Pain Management 1

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Author:
kris10leejmu
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182592
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Pain Management 1
Updated:
2012-11-08 21:44:11
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Clinical Practice ll
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Clinical Practice ll
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  1. Define pain.
    an unpleasant sensory and emotional experience associated with actual or potential tissue damage
  2. What are the two different results of pain?
    • beneficial
    • detrimental
  3. What are some benefits for an animal experiencing pain?
    • limit exposure to situations that damage tissue
    • learn to avoid the situation in the future
  4. What is pathologic pain?  Is pathologic pain detrimental or beneficial?
    • pain that is produced by tissue injury, inflammation, or direct damage to the nervous system
    • detrimental
  5. Is unrelieved pain a stressor?  What does it do to the body?
    • yes
    • triggers sympathetic nervous system, including the release of cortisol
    • slows recovery and healing
    • produces a catabolic state (tissue breakdown)
  6. What does detrimental pain trigger?
    exaggerated inflammatory response
  7. Does detrimental pain increase blood pressure?
    yes
  8. Do anesthetized animals experience conscious pain?
    no
  9. Even though anesthetized animals do not experience conscious pain, what still happens?
    their nociceptors (pain receptors) are stimulated by surgery
  10. What will happen if a patient does not receive pain medication before surgery?
    they will be in more pain when they recover
  11. Do nociceptors fatigue with continued stimulation like owther sensory receptors do?
    no
  12. What happens to a nociceptor that is continuously stimulated?  What does this result in?
    • it transmit a nerve impulse every time
    • develops increased sensitivity by lowering the pain detection threshold
    • this results in heightened pain sensation (hyperalgesia) and can lead to long term pain and debilitation
  13. What is acute pain?  How long does it last?
    • relatively short pain
    • lats minutes, hours, days, sometimes weeks but goes away as tissue heals
  14. Does acute pain happen suddenly?
    yes and is localized to the affected site
  15. Does acute pain usually have an identifiable cause?
    yes
  16. What can acute pain be associated with?
    soft tissue trauma or inflammation assoicated with surgery, injury, or disease
  17. Is acute pain a warning sign?
    yes
  18. What is chronic pain?
    pain that persists beyond the time required for healing after tissue trauma or is associated with chronic or degenerative disease
  19. Is chronic pain have a sudden onset or a more gradual onset?
    gradual onset
  20. Can chronic pain be continuous or sporadic?
    both
  21. What are some common causes of chronic pain?
    • cancer
    • osteoarthritis
    • otitis
    • degenerative disk disease
  22. Is chronic pain debilitating?
    yes, provides no survival advantages
  23. What is "wind up"?
    when spinal neurons are subjected to repeated or high-intensity nociceptive impulses they become more and more excitable and take less to "set them off"
  24. What is "central sensitization"?
    these neurons remain excitable even after the painful stimuli stop
  25. Because of wind up, untreated acute pain can lead to _____.
    chronic pain
  26. Which is harder to treat, chronic pain or acute pain?
    chronic pain
  27. Is pain easy to assess in an animal patient?
    • no, they can not talk and tell us how bad it hurts
    • the owner will usually be the best judge of the level of pain the animal is in
  28. How do we do an assessment of pain on a patient?
    • do a good PE
    • be familiar with the behavior of the species, breed, and individual
    • know the degree of pain to expect with particular surgical procedures and illnesses
    • recognize the behavior and physiological signs of pain
  29. Do some animals hide pain?  Why or why not?
    yes, survival mechanism or may not act painful around to people because they want to please them
  30. What are some examples of procedures/conditions that we can anticipate being severe pain?
    • cervical disc herniation
    • extensive inflammation
    • fracture repair
    • limb amputation
    • declawing
  31. What are some examples of procedures/conditions that we can anticipate being moderately to mildly painful?
    • cruciate repair
    • laparotomy (including spays)
    • mass removal
    • castration
    • dental procedures
  32. Do we need "proof of pain" before we start treating pain?
    no anticipate the level of pain the procedure may cause and treat the animal before it becomes painful
  33. What are some patient behaviors that indicate pain?
    absence of normal behavior
  34. What is the most dependable gauge of an animals pain?
    the animal's response to analgesic therapy
  35. What are some ways dogs and cats express pain?
    • vocalization
    • facial expression
    • self- awareness
    • activity
    • attitude
    • appetite
    • housetraining
    • grooming
    • response to palpation
    • withdrawing, scratching, escaping
    • posture
  36. What are some ways a dog vocalizes when they are in pain?
    • growling
    • whining
    • whimpering
  37. What are some facial expression a dog gives that expresses pain?
    • fixed stare
    • glazed appearance
  38. What does a dog do that is considered "self-awareness" when they are experiencing pain?
    • protecting wound or limb
    • licking, chewing or rubbing wounds, surgical site or painful area
  39. What is the dogs activity like when they are painful?
    • restlessness
    • restricted movement
    • trembling
    • shivering
  40. What is the dogs attitude like when they are painful?
    • increased aggression
    • fearful
  41. What is a dogs appetite like when they are painful?
    reduced
  42. What happens to a dog's housetraining when they are painful?
    • increased urination
    • decreased frequency of urination
    • failed housetraining
  43. What is a dog's posture like when they are painful?
    • hunched
    • lying on side
  44. What are some ways a cat vocalizes when they are in pain?
    • growling
    • purring
  45. What are some facial expression a cat gives when they are in pain?
    • furrowed brow
    • squinting eyes
  46. What does a cat do that is considered "self-awareness" when they are experiencing pain?
    • protecting wound or limb
    • licking, chewing, or rubbing wounds, surgical site, or painful area
  47. What is the activity level like for a cat who is in pain?
    • restricted movement
    • repeated meaningless movements
  48. What is the attitude of a cat like when they are in pain?
    • comfort-seeking
    • hiding
    • aggression
  49. What is the appetite like for a cat who is in pain?
    reduced
  50. What happens to housetraining for a cat who is in pain?
    failure to use the litterbox or go outside
  51. What is grooming like for a cat who is in pain?
    • failure to groom
    • unkempt appearance
  52. What is the posture like for a cat who is in pain?
    • hunched
    • lying on chest or abdomen
  53. What are the physiologic signs of pain?
    • sympathetic stimulation
    • clinical signs
  54. What is sympathetic stimulation?
    pain, especially acute pain, activates the symathetic nervous system - fight or flight physiologic responses
  55. What are some clinical signs of pain?
    • increased heart rate and blood pressure
    • peripheral vasoconstriction (blanched mucous membranes)
    • increased respiratory rates
    • muscle splinting
    • stress leukogram
    • dilated pupils, anxiety, fear
  56. What should be our pain management plan?
    • start pain meds as soon as possible
    • use more than one class of analgesics
    • provide adequate analgesia
    • evaluate patient's response to analgesic treatment
    • provide analgesia for the expected duration of pain
  57. When is acute pain (due to surgery, trauma, and disease) the most intense?
    during the first 24 - 72 hours following tissue injury

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