MSII Chapt 15 Pain Book notes.txt

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MSII Chapt 15 Pain Book notes.txt
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2012-03-24 17:02:39
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MS II Test Chpt 15 Pain book notes
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MS II Test 3 Chpt 15 Pain book notes
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  1. Gate control theory assumes that the pain experience reflects
    both physical and psychosocial factors
  2. What anesthetic has analgesic properties?
    Ketamine; may prolong analgesia for 12-24 hours after surgery
  3. Sympathetic nerve responses to pain
    Increase in BP, P, R, dilated pupils, perspiration, pallor
  4. Parasympathetic nerve response to pain
    Constipation and urinary retention
  5. Behavior changes in acute pain
    restless, thrashing, rubbing body part, pacing, grimacing, and other facial expressions of pain
  6. Behavioral changes in chronic pain
    Tired looking, minimal facial expression, quiet, sleeps, rests, attention on other things
  7. Cancer pain may be considered
    acute and chronic
  8. Nursing assessment of pain is essential to identify
    characteristics and amount of pain, whether pain is acute or chronic, and whether patient has both acute and chronic at the same time
  9. 6 steps in pain assessment
    Accept pt report, determine status of the pain, describe pain, examine site, identify coping methods, record the assessment, interventions and evaluation of interventions
  10. Possible nursing diagnoses for pain
    activity intolerance, anxiety, disturbed sleep pattern, fatigue and self care deficit
  11. How do physical interventions help pain?
    Increase pain threshold, reduce muscle spasm, decrease congestion in injured area
  12. How does jaw relaxation help pain?
    Effective in reducing mild to moderate pain and as an adjunct to drugs for severe pain
  13. How does simple imagery help pain?
    Use when patients express an interest in relaxation; requires 305 minutes of staff instruction
  14. How does music help pain?
    Patient preferred and easy listening music are effective in reducing mild to moderate pain
  15. How does imagery help pain?
    Effective for reduction of mild to moderate pain; requires skilled personnel
  16. How does educational instruction help pain?
    Should include sensory and procedural information and be aimed at reducing activity-related pain; requires 5-10 minutes of staff time
  17. How should pain meds be given when pain is predictable?
    Around the clock rather than prn; ATC maintains therapeutic blood levels of analgesics
  18. What properties do nonopioids have?
    Antipyretic, analgesic, or anti-inflammatory
  19. Parenteral nonopioid
    toradol (ketorolac)
  20. Nonopioids are not recommend for people with
    liver or kidney disorders; use cautiously with CHF or HTN
  21. Older adults should not use
    propoxyphene, meperidine, indomethacin, ketorolac, promethazine
  22. Adverse effects of nonopioids
    stomach irritation, fluid retention, increased bleeding time
  23. PCA instructions
    when pain begins to return, press PCA button; put it down and wait 10-15 minutes; if pain returns, push PCA again and repeat until pain is relieved
  24. What is an herbal remedy for migraine prevention?
    Feverfew
  25. Preferred treatment of chronic pain
    Oral analgesics
  26. Adjuvant analgesics
    antidepressants-neuropathic pain; benzos-muscle spasm and anxiety; antihistamine-nausea/anxiety; corticosteroids-spinal cord or nerve compression, bone pain; anticonvulsants-neuropathic pain; local aneth-diabetic neuropathy; clonidine-spinal cord, phantom limb, peripheral nerve; psychostimulants-analgesic effect-cancer pain
  27. When analgesic is not working,
    Check order; consider alternative script; collaborate with pt, other nurses, pharmacist and family
  28. Most chronic pain is
    neuropathic because of nerve damage

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