Pain

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Questions and Answers

What is the term used to describe the degree of pain an individual is willing to bear before seeking relief?

Pain threshold

Pain perception

Pain tolerance (correct)

Pain expression

Which type of pain is characterized by being constant until treatment is rendered and often associated with kidney stones?

Acute pain

Referred pain (correct)

Somatic pain

Neuropathic pain

What differentiates localized pain from referred pain?

Localized pain is confined to a specific area, while referred pain is felt in a different location. (correct)

Referred pain occurs only during physical activity.

Referred pain is always associated with chronic conditions.

Localized pain is only felt on one side of the body.

Which of the following best describes pain according to the definitions provided?

Pain is an unpleasant experience linked to actual or potential tissue damage. Signup and view all the answers

Which of the following statements about pain expression is accurate?

It refers to how pain is communicated to others. Signup and view all the answers

What type of pain involves injury to the skin or muscles and is typically sharp and well-localized?

Somatic pain Signup and view all the answers

In distinguishing back pain from kidney pain, which of the following is a common characteristic of kidney pain?

Pain may accompany abdominal pain. Signup and view all the answers

Which term describes a psychological or physical need for a habit-forming substance?

Addiction Signup and view all the answers

What is tolerance in relation to drug exposure?

A decrease in the drug's effects over time due to exposure Signup and view all the answers

Which of the following is a common side effect of opioid analgesics?

Respiratory depression Signup and view all the answers

Which medication is considered a non-opioid analgesic?

Aspirin Signup and view all the answers

What is the most commonly abused opioid in the US?

Heroin Signup and view all the answers

Which of the following therapies is NOT recommended for chronic pain treatment?

Medication with opioids Signup and view all the answers

What is the goal of the Methadone Maintenance Program?

To gradually reduce opioid use Signup and view all the answers

Which opioid requires the CYP2D6 enzyme for conversion to an active metabolite?

Codeine Signup and view all the answers

What is a common route of administration for Acetaminophen?

Oral and liquid preparations Signup and view all the answers

Study Notes

Acute and Chronic Pain

Pain is an unpleasant sensory and emotional experience associated with potential tissue damage.
Pain is defined by the experiencing person.
Acute pain is short-lasting, while chronic pain lasts longer.
Other types of pain include: somatic pain, visceral pain, and neuropathic pain.
Pain can be localized, radiating, or referred.
Pain is a complex process with different stages: transduction, transmission, perception, and modulation.
Substance abuse including addiction, pseudoaddiction, and tolerance can affect pain treatment.
There are different methods for managing pain ranging from basic medication to more complex approaches like PCA pumps and spinal analgesia.
Proper pain management involves a multidisciplinary approach, including medication, physical therapy, and psychological counseling.
In end-of-life care, pain management is crucial.

Pathophysiology of Pain

Pain begins with transduction, where a stimulus converts into a neural signal.
Transmission involves carrying this signal through nerve fibers to the spinal cord.
Pain perception occurs in the brain, where the signal is interpreted.
Modulation refers to the brain's ability to modify pain signals.

Transduction

Phospholipid cell membranes are initial point of pain signals.
Phospholipase A converts the membranes to arachidonic acid.
Cyclooxygenase converts arachidonic acid into prostaglandins, a key component in pain signaling.
NSAIDS inhibits cyclooxygenase's activity to reduce pain.

Pain Transmission

Small-diameter nerve fibers carry pain signals to the spinal cord.
The spinal cord contains a "gate" mechanism (substantia gelatinosa).
This gate can be open or closed to regulate pain signals.

Pain Perception

Pain threshold is the level of stimulation required for pain to be perceived.
Pain tolerance is the degree of pain an individual can endure before seeking relief.
Pain expression is how pain is communicated to others.

Types of Pain

Somatic pain originates in the body's skin, muscles, bones, or joints.
Visceral pain originates from the internal organs.
Neuropathic pain results from damage to the nervous system.

Locations of Pain

Localized pain is confined to a specific area.
Radiating pain spreads outward from the initial site.
Referred pain appears in an area distant from the actual source, for example, pain in the arm when the heart is having problems.

Referred Pain

This explains certain pain locations based on anatomical connections. For example: pain in the shoulder could be associated with gallbladder issues.

Distinguishing Back Pain from Kidney Pain

Key differences include:
- Locations of pain.
- Type of pain (constant pain versus intermittent).
- Underlying causes.

Approaches to pain management differ, based on individual attitudes and care practices.

Substance Abuse

Addiction is a physical or psychological need for a substance.
Pseudoaddiction can be caused by inadequate treatment.
Tolerance occurs when the body adapts to a drug and requires a higher dose to achieve the same effect.

Addiction

Addiction to drugs or alcohol involves a psychological and physical need.

Pseudoaddiction

Pseudoaddiction arises when pain is inadequately treated.
Patients undertreated for pain may develop behaviors that resemble addiction.

Tolerance

As the body adapts, the effects of a drug decrease over time.
A higher dose may be needed to achieve the same effect.

Physical Dependence

Physical dependence does not necessarily equate to addiction.

Nursing Management of Pain

Nurses need to carefully consider aggravating factors, localization of pain, and duration of pain.

Pharmacologic Therapy

Acetylsalicylic acid (Aspirin), Acetaminophen (Tylenol) and NSAIDS are common ways to treat pain.
GI disturbances are a potential side effect of some medications.

Non-Opioid Analgesics

Acetaminophen (Tylenol) is a common non-opioid analgesic.

Opioid Analgesics

Opioid medications are capable of stronger pain relief.

Drugs: Heroin

Heroin is a commonly abused opioid.

Heroin Dependence

Methadone maintenance programs can help manage heroin dependence.

Side Effects of Opioids

Opioids can cause side effects including Nausea and vomiting, Constipation, Sedation, Respiratory depression, Euphoria.

Pain Management in End of Life Care

Pain management is crucial in end-of-life care.

PCA Infusion Pump

PCA (patient controlled analgesia) pumps allow for self-administration of pain medication.

Spinal Analgesia

Epidural and intrathecal (subarachnoid) analgesia are methods for pain management.

Chronic Pain Treatment

Opioid medications are not always the first choice for chronic pain.
Treatment of chronic pain may involve physical therapy, psychological counseling and careful medication management.

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