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short in duration with an identifiable cause
Trauma, injury or surgery
Sympathetic Nervous Systems response to pain
- Increased BP, HR
pain that lasts after healing, usually longer than 3-6 months
It has no purpose and can occur without visible injury
Nuggets about people with chronic pain:
- may not have a visible response to new pain
- and may not have a SNS response to new pain either
What happens if you dont treat acute pain?
can turn to chronic pain which will be much more difficult to treat
severe pain that's crampy or gnawing
pain that is perceived in another are away from the original pain stimulus
sharp pain from skin, muscles, bones and joints
numbing, burning, shooting, stabbing pain.
- phantom pain
- diabetic neuropathy
palpate and pain occurs when pressures released
helps to decrease addiction potential
Swtich pt from parenteral medications to oral meds or vice versa
a natural phenomenon that occurs with regular use of medication.
ie-taking narcotics for more than 30 days...does not mean addicted
All addicts are dependent, but not all dependent patients are addicts
4 C's of addiction:
- Continued use despite harm
- impaired Control over the drug
- Compulsive use
They are driven to look for and find the drug that they require regardless of the effect on their life
development of drug seeking behaviors among pain patients due to inadequate pain management
Gate control theory
a pain stimulus of a certain intensity opens a neurological gate, allowing pain stimulus to proceed thru the nervous syustem to the brain to creat the sensation of pain
PQRST assement of pain
- Provoked-precipitated by
- Radiating or Region
- Time-how long does it last
pain assessment is ongoing
Endorphins and pain
levels of endorphins drop in people with chronic pain and depressed people.
endorphins are stronger than morphine
Describe pain response in the elderly
Elderly have a higher threshold to pain and a greater tolerance related to degenerative changes.
So they dont seek treatment for pain like younger people
**Keep in mind pain meds are strong on elderly, so titrate!!
- anti inflammatory
- risk for GI Bleed
Medication used for moderate to sever pain and oftenly used in combo with opioids
Oxycontin-oxycodone with acetaminophen
Synthetic opioid for moderate to severe pain
this med is a mu agonist and is a serotonin reuptake INHIBITOR
Tylenol 3 and 4
for moderate to severe pain....
has codeine in it so watch for:
nausea, vomit and constipation
Level III pain meds
How do they work?
- bind to mu receptor sites and
- block neuromediators that stimulate nociceptors which are receptors present in the brain and spinal cord
Examples of Level III pain meds
What is the PCA antidote?
When we use non pain meds like antidepressants, anticonvulsants or muscle relaxers to add pain relief
helps to decrease addition potential by switching medications