache and blurred vision. Upon assessment, the nurse notes the following: hypertension, bradycardia, and a flushed face. Which intervention should the nurse implement first? A. Apply compression stockings B. Lower the head of the bed C. Empty the client's bladder D. Increase the IV flow rate

C. Empty the client's bladder

A 9-year-old child has a fractured tibia, and a full leg cast is applied. Which assessment findings would the nurse immediately report to the health care provider? Select all that apply. Increased urine output Inability to move the toes Pedal pulse of 90 beats per minute Tingling sensation in the foot Fiberglass cast that is damp after 4 hours

Inability to move the toes Tingling sensation in the foot Fiberglass cast that is damp after 4 hours

what are examples of neurological mobility issues?

Multiple sclerosis - caused by immune response, blurred/double vision Amyotrophic lateral sclerosis - inherited, fine motor skills

Which intervention would the nurse perform first to manage the condition of a client with autonomic dysreflexia? Cover the client with blanket. Place the client in a sitting position. Assess the client's urinary retention. Administer alpha blockers to the client.

Place the client in a sitting position.

For a client with a fractured femur, a nurse is alert to the possibility of a fat embolus. The nurse specifically watches for: Bradypnea Restlessness Bradycardia Hypertension

Restlessness

How do you treat spine injury?

Stabilize Hx - ID mecahnism of injury, baseline sensation & changes, VS ABC's - oxygen Meds - antiemetics, pain meds, steroids DVT prophylaxis

A client has an open reduction and internal fixation (ORIF) of a fractured hip. The nurse monitors this client for signs and symptoms of a fat embolism. Which client assessment finding reflects this complication? Fever and chest pain Positive Homans sign Loss of sensation in the operative leg Tachycardia and petechiae over the chest

Tachycardia and petechiae over the chest

what is transmission in the context of pain?

axn potential continues from - injured site -> spinal cord - spinal cord -> brainstem & thalamus - thalamus -> cortex for processing

Which words are most likely to be used to describe neuropathic pain (select all that apply)? a. Dull b. Itching c. Burning d. Shooting e. Shock-like

b. Itching c. Burning d. Shooting e. Shock-like

Pain is best described as a. a creation of a person's imagination. b. an unpleasant, subjective experience. c. a maladaptive response to a stimulus. d. a neurologic event resulting from activation of nociceptors.

b. an unpleasant, subjective experience.

Appropriate nonopioid analgesics for mild pain include (select all that apply) a. oxycodone. b. ibuprofen (Advil). c. lorazepam (Ativan). d. acetaminophen (Tylenol). e. codeine with acetaminophen (Tylenol #3).

b. ibuprofen (Advil). d. acetaminophen (Tylenol).

An example of distraction to provide pain relief is a. TENS. b. music. c. exercise. d. biofeedback.

b. music.

An important nursing responsibility related to pain is to a. leave the patient alone to rest. b. help the patient appear to not be in pain. c. believe what the patient says about the pain. d. assume responsibility for eliminating the patient's pain.

c. believe what the patient says about the pain.

A cancer patient who reports ongoing, constant moderate pain with short periods of severe pain during dressing changes is a. probably exaggerating his pain. b. in need of a referral for surgical treatment of his pain. c. best treated by receiving a long-acting and a short-acting opioid. d. best treated by regularly scheduled short-acting opioids plus acetaminophen.

c. best treated by receiving a long-acting and a short-acting opioid.

A nurse is caring for a client with a spinal cord injury who reports a severe headache and is sweating profusely. vital signs include BP 220/110, apical heart rate of 54/min. Which of the following actions should the nurse take first? a. notify the provider b. sit the client upright in bed c. check the client's urinary catheter for blockage d. administer antihypertensive medication

c. check the client's urinary catheter for blockage

A patient is receiving a PCA infusion after surgery to repair a hip fracture. She is sleeping soundly but awakens when the nurse speaks to her in a normal tone of voice. Her respirations are 8 breaths/min. The most appropriate nursing action in this situation is to a. stop the PCA infusion. b. obtain an oxygen saturation level. c. continue to closely monitor the patient. d. administer naloxone and contact the provider.

c. continue to closely monitor the patient.

Unrelieved pain is a. not expected after major surgery. b. expected in a person with cancer. c. dangerous and can lead to many physical and psychologic complications. d. an annoying sensation, but it is not as important as other physical care needs.

c. dangerous and can lead to many physical and psychologic complications.

Giving opioids to an actively dying patient who has moderate to severe pain a. may cause addiction. b. will likely be ineffective. c. is an appropriate nursing action. d. will likely hasten the person's death.

c. is an appropriate nursing action.

T6 and above spinal nerve function

cardiac - injury will cause HoTN & bradycardia

What is cauda equina syndrome?

cauda equina - sack of nerve roots (nerves that leave the spinal cord between spaces in the bones of the spine to connect to other parts of the body) at the lower end of the spinal cord - injury causes inability to move & feel sensation in bowel + bladder

individual risk factors for pain

communication barriers cognitive impairment / developmental disability mental health conditions injury / conditions associated c pain

what is included in tertiary prevention for spinal cord injuries?

community education awareness

what is perception in the context of pain?

conscious experience of pain

What is transduction in the context of pain?

noxious stimuli cause cell damage with the release of sensitizing chemicals (EX) prostaglandins, bradykinin, serotonin, substance P, histamine these substances activate nociceptors & lead to generation of axn potential

chronic pain

pain lasting >3mos may last for years may be result of underlying pathology (EX) cancer, OA may develop from injury, illness, medical tx resultant alteration in somatosensory system (EX) peripheral, spinal, brain

How do you initially treat a fractured hip?

pain meds check distal pulses - before & after moving traction - reduces muscle spasm

what are some nonpharmacologic strategies for pain management?

physical therapies - exercise, massage, heat/cold, acupuncture, TENS cognitive therapies - distraction, relaxation breathing, guided imagery, hypnosis, art therapy, meditation, music therapy

what is SCIWORA?

spinal cord injury without radiographic abnormality - numbness, tingling, paralysis - xrays + CT normal - tx - immobilize, steroids, pain meds, symptom cntrl, use a collar

acute pain

sudden onset usually clearly linked to even injury or illness variable c individuals in intensity, frequency, duration

physiologic consequences of pain

tachycardia increased RR wt loss shock respiratory abnormalities cardiovascular abnormalities physical dysfunction

T1-L2 spinal nerve function

urinary - injured pt will have urinary issues