*mannerisms indicating pain in those who are unable to
communicate* Correct Answers moaning or groaning at rest or
with movement
failure to eat, drink, or respond to presence of others
grimacing or strained facial expressions
guarding or not moving body parts
resisting care
rapid heart beat, diaphoresis, change in vital signs
*mild pain* Correct Answers 1-3
*non opiod medications used*
acetaminophen, NSAIDS
non pharmocological measures also used
massage, heat/cold
*moderate pain* Correct Answers 4-6
*low dose opiods given*
-codeine, morphine, hydromorphone, etc
*non opiods with adjuvants given*
acetominophen with muscle relaxant
NSAID with antidepressant
mixture beneficial
*pain during dying process* Correct Answers *neuropathic
pain*
nerves are damaged
burning, electrical, or tingling sensation
deep and severe
difficult to relieve
,hard to control
*nociceptive pain*
associated with tissue inflammation or damaged tissue
exampes: cardiac ischemia, osteoarthritis
treated with acetominophen, NSAIDS, opiods as a last result
easier to control
decrease inflammation and pain goes away
*severe pain* Correct Answers 7-10
*high dose opiods used-addiction should not be feared when
treating pain at the end of life*
examples of opiods:
morphine-gold standard
codeine
hydromorphine
fentanyl
methadone
oxycodone
*do not use merperidine(demerol) or propoxyphene (darvocet)
with older persons!
confusion issues/pain relief
additional questions Correct Answers how many days do you
drink per week?
how many drinks do you have per day?
what is the maximum number of drinks you have per day?
what type of alcohol do you drink?
what is a 'drink'?
adjuvant analgesics Correct Answers work well with mild-
moderate pain
,enhances the effectiveness of other drug classes
useful for treatment with lower doses and less side effects
examples:
muscle relaxants
corticosteroids
anticonvulsants
antidepressants
topical medications
age related changes with hearing Correct Answers *internal
ear*
atrophy of organs in auditory portion of the inner ear
loss of sensory hair cells
*external ear*
auricle wrinkles and sags
increased cerumen production
cerumen becomes dry and hard
alcohol abuse Correct Answers prevalence 2-5% for men and
1% for women
risk factors
-genetic predisposition
-male >65 5x more likely
-limited education
-poverty
-depression
danger related to
-age related physical changes
-physical illnesses
-prescription drugs
, decline after age 60-less muscle mass and body water
women more likely dependent on prescription meds
alternative pain mngmt approaches Correct Answers
acupuncture
massage therapy
reiki therapy
chiropractors
herbal medicine
soft music
alternative therapies Correct Answers may be used in
conjunction with counseling
-biofeedback-mind over body experience ^bp, pulse
-massage therapy ^ blood flow
-progression muscle relaxation
-slow, deep breathing and visualize a 'happy scene' from youth
-tai chi
-yoga
-walking
-listening to music
-reading a book or watching a movie
analgesics Correct Answers administer analgesics routinely
prevent breakthrough pain and suffering by administering
medications around the clock
long-acting drugs provide consistent relief
short-acting or immediate release agents for prn use
anticipate and treat adverse effects of pain