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NURS 2910 Exam 3 Questions and Answers 2024 100% Verified.

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NURS 2910 Exam 3 Questions and Answers 2024 100% Verified.

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  • August 4, 2024
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  • nurs 2910 exam 3
  • NURS 2910
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NURS 2910 Exam 3
Describe the pathophysiology of pain and physiologic response.
Associated with the central and peripheral nervous system

Pain stimulates the nociceptors and transmits message to the CNS


Mechanosensitive nociceptors
sensitive to intense mechanical stimulation (i.e. pliers, pinched skin, stretching of tissue,
compression, surgical incisions, friction, skin shearing)




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Temperature-sensitive nociceptors
sensitive to heat and cold (touching a hot surface, earache on a cold day)


Chemical nociceptors
can be internal or external (lemon juice or acidic substance on a cut or chest pain).


Transduction
nociceptors become activated by the perception of mechanical, thermal, and chemical stimuli.


Transmission
pain impulse from the nociceptors relays the pain from the spinal cord to the brain


A-delta fibers (fast)
sharp initial pain or (seen in modulation: pleasurable stimuli can decrease pain)


C fibers (slow)

,lingering ache


Perception
pain recognition and prefrontal cortex perceives pain


Modulation
pain message is inhibited by the brain stem neuron and there is a neuron release of
endogenous neurotransmitters


Physiological responses to pain (Infants and children)
Neonates (skin mottling, grimacing, twitching, crying, poor feeding, temperature fluctuation,
elevated blood pressure, decreased oxygen saturations

Crying


Physiological responses to pain (Older Adults)
May be unable to report pain d/t cognitive impairment

Nonverbal cues (grimacing, rapid blinking, labored breathing, decreased activity withdrawal,
confusion.


All patients experiencing pain may have
Sympathetic responses (acute pain): (dilated pupils, impaired GI motility, increased HR/RR/BP,
reduced urinary output, pallor)

Parasympathetic (deep or prolonged pain): (breathing pattern changes, constricted pupils,
decreased pulse, decreased SBP, withdrawal)

Behavior & Psychological responses (voluntary): (agitation, fidgeting, grimacing, grinding teeth,
guarding, crying, rapid speech or slow, eating and sleeping poorly, reduced energy and interest,
change in gate) & (anger, anxiety, depression, fear, hopelessness, irritability, exhaustion).


Other physiological responses to pain
Decreased urinary output, resulting in urinary retention, fluid overload, depression of all immune
responses

Increased antidiuretic hormone, epinephrine, norepinephrine, aldosterone, glucagon, decreased
insulin, testosterone

,Hyperglycemia, glucose intolerance, insulin resistance, protein catabolism

Muscle spasm, resulting in impaired muscle function and immobility, perspiration

Increased respiratory rate and sputum retention, resulting in infection and atelectasis


Identify the ways pain can be classified.
Origin, cause, duration, onset, quality


Origin
Cutaneous pain/superficial pain – Skin or subcutaneous tissue

Visceral pain – Abdominal cavity, thorax, cranium

Deep somatic pain – Ligaments, tendons, bones, blood vessels, nerves

Radiating – perceived both at the source and extending to other tissues

Referred – perceived in body areas away from the pain source

Phantom pain– perceived in nerves left by a missing, amputated, or paralyzed body part.




Cause or type
Nociceptive – response to noxious insult or injury of tissues such as skin, muscles, visceral
organs, joints, tendons, or bones

Visceral pain (internal organs)

Somatic pain (skin, muscles, bones, or connective tissue)

Neuropathic – Injury to nerve resulting in repeated transmission of pain signals even in the
absence of painful stimuli. This can originate from poorly controlled diabetes, stroke, tumor,
alcoholism, amputation, a viral infection, or medications




Duration
Acute pain – usually associated with a recent injury

, Chronic pain – Usually associated with a specific cause or injury and described as a constant
pain that persists for more than 3-6 months

Intractable pain– Chronic & Defined by its high resistance to pain relief




Quality (intensity and pattern)
Pain quality - sharp or dull, aching, throbbing, stabbing, burning, ripping, searing, or tingling

Pain periodicity - episodic, intermittent, constant

Pain intensity - mild, distracting, moderate, severe or intolerable


Factors that influence pain
Emotions, Previous pain experiences, life cycle experiences, sociocultural factors,
communication and cognitive impairments

Do not assume that patients will react in the same way as others of the same ethnic or cultural
group. Each patient is unique

Nurses have a duty to provide culturally competent care and adequate pain control to every
patient

Indicators of pain: facial expressions, vocalizations, change in physical activity, changes in
routine, mental status changes, physiologic cues


Psychological factors affecting pain perception and assessment (Developmental level)
Pediatric

Chronic pain affects 15-20% of children

Fetuses may feel pain as early as 20 weeks

Geriatric

71-83% aged 60 and older in assisted living and 64-78% aged 60-89 experience significant pain




Cultural considerations
Pain is a universal experience

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