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noxious stimuli that are transmitted from the point of cellular injury over peripheral sensory nerves to pathways between the spinal cord and thalamus, and eventually from the thalamus to the cerebral cortex of the brain.
nociceptive pain is subdivided into
- somatic pain
- visceral pain
caused by mechanical, chemical, thermal, or electrical injuries or disorders affecting bones, joints, muscles, skin, or other structures composed of connective tissue.
pain caused by an insect bit or paper cut, is perceived as sharp or burning discomfort
- superficial somatic pain
- cutaneous pain
pain caused by trauma
deeper somatic pain
pain that arises from internal organs such as the heart, kidneys, and intestine that are diseased or injured.
visceral pain includes:
- compression of an organ
- intestinal distention with gas
- or contraction
term used to describe discomfort that is perceived in a general area of the body
pain that is processed abnormally by the nervous system. It results from damage to either the pain pathways in peripheral nerves or pain processing centers in the brain.
this pain occurs when drugs or radiation used to treat the cancerous tumor caused nerve damage
pain that is discomfort that has a short duration. It is associated with tissue trauma.
pain discomfort that last longer than 6 months.
chronic pain sufferers may have periods of acute pain, which is referred to as
the transmission of pain takes place in four phases:
is the conversion of chemical information in the cellular environment to electrical impulses that move toward the spinal cord, release various chemical mediators.
the chemicals that are released by the damaged cells stimulate specialized pain receptors located in the free nerve endings of peripheral sensory nerves called
is the phase during which peripheral nerve fivers form synapses with neurons int he spinal cord. The pain impulses move from the spinal cord to sequentially higher levels in the brain. The impulses ascend to the reticular activating system, the limbic system, the thalamus, and finally the cerebral cortex.
refers to the phase of impulse transmission during which the brain experiences pain at the conscious level. Brain structures in the pain pathway.
perception, the conscious experience of discomfort occurs when the pain threshold is reached. The ____ is the point at which the pain-transmitting neurochemicals reach the brain, causing conscious awareness.
a lowered pain threshold, may occur when excitatory neuro-transmitters such as glutamate sensitize the spinal cord to nociceptive input. In other words, the pain signals become amplified.
is the amount of pain a person endures once the threshold has been reached.
is the last phase of pain impulse transmission, painful sensation is reduced with the release of pain-inhibiting neurochemicals such as endogenous opioids.
a nurse expert on pain states, "Pain is whatever the person says it is, and exists whenever the person says it does."
an exaggerated pain response due to increased sensitivity to stimuli such as air currents, pressure of clothing, vibration
A pain assessment includes the client's description of its
refers to the technique used to prevent, reduce, or relieve pain.
pain associated with cancer may include
- nerve blocks
- analgesics administered intrathecally
- electrical stimulation in the spinal cord
- neurosurgical analgesic technique
analgesic drugs are administered by
when changes from a parenteral to an oral route, it is best to administer an ____, and oral dose that provides the same level of pain relief as when the drug is given by a parenteral route.
allows clients to self-administer their own narcotic analgesic by means of an intravenous pump system
patien-controlled analgesia (PCA)
a narcotic or local anesthetic is infused into the subarachnoid or epidural space of the spinal cord through catheter inserted by a physician. Relieves pain with minimal systemic drug affects.
refers to a repetitive pattern of drug seeking and drug use to satisfy a craving for a drug's min-altering or mood-altering effects.
is a condition in which a client needs increasingly larger doses of a drug to achieve the same effect as when the drug was first administered.
means that a person experiences physical discomfort, known as withdrawal symptoms, when a drug that he or she has taken routinely for some time is abruptly discontinued.
are medications that are ordinarily administered for reasons other than treating pain. When ____ are combined with opioid and nonopioid analgesics.
are natural morphine-like substances inthe boyd and modulate pain transmission by blocking receptors for substance.
is a pain management technique that delivers bursts of electricity to the skin and underlying nerves. It is safe for managing acute or chronic pain.
transcutaneous electrical stimulation (TENS)
a form of electroacupuncture. It combines the use of acupuncture needles with TENS.
percutaneous electrical nerve stimulation (PENS)
PENS therapy is administered for 30 mins three times a week for a total of 3 weeks. The technique has been successful in research trails on clients with
- low back pain
- pain caused by the spread of cancer to bones
- neuropathic pain
- migraine headaches
pain that does not respond to analgesic medications. Neurosurgical procedures that provide pain relief include rhizotomy and cordotomy.
a surgical procedure on the spine that involves a laminetomy followed by sectioning of the posterior (sensory) nerve root, resulting in the permanent loss of sensation, usually reserved for terminall ill clients.
is an interruption of pain pathways in the spinal cord. It carries less risk and usually is better tolerated by terminally ill clients.