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"whatever the experiencing person says it is, existing whenever s/he says it does" -defense mechanism -subjective -immeasurable -fifth vital sign |
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arises from skin, bone, and muscle -conducted by sensory nerves |
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originates in organs -travels by sympathetic fibers |
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-peripheral nerves -spinal cord -brain |
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detect actual or potential tissue damage (pain is a nociceptor) stimulated by: temperature mechanical chemical |
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neurotransmitter for pain |
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to skin, muscle, internal organs nerves enter at dorsal horn, release neurotransmitters, activate other nerve cells, transfer info to brain |
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pain messages arrive and the thalamus send to -somatosensory nerves -limbic system -frontal cortex |
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physical sensations are felt |
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combination of thinking and emotion |
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1. transduction 2. transmission 3. perception 4. modulation |
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begins with nociceptor stimulation--> chemical release--> mediators |
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sensory (afferent) fibers A delta-fast acute pain C move much slower--chronic pain |
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location and characteristics of pain perceived two stages: initial and secondary |
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dull, throbbing, aching, slow pain |
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pain inhibition -initiated spontaneously by person (by rubbing or shaking) -descend from brain -gate-control theory |
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gates open-allows impulse to ascend gates close-reduces or modifies impulse, endorphines secreted by CNS, blocks substance P |
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tissue injury -stress response -HR -RR -BP -pallor -sweating -nausea |
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-decrease in plasma serotonin -brain becomes more sensitive -vasodilation -cytokines -trigeminal nerve signals chronic with actute qualities |
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-lasts more than 6 months -symptoms less obvious -psyhcological effects -depression common -pain clinic |
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chronic syndrome women 9:1 ages 20-50 collection of symptoms, controversial major FATIGUE hyperalgesia (low pain threshold), allodynia (mild stimuli causing pain) sleep disturbances depression IBS |
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infiltration of orgains (visceral) -compression of structures -treatments with damage tissue -SNS activation and behavioral changes -multifaceted approach -quality of life |
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feels like pins and needles -abnormalities of nervous system -allodynia common -altered nociceptive input -trigeminal neuralgia -diabetic neuropathy -postherepetic neuralgia |
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-pain from loss of blood flow -tissue hypoxia and injury -release of inflammatory and pain-producing chemicals -acute vs. chronic |
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perceived in area other than the site of injury |
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nursing's responsibility with pain |
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assessment is crucial -BELIEVE THE PATIENT -patient history -physical exam -diagnostics |
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-numeric rating scale -visual analog scale -verbal descriptive scale -wong-baker faces scale |
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-assess 30 min. after parenteral -assess 1 hr after oral -report of any new pain -each v/s evaluation |
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-trauma to body tissues (surgery) -alterations in body tissues (edema) -blockage of a body duct -tumor -muscle spasm |
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-tissue ischemia (blocked coronary artery) -muscle spasm |
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