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feelings of distress or suffering

Major causes of pain

surgery, medical conditions, fever, injury, cancer

Subjective Information

information obtained from the patient and is not measurable

Examples of subjective information

headache, pain, nausea

Objective Information

information obtained through observation and is measurable and repeatable

Examples of objective information

bruise, pressure ulcer, vital signs, bones fractures

JCAHO determined that all patients must

have regular pain assessments and manage plan

what is considered the 5th vital sign


why is pain difficult to assess

because it is subjective

acute pain

occurs suddenly and has a short duration and is usually described as aching or throbbing

chronic pain

lasts for months to years and is usually described as dull, constant, shooting, tingling, or burning

examples of acute pain

sore throat, surgical incision

examples of chronic pain

back injury, arthritis, fibromyalgia

Nociceptive pain

involves injury to tissues which nociceptors are located

where are nociceptors located

joints, skin, and organs

examples of nociceptive pain

burns, trauma, surgery

what is the treatment for nociceptive pain

NSAIDS; they block substances that trigger nociceptors

NSAIDS stands for

Non Steroidal Anti Inflammatory Drugs

Neuropathic pain

is associated with dysfunction of the sensory parts of the nervous system

what happens to pain receptors with neuropathic pain

they become highly sensitive

what happens to nerve endings with neuropathic with pain

the nerve ending enlarge

what kind of disorders is neuropathic pain seen with

diabetes, some cancers

what is the treatment for neuropathic pain

analgesics, NSAIDS, antidepressants, anticonvulsants

Phantom pain

occurs after an amputation

what is phantom pain caused from

severing of the nerves from the amputation

Pain is

what the patient says it is

pain is affected by

culture, age, society and gender

Objectable signs of pain

crying, facial expressions, guarding

what would one look at if a patient denies pain

their vital signs

degree of pain

severity; excrutiating, severe, mild, annoying

quality of pain

description of type of pain; stabbing, dull, sharp, burning, crushing

location of pain

use anatomical terms to pinpoint exactly where pain is


how often; intermittent, constant, occasional, rare

what is the purpose of the pain scale

provide an understanding of how bad the pain is

who should use a face pain scale

children, confused pt, pt who can not communicate

NIPS stands for

Neonate Infant Pain Scale

what does NIPS look for

crying, body posture, muscle tension, vital signs

what signs would one look for to assess pain in a confused pt

restlessness, wandering, guarding

TENS stands for

Transcutaneous Electrical Nerve Stimulating unit

how does a TENS work

provides electrical stimulation across the skin

PENS stands for

Percutaneous Electrical Nerve Stimulating unit

how does a PENS work

small needles penetrate the skin; provides deeper pain relief

what does a Binder do

supports a structure

examples of binders

ace wrap, splint

what are relaxation techniques aimed in doing

relieving muscle tension, regulate breathing


relaxation technique that uses a machine to measure muscle tension


use of sounds or visual images to take mind off of pain

Guided Imagery/ Meditation

pt forms mental images of pleasant things and focuses on it


may make pt relax; nature music


trance state; below level of consciousness


promotes relaxation and relief of muscle tension

what areas are NEVER massaged

surgical areas and inflamed areas

Chiropractic manipulation

joint manipulation


chinese therapy using needles on energy points to relieve tension


use of pressure on energy points to relieve tension


pain relieving meds

COX-2 inhibitors

block COX2 enzyme that is thought to play a role in chronic pain


goes to the opiate receptors in the brain to block pain

why would someone get addicted to narcs

cause euphoria; a feeling of contentment/happiness

Adjuvant analgesics

anticonvulsants, antidepressants


as needed

examples of NSAIDS

ibuprofen, tylenol

an important thing to know about NSAIDS

they have side effects; causes liver and stomach issues

Oral medications

used for mild to moderate pain

Timed release meds

break down over time

Topical medication

put on skin or mucous membrane; cream or patch

Injected medication

referred to as IM or SubQ

Injected medication is faster acting than

oral medication

Intravenous medication

goes right into the blood stream; fastest of all


pushes an IV medication


concentrated dose given rapidly

What are two ways that an IV med can be

bolus or intermittent

PCA stands for

Patient Controlled Analgesia

Facts about PCA pump

meds are given through an IV bolus on demand by pt.

Facts about PCA pump

pt can NOT overdose; machine is set up with doses and timing by order from MD

Facts about PCA pump

machine settings are locked

Facts about PCA pump

can be intermittent or continous

Epidural Analgesia

small catheter placed in the epidural space

who places the epidural analgesia


what are uses for epidural analgesia

surgeries, if pt is needed to stay awake for surgery, pt who is at risk for dying in surgery

what kind of doses are epidurals

continuous or bolus

what kind of patients usually use epidurals

OB pt's, surgical pt's, sometimes cancer pt's

what is ver important to monitor when someone has an epidural


Stryker pain pump

catheter directly into incision; can be continuous or intermittent


time released beads right into the surgical incision

why is sleep needed

general health and well being

NREM stands for

Non Rapid Eye Movement

REM stands for

Rapid Eye Movement

what stage of sleep does a person receive most rest

NREM stage

When is the brain in high activity or dreaming

REM stage

How many cycles of NREM and REM happens each night

5-6 cycles

What are the 3 normal sleep requirements

amt of sleep varies, older and younger require more sleep, adults require 5-10 hours of sleep per night

infants can sleep up to

16 hours a day to their first year

what sill 8 hours of sleep a night decrease the chance of

chronic illness

Factors that affect sleep


Factors that affect sleep

working 2nd, 3rd, or swing shift

Factors that affect sleep


Factors that affect sleep


Factors that affect sleep

intake of caffeine and nicotine

Factors that affect sleep

exercise before bed

Factors that affect sleep


Factors that affect sleep

stress and illness

Factors that affect sleep

environmental factors


difficulty falling and staying asleep

what may be a cause of insomnia

stress, anxiety, change in sleep environment

sleep apnea

stop breathing for brief periods during sleep

what may cause sleep apnea

obesity, excessive use of alcohol, smoking


a machine that pushes air into the lungs during sleep


may be cause by obstructed air passages in the mouth or nose

what can snoring be a sign of

sleep apnea


sudden onset of recurrent uncontrolled brief episodes of sleep during hours of wakefullness

what is a treatment for narcolepsy

behavioral or light therapies

sedatives and hypnotics

for short term relief; ambien, lunesta

Over the counter medication

tylenol PM, benadryl, unisom

An important thing to tell patients if they take a sleep aid medication

make sure they allow adequate amount of sleep and do not drive after taking medication

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