NURSE-UN 240 A&E I– FINAL EXAM STUDY GUIDE WEEK 6 TO 10 Latest updated 2022,100% CORRECT
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NURSE-UN 240 A&E I– FINAL EXAM STUDY GUIDE WEEK 6 TO 10 Latest updated 2022
WEEK 6 – PAIN; SLEEP PAIN
What is Pain?
- “Whatever the person experiencing pain says it is”
- “Unpleasant sensory and emotional experience associated with actual or potential tissue damage”
- Subjective...
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NURSE-UN 240 A&E I– FINAL EXAM STUDY GUIDE WEEK 6 TO10 Latest
updated 2022
WEEK 6 – PAIN; SLEEP PAIN
What is Pain?
- “Whatever the person experiencing pain says it is”
- “Unpleasant sensory and emotional experience associated with actual or potential tissue
damage”
- Subjective: patient’s experience and self-report is essential
Nature of pain
- Involves physical, emotional, cognitive components
- Subjective & individualized
- Reduces quality of life
- Not measurable objectively
- May lead to serious physical, psychological, social and
1st level (nociceptor spine): alpha-delta and c-delta fibers go through dorsal root
ganglion into the spinal cord 2nd level (spine brain)
3rd level (brain to different parts that are going to interpret that pain responses)
Nociceptive pain originates when the tissue is injured
- Transduction – occurs when there is release of chemical mediators
o Converts energy produced by these stimuli into electrical energy
o Begins in the periphery when a pain-producing stimulus sends an impulse
across a sensory peripheral pain nerve fiber (nociceptor), initiating an action
, potential
o Once transduction is complete, transmission of pain impulse begins
- Transmission – involves the conduct of the action potential from the periphery (injury
site) to the spinal cord and then to the brainstem, thalamus, and cerebral cortex
o Sending of impulse across a sensory pain nerve fiber (nociceptor)
o Nerve impulses
o Pain impulses
- Perception – the conscious awareness of pain
o The point at which a person is aware of pain
, o The somatosensory cortex identifies the location and intensity of pain,
whereas the association cortex (primarily limbic system) determines how a
person feels about it
o There is no single pain center
- Modulation – involves signals from the brain going back down the spinal cord to modify
incoming impulses
o Inhibits pain impulse
o A protective reflex response occurs w/ pain reception
Physiology of pain
- Gate-control theory of pain
o Pain has emotional & cognitive components in addition to a physical sensation
o Gating mechanisms in the CNS regulate or block pain impulses
o Pain impulses pass through when a gate is open and are blocked when a gate is closed
o Closing the gate is the basis for non-pharmacological pain relief interventions
- As pain impulses ascend the spinal cord toward the brainstem and thalamus, the
stress response stimulates the autonomic nervous system (ANS) – fight or flight
- Continuous, severe or deep pain typically involving the visceral organs activates the
parasympathetic nervous system (PNS)
- Common indications of acute pain – clenching teeth, facial grimacing, holding or
guarding the painful part, bent posture
- Chronic pain affects pt’s activity and PNS & SNS does not react like they do to acute pain
- Lack of pain expression does not indicate that a pt is not experiencing pain
Types of pain
- Acute/transient – protective (body tells you something is wrong), identifiable, short
duration; limited emotional response
- Chronic/persistent noncancer – not protective, has no purpose, may or may not have an
identifiable cause
- Chronic episodic – occurs sporadically over an extended duration; usually above their chronic
baseline
- Cancer – can be acute or chronic
- Idiopathic – chronic pain w/o identifiable physical or psychological cause
Factors influencing pain
- Physiological – age, fatigue, genes
(threshold and tolerance),
neurological fxn (ie DM w/ ulcer)
o Fatigue increases perception of
pain and cancause problems w/
sleep and rest
- Social – attention, previous
experiences, family & social support
- Spiritual – includes active searching for
meaning in situations w/ questions such
, as “why am I suffering?”
- Psychological – anxiety, coping style
- Pain tolerance – the level of pain a person
is willing to accept
- Culture & ethnicity – meaning of pain
Critical thinking – knowledge of physiology
and the many factors that influence pain help
you manage a pt’s pain
Nursing Process & Pain
- Pain mgmt needs to be systematic &
needs to consider pt’s QOL
- Clinical guidelines are available to manage
pain – American pain society, sigma theta
tau, nat’l guidelines clearinghouse
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