nocebo harmful or undesirable response from placebo Nociplastic pain chronic primary pain; ex. cancer or fibromyalgia; not classified as nocicpetive or enuropathic enkephalins inhibit release of substance P to reduce pain sensation Sharp quality of pain that is stabbing and intense Acetaminophen viewed as one of the safest & best- tolerated analgesics Neuropathic pain caused by lesion or disease of peripheral or central somatosensory nervous system serotonin stimulate smooth muscles, inhibit gastric secretion; cause vasoconstriction Postherpetic neuralgia follows acute CNS infection (ex. herpes zoster - shingles) Hypnosis produces a subconscious state accomplished by suggestions made by hypnotist Oral (po) Preferred route of medication for cancer pain Diversion any act that results in a controlled drug not reaching the prescribed pt substance P sensitizes receptors on nerves to feel pain; increase nerve firing rate endorphins powerful pain blocking chemicals; prolonged analgesic effects; produce euphoria Intractable pain resistant to therapy; no relief from interventions referred pain pain originates in one part of body but perceived in area distant from point of origin PCA pump to be operated by patient only prostaglandins send additional pain stimuli to CNS Opioid analgesic Assess for respiratory depression with these meds; reversal Narcan (naloxone) BP, O2 sat, RR Pertinent VS to monitor with PCA or Epidural analgesia chronic pain persists or recurrent greater than 3 months Cutaneous stimulation massage; heat/cold therapy; acupressure; TENS unit Pasero Opioid- Induced Sedation Scale used to assess respiratory depression S1234 Cutaneous pain superficial; involves skin or SQ tissue; ex. paper cut Nociceptive pain represented by normal pain process modulation process by which the sensation of pain is inhibited or modified Breakthrough pain temporary flare- up of mod.- severe pain that occurs with ATC (around the clock) meds 30 degrees HOB elevation for epidural analgesia Visceral pain poorly localized; originates in thorax, cranium and abdomen; usually r/t disease pain it is what pt says it is Phantom pain does not have an identifiable physiologic or pathologic cause; ex. amputation transduction activation of pain receptors NSAIDs Contraindicated with bleeding disorders, probable infections and pregnancy >/+ 20 weeks Tolerance body becomes accustomed to opioid and need larger doses Pain tolerance max intensity of stimulus that produces pain a person is willing to accept Multimodal analgesic therapy combines 2+ classes of analgesics that target different sites in peripheral and CNS to maximize pain relief Gate Control Theory pain is believed to be controlled by closing the gating mechanism in the spinal cord CRIES pain scale used for neonates (0-6mo.) Somatic pain diffuse; originate in tendons, ligaments, bones blood vessels or nerves addiction chronic, relapsing brain disease; compulsive drug seeking placebo sham med or procedure designed and known to not be of any therapeutic clinical value FLACC pain scale for 2 months to 7 years bradykinin vasodilator; triggers release of histamine; assists in inflammation s/s EMLA cream cover w/ occlusive dressing 1hr prior to procedure for local pain relief pain threshold min. intensity of a stimulus that is perceived as painful Physical dependence body physiologically accustomed to opioid therapy and suffers withdrawal symptoms if it is removed or rapidly decreased transmission pain sensation from site of injury or inflammation travel to spinal cord then brain nociceptors peripheral/pain receptors; respond to selective stimuli acute pain rapid in onset; mild to severe; protective in nature nocebo harmful or undesirable response from placebo Nociplastic pain chronic primary pain; ex. cancer or fibromyalgia; not classified as nocicpetive or enuropathic enkephalins inhibit release of substance P to reduce pain sensation Sharp quality of pain that is stabbing and intense Acetaminophen viewed as one of the safest & best- tolerated analgesics Neuropathic pain caused by lesion or disease of peripheral or central somatosensory nervous system serotonin stimulate smooth muscles, inhibit gastric secretion; cause vasoconstriction Postherpetic neuralgia follows acute CNS infection (ex. herpes zoster - shingles) Hypnosis produces a subconscious state accomplished by suggestions made by hypnotist Oral (po) Preferred route of medication for cancer pain Diversion any act that results in a controlled drug not reaching the prescribed pt substance P sensitizes receptors on nerves to feel pain; increase nerve firing rate endorphins powerful pain blocking chemicals; prolonged analgesic effects; produce euphoria Intractable pain resistant to therapy; no relief from interventions referred pain pain originates in one part of body but perceived in area distant from point of origin PCA pump to be operated by patient only prostaglandins send additional pain stimuli to CNS Opioid analgesic Assess for respiratory depression with these meds; reversal Narcan (naloxone) BP, O2 sat, RR Pertinent VS to monitor with PCA or Epidural analgesia chronic pain persists or recurrent greater than 3 months Cutaneous stimulation massage; heat/cold therapy; acupressure; TENS unit Pasero Opioid- Induced Sedation Scale used to assess respiratory depression S1234 Cutaneous pain superficial; involves skin or SQ tissue; ex. paper cut Nociceptive pain represented by normal pain process modulation process by which the sensation of pain is inhibited or modified Breakthrough pain temporary flare- up of mod.