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115 terms

Pain, Comfort, and Sleep

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Pain
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
pain
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
frequency
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
Biofeedback
relaxation technique that uses a machine to measure muscle tension
Distraction
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
Music
may make pt relax; nature music
Hypnosis
trance state; below level of consciousness
Massage
promotes relaxation and relief of muscle tension
what areas are NEVER massaged
surgical areas and inflamed areas
Chiropractic manipulation
joint manipulation
Acupuncture
chinese therapy using needles on energy points to relieve tension
Acupressure
use of pressure on energy points to relieve tension
Analgesics
pain relieving meds
COX-2 inhibitors
block COX2 enzyme that is thought to play a role in chronic pain
Narcotics
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
PRN
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
an LPN NEVER
pushes an IV medication
Bolus
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
anesthesiologist
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
respirations
Stryker pain pump
catheter directly into incision; can be continuous or intermittent
Depodur
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
school
Factors that affect sleep
working 2nd, 3rd, or swing shift
Factors that affect sleep
travelling
Factors that affect sleep
snoring
Factors that affect sleep
intake of caffeine and nicotine
Factors that affect sleep
exercise before bed
Factors that affect sleep
napping
Factors that affect sleep
stress and illness
Factors that affect sleep
environmental factors
Insomnia
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
C-PAP
a machine that pushes air into the lungs during sleep
Snoring
may be cause by obstructed air passages in the mouth or nose
what can snoring be a sign of
sleep apnea
narcolepsy
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