MS II Test 3 Chpt 15 Pain.txt
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MS II Test 3 Chpt 15 Pain.txt
MS II Test Chpt 15
MS II Test 3 Chpt 15
McCaffery�s definition of pain
Pain is whatever the person experiencing it says it is and exists whenever he says it does
receptors that activate the afferent pathways; unable to adapt to repeated stimuli so they continue to fire until the stimuli are removed
What can inhibit pain?
Endorphins and enkephalins that can have an opioid effect by blocking or diminishing pain perception
What can decrease endorphin levels?
Prolonged stress and pain, prolonged use of morphine and alcohol
What can increase endorphin levels?
Brief stress and pain, laughing, exercise, sex, acupuncture, TENS, massive trauma
Factors that cause the gate to open include
tissue damage, monotonous environment, and fear of pain
What can close the gate?
Stimulation of large-diameter fibers through massage, position change, and heat or cold applications; distraction, guided imagery, preparatory information
What physical factors affect pain?
Pain threshold, pain tolerance, age, physical activity, surgery and anesthesia
Point at which stimulus causes sensation of pain
What lowers pain threshold?
Anger, fatigue, anxiety, insomnia, depression and uncontrolled pain
Intensity of pain that a person will endure
What is the most painful surgery?
What psychological factors affect pain?
Culture, religion, past experiences, anxiety, situational factors
Because the brain interprets pain as a stressor, it activates the
What are predictable responses to acute pain?
Increased heart rate, respiratory rate, and BP
Cause of acute pain is
known, treatable, and temporary
follows the normal pathway for pain from nociceptor activation to the brain
persistent, recurs for > 6 months; neuropathic because it follows an abnormal pathway
Unusual sensations of chronic pain
burning, shooting pain and abnormal sensations that occur when there is no pain stimulus present; cause may be unknown
What purposes do pain serve?
Chronic-no useful purpose; acute warns of tissue damage and trauma
Sympathetic nervous system adapts
so HR, BP and R may be normal; nurse may underestimate severity and undermedicate
Most chronic pain is
When should pain be assessed?
On admission and on a regular basis
Six steps of pain
Accept pt report, determine status of pain, describe pain, examine site of pain, identify coping methods, document findings and evaluate interventions
How should pain be described?
Location, quality, intensity, aggravating and alleviating factors
physical comfort measures, environmental control, stimulation techniques
anxiety reduction, distraction, relaxation and imageryn
increase tolerance and threshold
Hot and cold
heat< 30 minutes and don�t put on abdominal pain or malignancy; cold<15 minutes and don�t put on people taking vasoconstriction and heart disease
Nonopioid analgesics affect
PNS, have ceiling effect on analgesia
Opioid analgesics affect
Examples of opioid agonists
codeine, methadone, dilaudid, Demerol, morphine, fentanyl
Examples of opioid agonist antagonists
nubain, puprenex, stadol, talwin
Side effects of opioids
constipation, sedation, nausea, respiratory depression, confusion, hypotension, dizziness, urinary retention