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  1. Intractable Pain
    • Pain not relieved by ordinary measures.
    • Chronic.
    • Med-Surg & nursing measure does not reliev pain.
    • Psychgenic in nature.
  2. Referred Pain
    refelctive pain. Pain felt at another part of the body away from the original site.
  3. Deep/Somatic Pain
    Skin or Muscle

    • Sharp
    • Well localized
    • Aching
    • Throbbing
  4. Superficial/Cutaneous Pain
    On the skin surface
  5. Visceral Pain
    Pain in the internal organs

    • Dull
    • Crampy
    • Colicky
    • Poorly localized
  6. Phantom Pain
    Pain in a part of the body that was amputated or missing.
  7. Neuropathic Pain
    Nerve pain, up a nerve path.

    • Pins & needles
    • Numbness
    • Burning
    • Coldness
    • Shooting
  8. Gate Control Theory
    The synapses at the point of entry in the spinal cord act as a gate that closes to keep impulses from reaching the brain or open to premit impulses to ascend to the brain.

    A-fibers, thick/large, close the gate

    • C-fiber, thin/small, open the gate
  9. Activation of autonomic nervous system
    It activates, then depress somatic functions.

    The sympathetic nervous system becomes dominate.
  10. Fight or Flight
    Increased Oxygen, resp, HR, BP, Blood sugar, Muscle tension

    Decrease GI motility.

  11. Process of Adaptaion
    When pain continues, adaptation take place.

    Parasympathic is dominate.

    • Gastric functions return like nausea.
    • cane be weak and exhausted.
  12. P

    What caused it to start?
  13. Q

    In cl own words ( stabbing, pounding, cramping, sharp)
  14. R

    Where is the pain? Does it radiate?
  15. S

    Pain scale
  16. T

    When does it start and how long?
  17. Pain scale
    0 = no pain

    1-3 mild intensity ( annoying but can fx)

    4-6 Moderate (interferes with comfort & fx)

    7-10 Severe ( debilitating & affects quality of life)
  18. Non narcotics
    Acetaminophen (Tylenol) 650mg

    • NSAID's
    • asprin (ASA) 650mg
    • ibuprofen (Mortin, Advil) 400-800mg
    • naproxen (Naprosyn) 250-500mg
    • tramdol (Ultram) 50-100mg
  19. Narcotic (opioid) mild to moderate
    • codeine 30mg
    • hydrocodone (Hycodan) 10mg
    • meperidine (Demerol) 50mg
    • oxycodone (OxyIR) 5mg
    • fentanyl (Duragesic) patch
    • propoxphene 65mg
  20. Lortab 5/500
    Hydrocodone 5mg & acetaminophen 500mg
  21. Lortab ASA
    hydrocodone 5mg & ASA 500mg
  22. Percocet
    Oxycodone 5mg & acetaminophin 325mg
  23. Percodan
    oxycodone 5mg & ASA 325mg
  24. Tylenol #3
    codeine 30mg & acetaminophen 300mg
  25. Tylenol #4
    codiene 60mg & acetaminophen 300mg
  26. Tylox
    Oxycodone 5mg & actaminophen 325-500mg
  27. Vicodan
    hydrocodone 5mg & acetaminophen 325-500mg
  28. Asprin
    • antiinflammatory
    • pain relever
    • interferes with platelet function
    • Tinnitis
    • linked to Reye Syndrome
    • incease GI Upset and bleeding
    • 21 & older
  29. Acetaminophen

    • non antiinflammatory
    • limit to 3 grams per day
    • 2 grams if liver disease
  30. Narcotic affect
    reduce pain in the CNS
  31. NON Narcotics affects
    the Peripheral nervous system
  32. Romaczicon (flumazenil)
    reveses Versed (midazolom)
  33. Adiction
    • voluntary behavior pattern
    • usuing drugs for psychic effects
  34. Physical dependence
    involuntary physiological changes where cl will experience withdrawal
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