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