NSG 3600 / NSG3600 Galen College Of Nursing -NSG 3600 - Pediatric Health Exam 2 Questions With Complete Solutions

1. Describe the how pain is transferred to the CNS - ANSWER 1. nerve endings get a message from the injured site 2. Substance P, bradykinin, and prostaglandins are released to sensitize the nerve endings, helping transmit the pain from the injured site to the brain 3. Signal travels as an electrochemical impulse along the length of the nerve to the dorsal horn on the spinal cord (receives signals from all over the body) 4. Spinal cords sends message to the thalamus, the to the cortex 5. Pain relief starts w/ signals from the brain that defend by way of the spinal cord 6. Chemicals (endorphin S) are released in the dorsal horn to diminish the pain message 2. Give an example of a chemical that is released in the dorsal horn to diminish the pain message - ANSWER endorphin S, opiates, enkephalins. These bind to the opiate receptors in the dorsal horn of the spine and block pain transmission 3. Where does the pain signal travel to - ANSWER dorsal horn of the spinal cord 4. The spinal cord sends a message to where - ANSWER thalamus 5. Thalamus sends a message to where - ANSWER cortex of brain 6. GABA - ANSWER Gabapentin 7. How does GABA block pain - ANSWER Binding to GABA specific receptors in the dorsal horn 8. Explain "Gate Control Theory" - ANSWER Body responds to a painful stimulus by either opening the neural gate to allow pain to be produced or creating a blocking effect at the synaptic junction to stop the pain 9. Most common clinical interpretation of pain transmission is a concept called - ANSWER nociception, which means the perception of pain by sensory receptors located throughout the body (nociceptors) 10. What are the four steps in nociception - ANSWER Transduction, Transmission, Perception, Modulation 11. Noxious stimuli creating enough energy potential to have caused nerve impulse perceived by nociceptors (free nerve endings) is - ANSWER Transduction 12. Inhibitory and facilitating input from the brain modulates or influences the sensory transmission at the level of the spinal cord is - ANSWER Modulation 13. Signal moves from the periphery to the spinal cord and up to the brain is - ANSWER transmission 14. Impulses being transmitted to the higher areas of the brain are identified as pain is - ANSWER perception 15. Explain the four steps in Gate Control Theory - ANSWER 1. Continued pain on peripheral neurons cause the gate to open through depolarization of nerve fiber 2. Pain passes from the PNS at the synaptic junction to the CNS up the afferent nerve pathway 3. Passes through the dorsal horn to the structures of the limbic system and cerebral cortex 4. Cortex identifies pain and response is created. 16. The transmission of pain stimulus uses two separate but continuous systems what are they? - ANSWER PNS and CNS 17. Centrally Mediated Pain Syndrome is - ANSWER Pain occurs w/o pain stimulus. 18. Acute pain lasts roughly - ANSWER 1 second to 6 months 19. Chronic pain lasts - ANSWER more than six months 20. Pain that originates from abdominal organs is called? What is the common pain complaints? - ANSWER Visceral pain; gnawing or cramping 21. Pain derived from the dermis, epidermis, and subcutaneous tissue is? Patients complain of? - ANSWER Cutaneous pain; complain of often burning or sharp 22. What is referred pain and give an example? - ANSWER Pain that radiates from another site; cardiac pain (pain experiences include indigestion, neck, or arm pain) 23. Pain that originates from the skin, muscles, bones and joints and is often described as sharp is? - ANSWER Somatic pain 24. Ability of the nervous system to change or alter function is - ANSWER Neuronal plasticity 25. Windup is described as - ANSWER enhanced response of pain stimulus produced by prolonged pain production 26. Excitatory process involving spinal nerves produced by continued pain stimuli that can persist even after peripheral simulation is no long present is - ANSWER Central Sensitization 27. What is a result of inflammatory process that creates hypersensitivity to touch or pressure - ANSWER Peripheral Sensitization 28. If acute pain is not properly treated what can happen? - ANSWER Impair pulmonary function, decreased immune response, prolonged hospital stays 29. CRPS is - ANSWER neuropathic pain syndrome 30. What patients are at high-risk for CRPS - ANSWER patients who have had surgery or crush-type injury 31. What are symptoms should a nurse look for in patients who have had surgery or a crush-type injury? - ANSWER High levels of pain w/ subsequent loss of function, temp sensitivity, selling, skin changes (hair loss at affected area). May indicate patient developing CRPS. Common terms patients may uses pain that is burning, tingling, pins and needles, and numbness 32. What are some objective indicators of the physiological response to pain - ANSWER increased blood pressure respiratory, and heart rate. Note: patient will feel the urge to move way from the painful stimulus 33. NPI and