NU 136 Galen College of Nursing-San Antonio
NU 136 EXAM 4 - Sleep, Pain, Comfort,
Diagnostics, Fluid & Electrolytes, Transfer
Admission & Discharge (Complete + Includes
NCLEX Practice Questions)
Pain
- discomfort that interferes with normal activity
- considered a vital sign
- occurs in surgery, illness, infection, trauma, fever, cancer, etc
- now understood as a condition in itself
- feeling of distress or suffering
- can be a warning of tissue damage
- considered subjective data (a symptom not a sign)
- transmitted through the nervous system
The Joint Commission requires....
- Patient rights to pain assessment and treatment
- Pain assessed in all patients
,- Patient education on pain and its management
- Discharge planning must address pain care needs
Pain is discomfort caused by stimulation of....
nerve endings
Afferent neurons
These neurons carry signals to the brain & then the pain
response follows
Gate Control Theory (Melzack & Wall, 1965)
- Pain transmission controlled by a CNS “gate”
- Small fibers (tissue damage) open the gate
- Large fibers (massage, vibration) close the gate
- High sensory input (e.g., distraction) closes gate
- Anxiety opens the gate; calmness helps close it
Endorphins
- Natural opiate-like peptides
- Reduce or block pain perception
- Bind to opioid receptors like morphine
- Released by physiologic or psychological stress
- Promote pain relief and well-being
How is pain classified?
,- Duration
- Cause
- Type
Acute pain
- Short duration, usually related to recent injury or illness
- Often only lasts hours to days
- Common causes: burns, fractures, strains, pneumonia, angina,
infections, injury, medical condition, surger7
- Symptoms: aching, throbbing, searing
- Physical signs: ↑ HR, BP, RR; guarding behavior (not letting
you touch)
- Anxiety/fear can intensify pain
- Treatable with analgesics, surgery, or other interventions
Chronic pain
- Persists beyond normal healing time and may become its own
disease process
- Lasts more than 3 months, may be lifelong
- Linked to conditions like arthritis, back pain
- May be dull, constant, shooting, tingling, or burning
- Vital signs often normal, unlike acute pain
- Can lead to psychosocial impact and lifestyle changes
, - Best managed with combined pharmacologic &
nonpharmacologic approaches
Cancer pain
- Pain caused by the cancer itself or its treatments
- Considered a causative category of pain
Nociceptive pain
- Pain from actual or threatened tissue damage activating
nociceptors
- Often described as aching, throbbing, or sharp
- Results from injury to body tissue such as muscles, joints, or
skin
- Often caused by tissue injury to the skin, muscles, joints, and
viscera
- Common causes include trauma, burns, and surgery
- Involves 4 phases: transduction, transmission, perception,
modulation
4 phases of nociceptive pain....
- transduction
- transmission
- perception
- modulation
Transduction
- First phase of nociceptive pain
NU 136 EXAM 4 - Sleep, Pain, Comfort,
Diagnostics, Fluid & Electrolytes, Transfer
Admission & Discharge (Complete + Includes
NCLEX Practice Questions)
Pain
- discomfort that interferes with normal activity
- considered a vital sign
- occurs in surgery, illness, infection, trauma, fever, cancer, etc
- now understood as a condition in itself
- feeling of distress or suffering
- can be a warning of tissue damage
- considered subjective data (a symptom not a sign)
- transmitted through the nervous system
The Joint Commission requires....
- Patient rights to pain assessment and treatment
- Pain assessed in all patients
,- Patient education on pain and its management
- Discharge planning must address pain care needs
Pain is discomfort caused by stimulation of....
nerve endings
Afferent neurons
These neurons carry signals to the brain & then the pain
response follows
Gate Control Theory (Melzack & Wall, 1965)
- Pain transmission controlled by a CNS “gate”
- Small fibers (tissue damage) open the gate
- Large fibers (massage, vibration) close the gate
- High sensory input (e.g., distraction) closes gate
- Anxiety opens the gate; calmness helps close it
Endorphins
- Natural opiate-like peptides
- Reduce or block pain perception
- Bind to opioid receptors like morphine
- Released by physiologic or psychological stress
- Promote pain relief and well-being
How is pain classified?
,- Duration
- Cause
- Type
Acute pain
- Short duration, usually related to recent injury or illness
- Often only lasts hours to days
- Common causes: burns, fractures, strains, pneumonia, angina,
infections, injury, medical condition, surger7
- Symptoms: aching, throbbing, searing
- Physical signs: ↑ HR, BP, RR; guarding behavior (not letting
you touch)
- Anxiety/fear can intensify pain
- Treatable with analgesics, surgery, or other interventions
Chronic pain
- Persists beyond normal healing time and may become its own
disease process
- Lasts more than 3 months, may be lifelong
- Linked to conditions like arthritis, back pain
- May be dull, constant, shooting, tingling, or burning
- Vital signs often normal, unlike acute pain
- Can lead to psychosocial impact and lifestyle changes
, - Best managed with combined pharmacologic &
nonpharmacologic approaches
Cancer pain
- Pain caused by the cancer itself or its treatments
- Considered a causative category of pain
Nociceptive pain
- Pain from actual or threatened tissue damage activating
nociceptors
- Often described as aching, throbbing, or sharp
- Results from injury to body tissue such as muscles, joints, or
skin
- Often caused by tissue injury to the skin, muscles, joints, and
viscera
- Common causes include trauma, burns, and surgery
- Involves 4 phases: transduction, transmission, perception,
modulation
4 phases of nociceptive pain....
- transduction
- transmission
- perception
- modulation
Transduction
- First phase of nociceptive pain
