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Exam (elaborations)

Nursing 3320 Exam 2 – Questions With Applicable Solutions

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Nursing 3320 Exam 2 – Questions With Applicable Solutions

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Terms in this set (182)


An unpleasant sensory and emotional experience
Pain definition
Pain is whatever and whenever the person says it is

Pain has often been undertreated
Recommendations that pain is considered the 5th vital
sign
Inadequate treatment can result in a physiologic,
Conceptual foundations
psychological and emotional distress leading to chronic
pain
Healthy people 2020 goal in pain management: Health
related quality of life and well-being

Pain Perception: injured tissue releases chemicals that affect nociceptors
Transduction sending pain message up sensory neuron

Pain Perception: Pain from nociceptors relays the pain from the spinal
Transmission cord to the brain

Pain Perception: Perception Pain perceived in the brain

Pain message is inhibited by brain stem neuron. Neuron
Pain Perception:Modulation
release of endogenous neurotransmitters

Nociception how noxious stimuli are perceived as pain

, -Anxiety, fear, suicide
thoughts, hopelessness
• Focus on pain, reports of
pain, cries and moans,
frowns and facial grimaces
• Decrease in cognitive
function, mental
confusion, dilated pupils
• Increased heart rate,
increased blood pressure
Physiologic Responses to
• Increased respiratory rate
Pain
& sputum retention,
resulting in infection &
atelectasis
• Decreased gastric &
intestinal motility
• Decreased urinary
output --> retention
• Increasednhormone
response, hyperglycemia
• Muscle spasm

-Duration (How long)
-Etiology- acute, chronic (> 6 months) or cancer pain
Pain Classification
-Location- Cutaneous, visceral (abdominal cavity),
parietal (ligaments, tendons, and bones)

• Acute
- Guarding(protecting, as with acute abdominal pain),
grimacing, moan, restless,
diaphoresis, change in VS
Nonverbal Behaviors • Chronic
- Adaptation. Bracing (supporting, as in
supporting a joint), rubbing, diminished
activity, sighing, change in appetite, sleeping,
irritability

, • Can be acute (sudden &
severe) or chronic > 3nmos.
• Includes somatic, visceral
and neuropathicnpain
• Causes breakthrough pain
• Depends on type and stage of the cancer
• May be triggered by blocked blood vessels or
pressure on a nerve from the tumor
• Side effects of Cancer tx such as surgery, radiation and
Cancer Pain Box (p. 147) chemotherapy include pain
• About 90% of clients with
advanced cancer experience
severe pain which is often
undertreated
• Can result from: blocked blood, vessels, bone fracture
from metastasis, infection, inflammation, psych.
problems,
tx. side effects or tumor
pressure on a nerve

• Radiating pain:Perceived both at the source and
extending to other tissues
• Referred pain: Perceived in body areas AWAY from the
Additional Classification pain source
• Phantom pain: Perceived in nerves left by a missing,
amputated or paralyzed body part
• Intractable pain: high resistance to pain relief

1. Physical
2.Sensory
3. Behavioral
4. Sociocultural
The 7 Dimension of Pain
5. Cognitive
Assessment
6. Affective
7. Spiritual


Black Camaro's Are Pretty So Says Sally

-Studies suggest that term and premature newborns
feel pain
Developmental Level: - Infants are at high risk for under‐treatment of
Infants pain; can lead to chronic pain in adulthood
- Inhibitory neurotransmitters are insufficient until full
term birth

, QUESTT
-Question the child
-Use the pain rating scales
Developmental Level:
-Evaluate behavior and physiologic changes
Children
-Secure parents' involvement
-Take cause of pain into account
-Take action and evaluate results

- TheAPS reports adults age 60 and older experience
significant pain
- High risk of under‐treatment in cognitively impaired
adults
Developmental Level:
- Numeric Rating Scale (NRS) shown to be best for
Aging Adults
older
adults without cognitive impairment.
- Categorical Rating Scale—None(0),Mild(1),
Moderate(2), or Severe(3)

Developmental Level: -as about pain worse with activity
Older Adults -look at history

- how people respond to pain varies with culture
- be careful not to stereotype
Developmental Level:
nurses must examine their own responses to pain
Culture
-ask patient how he or she typically behave when in
pain

-Based on beliefs
-not "manly"
-pain as punishment
- condition may be getting worse
-pain medications re addictive and may cause awful
side effects
Barriers to Pain Assessment -Based on physical condition
-current disease and others are causing pain
-Based on healthcare provider's benefits
-complaining patients are drug addicts
-inability to feel pain in very old, neonates, fetuses and
sleeping pts.
- give pain meds at night so pt will sleep

-nonverbal and preverbal patients- adults with cognitive
Special Populations impairment/dementia or infants and preverbal toddlers
- patients with addictive diseases

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