Nur 102 Unit 2 and 3 Comfort and Spiritual

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Michealbledsoe
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132381
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Nur 102 Unit 2 and 3 Comfort and Spiritual
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2013-05-09 18:20:19
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Comfort Spiritual
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Unit 2 comfort unit 3 Spirtual
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  1. Prairie state definition of pain
    Whatever bodily hurt the client says he has, existing whenever he says it does (all ages can have pain) Under treatment major health problem
  2. Charateristics of acute pain
    • Identifiable cause
    • short duration
    • sudden onset
    • well-defined
    • decreases with healing
    • reversible
    • objective S&S may be present
    • anxiety present
  3. Charateristics of Chronic pain
    • causes may be hard to find
    • long duration
    • begins gradually & persist
    • may or may not be well defined
    • persist beyond healing time
    • is exhausting and useless
    • objective signs of pain may be absent
    • depression and fatigue often present
  4. Where does the Physiological response to pain result from?
    results from activity within the autonomic nervous system which activates then depresses certain somatic functions. (Normally the sympathetic and parasympathetic exert an equal influence over somatic functions)
  5. Sympathetic nervous system is
    Flight or fight
  6. Parasympathetic nervous system is
    Protective
  7. Adaptation
    If pain continues parasympathetic NS takes over to restore homeostasis. Opposite effect of fight or flight. Patient can be weak and exhausted. Nausea can occur as gastric fx occurs Blood pressure comes down. Body systems return to normal tho pain is still present
  8. Fight or flight reaction charateristics
    • Increased need for O2 leads to dialation of bronchial tubes and increased resp rate
    • increased heart rate results in increased O2 transported to body cells
    • Increased BP due to peripheral vasoconstriction
    • blood supply is shifted from the peripheral blood vessels and the vicera to the skeletal muscle and brain to facilitate rapid thought and action
    • increased blood sugar due to release of glucose from liver
    • increased muscle tention prepares the muscles for action
    • dialation of pupils results in better vision
    • decreased Gi motility frees energy for more immediatly necessary activity
    • diaphoresis occurs
  9. Nociception
    the theory of pain preception
  10. Gate control theory (look this up in more detail)
    Pain impulses are prevented from asending to brain when other impulses are competing for synaptic gates.  When there are a great number of impulses on the THICK NERVE FIBERS which carry impulses of HEAT, COLD, TOUCH ETC. the gates close to pain on the thin nerve fibers.  That's why when you are in pain sometimes you will apply cold or heat...
  11. Which nerve fibers carry impulses for pain
    Thin nerve fibers
  12. Gate control theory suggest that these CNS factors can contribute to influence of opening and closing of synaptic gates
    anxiety, attention to pain and distraction
  13. Which nerve fibers carry impulses for cold, heat, touch etc
    Thick nerve fibers
  14. Cognitive componet of pain
    Mental factors that influence how we experience pain. I.E. anxiety, attention, anticipation, and thoughts (like the sound of the drill at the dentist)
  15. In what age group is it appropriate to use the pain scale
    Teenagers
  16. what is the best indicator for pain in infants
    Behavior
  17. Who is a pts. best authority for pain
    The patient themselves
  18. Stoic
    Lack of expression of pain (person feels pain but is very non chalant about it)
  19. Pain tolorence
    Patients own uniqe response to pain and how much they can with stand
  20. What shoud we do about procedural pain
    We should try to predict it and prevent it
  21. 4 types of non physical forms of pain
    • Social
    • financial
    • spiritual (could include guilt)
    • emotional
  22. what it intractable pain
    pain that is not relieved by anything or hard to relieve (ex: cancer pain)
  23. what is referred pain
    pain that is felt in part of body other than source (ex: stomach pain that feels like heart burn/heart attack)
  24. what is deep/somatic pain
    Sharp, aching, throbbing, well localized pain (ex: osteoarthritis, myofascial pain)
  25. what is visceral pain
    Dull, cramping, colicky, poorly localized pain (ex: heart attack, bowel obstruction)
  26. what is phantom limb pain
    pain from a limb that has been removed
  27. what is neuropathic pain
    shooting, burning, electric-like pain (trigenimal neuralgia, posterpetic neuropathy)
  28. what is the face rating scale for pain
    wong-baker
  29. what are morphine dose equivalents for IM, IV and oral
    • IM = 10mg
    • IV = 4mg
    • PO = 10-20
  30. 60mg of codeine equals
    10mg morphine IM and 10-30mg morphine PO
  31. dilaudid doses and morphine
    • 1.5mg IM = 10mg morphine
    • 7.5mg PO = 10-30mg morphine
    • 2mg IV = 4mg morphine
  32. what is percodan a mixture of
    oxycodone and ASA
  33. what are the only two pain relievers with ASA in it
    percodan and lortab ASA...lortab must specify ASA to have asprin in it
  34. what is in tylenol #3 and #4?
    codeine and acetaminophen
  35. what is in vicodin
    hydrocodone and acetaminophen
  36. what are some amticonvulsant adjuvant drugs
    Dilantin and tegretol...think about your fathers seizures
  37. what are some benzodiazepine adjuvant drugs
    Valium, Librium and Ativan
  38. Disadvantages of asprin
    • interferes with platelet function
    • tinnitus
    • linked to reyes syndrome
    • increased GI upset
    • GI bleeding
  39. Disadvantages of acetaminophen
    hepatoxicity
  40. narcan details
    for narcotic resp distress (to reverse effects of the narcotic) 0.1-0.2mg IV q2-3 mins
  41. difference between addiction and physical dependence
    addiction is a voluntary behavior pattern...client is obsessed with obtaining and using drug to feel the "feel good" effect

    physical dependance involuntary physiological changes where a client will experience withdrawal
  42. hint for sympathetic and parasympathetic
    Parasympathetic is Protective (includes adaptation)

    Sympathetic is Severe Situation (includes fight or flight)
  43. what are the 3 stages of GAS (general adaptation syndrome)
    • Alarm reaction (fight or flight occurs from SNS, involves epinephrine and norepinephrine)
    • Resistance (body adapts to stressor and signs of acute emergency disappear. Stressor limited to smallest part of body that can handle it. If successful GAS ends here)
    • Exhaustion (if you reach this stage, exhaustion sets in and endocrine activity increases. If body defenses can't cope, death occurs)
  44. Details of Local Adaptation Syndrome (LAS)
    • similar to local inflammatory response
    • body adapts to stressor that is taking place in small area of the body. Parasympathetic nervous system kicks in and stops fight or flight or inflammatory response
  45. Details of GAS (General Adaptation Syndrome)
    • takes over when body has to cope with too many stressors
    • involves autonomic nervous system
    • endocrine system
    • (aldosterone and cortisol)

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