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Terms in this set (55)
How do we assess pain?
COLDSPA: character, onset, location, duration, severity, pattern, associated factors
What is the origin of pain
site where the pain is felt - not necessarily the source
ex. paper cut
deep internal pain receptors (internal organs)
abdominal cavity, cranium, thorax
Ex. menstrual cramps, labor pain, GI/Bowel, organ cancers
deep somatic pain
-originated in ligaments, tendons, nerves, blood vessels, bones, connective tissue
Ex. fractures, sprains, arthritis, bone cancer
-starts at origin but extends to other locations
-close to the origin
Ex. sore throat--> ears & head
tooth pain --> ears & cheek
gastric reflux --> sternum, entire chest
-distant from original site
-MI --> left arm, back & jaw
-kidney stones --> lower abdomen
-arises from the mind
-no physical cause can be identified, but can be severe
believed to result from unconscious denial, repression, and displacement of anxiety all over body pain from depression
-perceived to originate from an area that has been surgically removed
-type of neuropathic pain
What are pain receptors
specialized nerve endings located throughout the body that transmit pain to the spinal cord and brain
-occurs when pain receptors respond to stimuli that are potentially damaging
-thermal, chemical, or mechanical types of injury
What are some causes of nociceptive pain?
trauma, surgery, inflammation
How is nonciceptive pain described by patients?
-complex & often chronic
-injury to nerves
-repeated transmission of pain signals in absence of painful stimuli
examples of neuropathic pain
-diabetes: diabetic neuropathy usually in lower extremities, high blood sugar can damage nerves
How do patients describe neuropathic pain?
burning, numbness, itching, pins & needles, prickling pain
up to 6 months duration, rapid onset (injury, surgery)
greater than 6 months duration
interferes with daily activities
how many americans live with chronic pain
1 in 6
-chronic & highly resistant to relief
-requires multiple methods of pain relief
periodicity of pain
episodic, intermittent, constant
intensity of pain
mild, distracting, moderate, severe, intolerable
the transfer of physical energy (stimulus) to nervous system
external forces, pressure or friction against the body
exposure to extreme heat or cold
-external stimulus, acid on skin
-internal stimulus, ischemia, heart attack
tissue damage promotes the release of ...?
bradykinin, histamine, & prostaglandins
-red, swollen, tender
-local immune response
-activate nociceptors in surrounding tissues
What meds decrease prostaglandin response?
What is the most frequent cause of pain?
peripheral nerves transmit pain messages to the dorsal horn of the spinal cord
-initial sharp pain when you stub your toe
-dull diffuse pain, lingering ache
What is the somatosensory cortex responsible for?
perceives and interprets physical sensations
What is the limbic system responsible for?
what is the frontal cortex responsible for?
-thought & reason- the recognition and definition of pain
-person now perceives PAIN
extreme sensitivity to pain
-naturally occurring analgesic neurotransmitters that bind to opiate receptor sites in the central and peripheral nervous system at receptor sites (mu, kappa, delta, sigma)
-reduce the perception of pain when attached to receptor sites
How do opioids affect the digestive tract?
slow peristalsis- opioid induced constipation
What does gate control theory alter?
perception of the pain
Involuntary response from acute pain
increased BP, HR & RR (only last a short time)
involuntary response of deep prolonged pain
decreased BP, HR &RR
voluntary response from pain
withdrawal from painful stimulus, moaning, grimacing, crying, agitation, guarding the painful area
psychological affects of pain
anxiety, depression, anger, fear, exhaustion, hopelessness, irritability
increases blood sugar, suppresses immune system, suppresses digestive system, can affect mood
can contribute to osteoarthritis, hypertension, hyperglycemia
(body tissue less sensitive to insulin)
fight or flight- increase HR, BP, decrease digestion
more glucose released from the liver
What hormones increase with pain?
ACTH, cortisol, ADH, growth hormone, catecholamines, glucagon
what hormones decrease with pain?
insulin and testosterone levels
THIS SET IS OFTEN IN FOLDERS WITH...
funds medication administration
funds activity and exercise
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