explain - ANSWER Numeric pain intensity; one dimensional pain scale 0-10 (1 to 3 mild pain; 4-6 moderate pain; 7-10 severe pain) 34. Stress response causes the release of - ANSWER epinephrine, norepinephrine and cortisol which have a neuroendocrine and metabolic response 35. What are the effects of stress releasing hormones - ANSWER increase oxygen consumption, blood glucose and lactate levels, metabolism, and ketones 36. What are behaviors that indicate pain - ANSWER vocalization, facial grimacing, bracing, rubbing painful areas, restlessness 37. Name some one dimensional pain scales - ANSWER VAS, VDS, NPI, Combined thermometer scale 38. VAS - ANSWER Visual Analog Scale 39. VDS - ANSWER Verbal descriptor scale 40. Name some multidimensional scales - ANSWER McGill Pain Questionaire (MPQ) or Brief Pain Inventory (BPI) used usually for research 41. Pain an infant may show includes - ANSWER brow bulge, eye squeeze, open lips, stretched mouth, taut tongue, chin quiver, tongue protrusion 42. FLACC - ANSWER Face, Legs, Activity, Cry, Consolability 43. What is a opioid tolerance - ANSWER patient that has an altered physiologic response to pain stimulus and becomes more sensitive over time 44. Indications of chronic pain include - ANSWER self reported pain, discomfort, facial mask, weight loss, depression, insomnia, frequent position changes 45. What type of pain scale is this " a set of verbal descriptors used to capture the sensory aspect of the pain experience" - ANSWER McGill Pain Questionnaire 46. A nurse has assessed the blood pressure of a recently admitted patient and obtained a reading of 128/78 mm Hg. What is the patient's pulse pressure? - ANSWER 78 mm Hg 47. Nurse asks "On a scale of 0-10 rate your pain?" the nurse is trying to assess what element of the assessment - ANSWER Intensity/Severity 48. Nurse asks "Is there anything that you notice that makes the pain worse?" the nurse is trying to assess what element of the assessment - ANSWER Aggravating factors/Time 49. Nurse asks "Do you live alone?" the nurse is trying to assess what element of the assessment - ANSWER How does it affect U 50. Nurse asks "Does it hurt when I put pressure on the area?" the nurse is trying to assess what element of the assessment - ANSWER palliative 51. Nurse asks "Is the pain sharp or dull, sporadic or constant?" the nurse is trying to assess what element of the assessment - ANSWER Quality 52. Nurse asks "What is an acceptable level of pain?" the nurse is trying to find the patients - ANSWER Pain goal/threshold 53. What is important to know in addition to the medications a patient is taking? - ANSWER Name, dose, route and reason for taking it. 54. What are the most important family conditions to note: - ANSWER High BP, CAD, High Cholesterol, stroke, cancer, diabetes mellitus, obesity, alcohol, drug addiction, mental illness 55. Why are functional health patterns important to nursing? - ANSWER Focus on the effects of health or illness on a patient's quality of life 56. ADLS - ANSWER Activities of daily living 57. gravida in a medical record means - ANSWER number of pregnancies 58. para documented in a medical record indicates - ANSWER number of births 59. What are valuable clues to overall health - ANSWER physical appearance and mobility 60. Bad breath may indicate - ANSWER poor hygiene, allergic rhinitis or infection ( tonsillitis, sinusitis) ___________in health care is a philosophy that emanates directly from Florence Nightingale - ANSWER Holism who believed in care that focused on unity, wellness, and the interrelationship of human beings, events and environment - ANSWER Florence Nightingale Who is is the definitive voice for holistic nursing - ANSWER ANHA Holistic nursing is defined as - ANSWER "all nursing practice that has healing the whole person as its goal" CAM - ANSWER Complementary/Alternative/Integrative Modalities HN - ANSWER Holistic Nurse Core Values of Holistic Nursing - ANSWER 1. Holistic philosophy, theory and ethics 2. Caring process 3. Holistic Communication Therapeutic environment and cultural diversity 4. Holistic Education and Research 5. Holistic nurse self care Continued education, rich and knowledge and diversity is what holistic core value - ANSWER Holistic Education and Research Communicates as an authentic, caring and compassionate and sincere is what holistic core value - ANSWER Holistic Communication Therapeutic environment and cultural diversity The nurse asks, "what are the most important things to you in life?" to assess functional pattern related to? A Self-Perceptions; B values; C role - ANSWER B "How would you describe yourself?" - ANSWER Self perception The nurse performs patient teaching after assessing that the nutritional history reveals a patient generally consumes a high fat, high-calorie diet. This critical thinking is based on - ANSWER subjective data to analyze findings and intervene Health history is to collect _____________ data from the patient - ANSWER subjective Client states "they are having abdominal pain" this is - ANSWER subjective data