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20 Cards in this Set
- Front
- Back
How pain travels |
transmitted from the site of stimulation of peripheral receptors to the spinal cord (transduction), up the spinal cord (transmission) to the cerebral cortex (perception), and back down the spinal cord (modulation) |
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Pain definition |
"whatever the experiencing person say it is, existing whenever he says it does" -subjective report is most reliable indicator of pain |
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Nociception |
term used to describe how noxious stimuli are typically perceived as pain. Four phases: |
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Pain classified by source |
visceral pain, deep somatic pain, superficial (cutaneous) pain, or referred pain (originates in one location but felt in another) Equianalgesia: does of one opioid who's pain-relieving effects are equivalent to a dose of another opioid |
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Neuropathic pain |
pain resulting from a nerve injury in either central or peripheral nervous system. Type of pain that does not follow typical or predictable phases of nociceptive pain Somatic: superficial (skin) or deep (joints) Visceral: larger interior organs (kidneys, pancreas) |
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Pain classified by duration |
Acute: short term and self-limiting, often follows predictable track and ends after injury healed Persistent: continues for 6 months or longer than expected time of tissue healing, can last for years. intensity of pain doesn't reflect physical findings. |
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Factors affecting experience of pain |
developmental age ethnocultural aspects gender differences |
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Pain Scales |
Uni-dimensional and intended to reflect pain intensity. Numeric scales- adult patients Pediatric scales with pictures |
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Mental Health |
Relative state of mind in which a person who is healthy is able to cope with and adjust to daily stresses in an acceptable way. |
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Mental Status |
degree of competence that a person show in intellectual, emotional, psychological, and personality functioning |
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Considerations for mental status |
consciousness language mood and affect orientation attention memory abstract reasoning though process thought content perceptions |
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Developmental perspective for infants |
Must consider consciousness, use of language, attention span, and ability to think abstractly |
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4 components addressed during mental status assessment |
Appearance- posture, body movements, dress, grooming and hygiene Behavior- level of consciousness, facial expression, speech, mood and affect Cognitive functions- orientation, attention span, recent and remote memory, new learning Thought processes- thought processes, though content, perception, screen for suicidal thoughts |
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Mini mental status exam |
Quick and easy means of assessing cognitive function. Used to detect dementia and delirium as well as differentiate organic disorders from psychiatric illnesses. Nipissing District Developmental Screen- kids ABCT - adults |
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Assessment #1- Inspection |
refers to visual examination of body (movements and posture) as well as smell. |
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Assessment #2- Palpation |
Use of nurses hands to feel texture, size, shape, consistency, and location of certain parts of clients body and also identify areas the client reports as being tender or painful Light palpation (1-2 cm) Deep palpation (4-7cm) Dorsa of hand- temperature Base of fingers- vibration |
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Assessment #3- Percussion |
tapping the persons skin with short, sharp strokes to assess underlying structures by litsening to sound waves heard as 'notes' Direct: striking hand contacts body Indirect: striking hand contacts stationary hand |
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Percussion Sounds |
Resonant sounds are low pitched, hollow sounds heard over normal lung tissue. Flat or extremely dull sounds are normally heard over solid areas such as bones. Dull or thudlike sounds are normally heard over dense areas such as the heart or liver. Dullness replaces resonance when fluid or solid tissue replaces air-containing lung tissues, such as occurs with pneumonia, pleural effusions, or tumors. Hyperresonant sounds that are louder and lower pitched than resonant sounds are normally heard when percussing the chests of children and very thin adults. Hyperresonant sounds may also be heard when percussing lungs hyperinflated with air, such as may occur in patients with COPD, or patients having an acute asthmatic attack. An area of hyperresonance on one side of the chest may indicate a pneumothorax. Tympanic sounds are hollow, high, drumlike sounds. Tympany is normally heard over the stomach, but is not a normal chest sound. Tympanic sounds heard over the chest indicate excessive air in the chest, such as may occur with pneumothorax. |
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Characteristics of Percussion Sounds |
Amplitude: loudness or softness of a sound Pitch: number of vibrations or cycles per second Quality: subjective diff. in a sounds distinctive overtones Duration: length of time the note lingers |
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Assessment #4- Auscultation |
Act of listening to sounds within body commonly using a stethoscope Diaphragm: used to hear high pitched sounds Bell: better to locate low pitched sounds like murmurs and bruits |