- severe pain that occurs with ATC (around the clock) meds 30 degrees HOB elevation for epidural analgesia Visceral pain poorly localized; originates in thorax, cranium and abdomen; usually r/t disease pain it is what pt says it is Phantom pain does not have an identifiable physiologic or pathologic cause; ex. amputation transduction activation of pain receptors NSAIDs Contraindicated with bleeding disorders, probable infections and pregnancy >/+ 20 weeks Tolerance body becomes accustomed to opioid and need larger doses Pain tolerance max intensity of stimulus that produces pain a person is willing to accept Multimodal analgesic therapy combines 2+ classes of analgesics that target different sites in peripheral and CNS to maximize pain relief Gate Control Theory pain is believed to be controlled by closing the gating mechanism in the spinal cord CRIES pain scale used for neonates (0-6mo.) Somatic pain diffuse; originate in tendons, ligaments, bones blood vessels or nerves addiction chronic, relapsing brain disease; compulsive drug seeking placebo sham med or procedure designed and known to not be of any therapeutic clinical value FLACC pain scale for 2 months to 7 years bradykinin vasodilator; triggers release of histamine; assists in inflammation s/s EMLA cream cover w/ occlusive dressing 1hr prior to procedure for local pain relief pain threshold min. intensity of a stimulus that is perceived as painful Physical dependence body physiologically accustomed to opioid therapy and suffers withdrawal symptoms if it is removed or rapidly decreased transmission pain sensation from site of injury or inflammation travel to spinal cord then brain nociceptors peripheral/pain receptors; respond to selective stimuli acute pain rapid in onset; mild to severe; protective in nature
(Print)
harmful or undesirable response from placebo
chronic primary pain; ex. cancer or fibromyalgia; not classified as nocicpetive or enuropathic
inhibit release of substance P to reduce pain sensation
quality of pain that is stabbing and intense
viewed as one of the safest & best-tolerated analgesics
caused by lesion or disease of peripheral or central somatosensory nervous system
stimulate smooth muscles, inhibit gastric secretion; cause vasoconstriction
follows acute CNS infection (ex. herpes zoster - shingles)
produces a subconscious state accomplished by suggestions made by hypnotist
Preferred route of medication for cancer pain
any act that results in a controlled drug not reaching the prescribed pt
sensitizes receptors on nerves to feel pain; increase nerve firing rate
powerful pain blocking chemicals; prolonged analgesic effects; produce euphoria
resistant to therapy; no relief from interventions
pain originates in one part of body but perceived in area distant from point of origin
to be operated by patient only
send additional pain stimuli to CNS
Assess for respiratory depression with these meds; reversal Narcan (naloxone)
Pertinent VS to monitor with PCA or Epidural analgesia
persists or recurrent greater than 3 months
massage; heat/cold therapy; acupressure; TENS unit
used to assess respiratory depression S1234
superficial; involves skin or SQ tissue; ex. paper cut
represented by normal pain process
process by which the sensation of pain is inhibited or modified
temporary flare-up of mod.-severe pain that occurs with ATC (around the clock) meds
HOB elevation for epidural analgesia
poorly localized; originates in thorax, cranium and abdomen; usually r/t disease
it is what pt says it is
does not have an identifiable physiologic or pathologic cause; ex. amputation
activation of pain receptors
Contraindicated with bleeding disorders, probable infections and pregnancy >/+ 20 weeks
body becomes accustomed to opioid and need larger doses
max intensity of stimulus that produces pain a person is willing to accept
combines 2+ classes of analgesics that target different sites in peripheral and CNS to maximize pain relief
pain is believed to be controlled by closing the gating mechanism in the spinal cord
pain scale used for neonates (0-6mo.)
diffuse; originate in tendons, ligaments, bones blood vessels or nerves
chronic, relapsing brain disease; compulsive drug seeking
sham med or procedure designed and known to not be of any therapeutic clinical value
pain scale for 2 months to 7 years
vasodilator; triggers release of histamine; assists in inflammation s/s
cover w/ occlusive dressing 1hr prior to procedure for local pain relief
min. intensity of a stimulus that is perceived as painful
body physiologically accustomed to opioid therapy and suffers withdrawal symptoms if it is removed or rapidly decreased
pain sensation from site of injury or inflammation travel to spinal cord then brain
peripheral/pain receptors; respond to selective stimuli
rapid in onset; mild to severe; protective in nature
