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Pediatrics > Pain Management > Flashcards

Pain Management Flashcards

1
Q

Transduction

A

nociceptors are activated when exposed to noxious stimuli

-mechanical, chemical, or thermal

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2
Q

Transmission

A

stimuli are converted to electrical impulses and relayed to spinal cord and brain by afferent nerve fibers and unmyelinated C fibers
-neurotransmitters facilitated transmission process to the brain

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3
Q

Pain

A
  • an unpleasant sensory and emotional experience that is associated w/ actual or potential tissue damage
  • whatever the person says it is
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4
Q

What is the 5th vital sign?

A

Pain

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5
Q

A-delta Fibers

A

lead to sharp stabbing local pain

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6
Q

C Fibers

A

lead to diffuse, dull burning or aching pain

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7
Q

Perception of Pain

A
  • nerve fibers divide in dorsal horn of spinal cord, cross to opposite side, rise upward to thalamus
  • thalamus sends message to somatosensory cortex of brain where impulse is interpreted as pain
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8
Q

Pain Threshold

A

point where person feels lowest intensity of painful stimulus

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9
Q

Modulation

A

neuromodulators modulate pain sensation

can be modified peripherally or centrally

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10
Q

Examples of Neuromodulators

A

Serotonin
Endorphins
Enkephalins
Dynorphins

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11
Q

Classifications of Pain

A
  • duration
  • etiology
  • source/location
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12
Q

Types of Duration

A

Acute or Chronic

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13
Q

Acute Duration

A

rapid onset of varying intensity, sore throat, appendicitis, surgery, invasive procedure

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14
Q

Chronic Duration

A

pain that continues past the expected point of healing for injured tissue, abdominal pain, headache, sickle cell disease, or migraines

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15
Q

Types of Etiology

A

Nociceptive

Neuropathic

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16
Q

Nociceptive

A

due to noxious stimuli that damages normal tissue or has the potential to, chemical burn, sun burn, appendicitis

17
Q

Neuropathic

A

pain due to malfunctioning or the peripheral or central nervous system, spinal cord injury, phantom limb pain

18
Q

Types of Source/Location Pain

A

Somatic

Visceral

19
Q

Somatic

A

pain that develops in the tissues; superficial or deep

20
Q

Visceral

A

pain that develops w/in organs such as heart, lungs, GI tract, bladder, etc.

21
Q

Factors Influencing Pain

A 
Age 
Gender
Cognitive level
Temperament 
Previous experiences 
Family and Cultural background
22
Q

Situational Factors Influencing Pain

A

behavioral
cognitive
emotional

23
Q

Behavioral Factor

A

how the child and family react and what they do about the pain experience

24
Q

Cognitive Factor

A

what the child understands and believes about the pain experience

25
Q

Emotional Factor

A

how the child and family feels about the pain experience

26
Q

Indicators of Pain in Infants

A
  • facial expressions
  • body movements
  • crying
  • changes in HR, RR, BP, oxygen sat, vagal tone, palmar sweating, and plasma cortisol or catecholamine levels
27
Q

Toddlers and Pain

A
  • encourage to verbalize pain
  • may hit, bite, scream, or kick
  • use words they understand
28
Q

Preschoolers and Pain

A
  • may not verbally report pain
  • thinking pain is expected
  • think adults are aware of pain
  • “I need to go to the bathroom”
  • difficulty describing pain
29
Q

School Age Children and Pain

A
  • type, location, and severity
  • use descriptions based on things they know
  • try to be brave
  • might be embarrassed about acting out
  • withdraw
  • muscular rigidity
30
Q

Adolescents and Pain

A
  • concerned primarily w/ body language
  • concerned w/ fear of losing control of behavior
  • can deny or refuse meds
  • mood affects response to pain
  • don’t want to look like child
  • look for subtle changes
31
Q

What subtle changes should you look for in response to pain for adolescents?

A

rapid breathing, clenched teeth, clenched fists

32
Q

Factors Affecting Child’s response to Pain

A

type of pain
extent of pain
age/developmental

33
Q

Key Principles of Pain Assessment

A
  • question the child
  • use reliable and valid pain scale
  • evaluate child’s behavior and physiologic changes to establish baseline
  • secure parents involvement
  • take cause of pain into account
  • take action
34
Q

Health History Data Related to Pain Assessment

A
  • location, quality, severity, and onset of pain
  • conditions that preceded the onset of pain and conditions that followed
  • any associated symptoms such as weight loss, fever, vomiting, diarrhea, that may indicate illness
  • any recent trauma including interventions used
35
Q

Pain Management Guide For Children

A
  • individualized interventions
  • use nonpharmacologic and pharmacologic approaches to ease/eliminate pain
  • teach child and fam about pain relief interventions and techniques
36
Q

What should you base your individualized interventions on when managing pain?

A

Amount of pain experienced, the child’s characteristics such as developmental level, temperament, previous pain experience and coping strategies

37
Q

Nonpharmacologic Techniques

A

relaxation
distraction
guided imagery

38
Q

Behavioral-Cognitive Pain Management Strategies

A
  • relaxation
  • distraction
  • imagery
  • biofeedback
  • thought stopping
  • positive self talk
39
Q

Biophysical Interventions for Pain Management

A
  • sucking and sucrose
  • heat and cold applications
  • massage and pressure

Pediatrics (24 decks)

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