Pain

Question 1

Relay impulses that are poorly localized, burning and persistent
ex: MI, stepping on a nail.

Answer 1

C Fibers

Question 2

An unpleasant, subjective and emotional experience associated with actual or potential tissue damage

• whatever the experiencing person says it is, existing whenever they say it does
• it is not the responsibility of patients to prove they are experiencing this, it is a nurses Responsibility to accept their report

Answer 2

Pain

Question 3

Inhibition of the pain impulse is the fourth and last phase of the nociceptive process

Answer 3

Modulation

Question 4

• what affects pain expression
• some believe its natural to be demonstrative about pain
• others tend to be more introverted

Answer 4

Culture

Question 5

Absence of identifiable physical or psychological cause or pain perceived as excessive for the extent of an organic pathological condition

• chronic pain
• CPRS

Answer 5

Idiopathic Pain

Question 6

Pain at the actual site of the tumor or distant to the site

Answer 6

Referred pain

Question 7

Pain that occurs sporadically over an extended period of time

• episodes last for hours, days or weeks
• pain R/T sickle cell disease
• migraine headaches

Answer 7

Episodic pain

Question 8

level of pain a person is willing to accept

Answer 8

Pain tolerance

Question 9

the point at which a person feels pain

-everyone is different

Answer 9

Pain threshold

Question 10

substances that increase pain transmission and cause an inflammatory response
-neurotransmitters involved in pain response

Answer 10

substance P
prostraglandins
bradykinin
histamine

Question 11

substances that decrease pain transmission and produce analgesia

Answer 11

serotonin

endorphins

Question 12

arises from damage to or inflammation of tissue other than of peripheral CNS

• usually throbbing, aching, localized pain
• responds to opioids and non opioids
• somatic(muscle) and visceral(organ)
• surgical incision that is dull, throbbing and aching

Answer 12

nociceptive pain

Question 13

a state of adaptation that is manifested by a drug class specific withdrawal syndrome produced by abrupt cessation and rapid dose reduction, decreased B/P

Answer 13

physical dependence

Question 14

contributes to venous thrombus formation

• damage to vessel wall
• alterations in blood flow
• alterations n blood constitutes

Answer 14

Virchow’s triad

Question 15

arises from abnormal or damages pain nerves
-responds to adjuvant meds
-phantom limb 
pain below spinal cord injury 
diabetic neuropathy
-burning shooting or electric like

Answer 15

neuropathic pain

Question 16

a person with chronic pain will seek numerous health care providers to alleviate pain

Answer 16

pseudoaddiction

Question 17

identifies the location and intensity of pain

Answer 17

somatosensory cortex

Question 18

web of hand between thumb and index finger

-influences nerve pathways to the face and head

Answer 18

acupressure

Question 19

mental and physical freedom from tension or stress that provides individuals a sense of self control

• meditation, yoga, zen, guided imagery
• only teach when patient is not distracted by discomfort

Answer 19

relaxation

Question 20

• sensation of pain extending from initial site to another body part
• pain feels traveled down and along body
• intermittent or constant
  ex: low back pain from ruptured disk

Answer 20

radiating pain

Question 21

no pain receptors

• perception of pain in unaffected area
• sensory neurons into same spinal cord segment from area of pain
• pain in part of body separate source of pain and assumes characteristics

Answer 21

referred pain

Question 22

• pain resulting from stimulation of skin
• short duration
• localized
• usually sharp sensation
  ex: needle stick, small cut, laceration

Answer 22

superficial or cutaneous

Question 23

resulting from stimulation internal organs

• diffuse/radiates different directions
• duration varies-last longer in superficial
• pain is sharp dull or unique to organ involved
• ex: crushing sensation, burning sensation

Answer 23

deep or visceral

Question 24

primarily limbic system determines how a person feels about pain

Answer 24

association cortex

Question 25

somatic and visceral free nerve endings of thinly mylinated and unmyelinated fibers -react to tissue injury but many also be excited by endogenous chemical substances

Answer 25

nociceptors

Question 26

lasts longer than 6 months - constant or recurring with a mild to severe intensity - does not always have an identifiable cause which can lead to personal suffering - usually non life threatening

Answer 26

chronic pain

Question 27

affective cognitive behavioral spiritual and social dementions -peripheral neuropathy, arthritis, low back pain, myofascial pain, headache

Answer 27

chronic pain

Question 28

protective and has an identifiable cause - short duration - limited tissue damage and emotional response - SNS(flight/fight) tachycardia, anxiety, sweating, muscle tension

Answer 28

acute pain/transient complete pain relief is not always achievable but reducing pain to a tolerable level is realistic -assess location, severity, and quality

Question 29

what is the physiological process of nociceptive pain?

Answer 29

1. transduction 2 transmission 3. perception 4. modulation

Question 30

inhibition of pain/release of inhibitory neurotransmitters - ways to decrease pain with nonpharmocologics - release endogenous opioids work to hinder pain and help produce an analgesic effect

Answer 30

modulation

Question 31

the patients experience of pain | -the point the person is aware of the pain

Answer 31

perception

Question 32

conversion of stimulus into electrical energy | -begins in periphery when pain producing stimulus sends an impulse across nerve fiber initiating action potential

Answer 32

transduction thermal, chemical, and mechanical are stimulus causing pain

Question 33

sending of impulse across a sensory pain nerve fiber(nociceptor) -where pain impulse begins

Answer 33

transmission

Question 34

sends sharp localized and distinct sensations that specify the source of pain and its intensity ex: stepping on a nail

Answer 34

A Fibers

Question 35

what controls the rhythm of the sleep wake cycle?

Answer 35

suprachiasmatic nucleus nerve cells in the hypothalamus

Question 36

excessive sleeping without obvious cause

Answer 36

hypersomnolence

Question 37

measures eye movement muscle tone changes and brain electrical activity during at least 4 napping opportunities spread throughout the day

Answer 37

multiple sleep latency test

Question 38

These neuroregulators are generated from the breakdown of phospholipids cell membranes and is thought to increase sensitivity to pain

Answer 38

Prostaglandins

Question 39

This new regulator is released from plasma that leaks from surrounding blood vessels at the site of tissue injury. It binds to receptors on peripheral nerves increasing pain stimuli. Binds to cells that cause a chain reaction producing prostaglandins

Answer 39

Bradykinin

Question 40

Found in pain neurons of the dorsal horn. Needed to transmit pain impulses from the periphery to higher brain centers. Causes vasodilation and edema

Answer 40

Substance P

Question 41

Produced by mast cells causing capillary dilation and increases capillary permeability

Answer 41

Histamine

Question 42

Released from the brainstem and dorsal horn to inhibit pain transmission

Answer 42

Serotonin

Question 43

What are some associated symptoms of chronic pain

Answer 43

Fatigue insomnia anorexia weight loss apathy hopelessness and anger

Question 44

What is PQRST in relation to pain assessment

Answer 44

Palliative or provocative factors: what makes pain better what makes your pain worse. Quality: how do you describe your pain Region or radiation: show me where you hurt. does is stay there or does it spread someone else Severity: on a scale of 1 to 10 how bad is your pain now. What is the worst pain you have had in the last 24 hours. What is the average pain you have had in the past 24 hours. Timing: is your pain constant intermittent or both and when did it start.