NSG 533 EXAM 2
What is acute pain?
occurs as a result of injury or surgery & self-limited, subsiding when injury heals
untreated - tachypnea, tachycardia, increased SNS activity (pallor, diaphoresis, &
pupil dilation)
What is somatic acute pain?
arises from injury to skin, bone, joint muscle, & connective tissue
localized to site of injury
What is visceral acute pain?
injury to internal organs & can present as diffuse, poorly differentiated, & often
referred pain
What is chronic pain?
persists beyond expected normal time for healing & serves no useful physiologic
purpose
might be nociceptive, inflammatory, neuropathic, or nociplastic
intermittent, persistent, or both
effects physical function, psychological changes, social consequences, societal
consequences
What is nociceptive pain?
,transient pain in response to noxious stimulus @ nociceptors located in cutaneous
tissue, bone, muscle, connective tissue, vessels, viscera
What are nociceptors classified as?
thermal, chemical, or mechanical
What is the nociceptive system?
prevents further tissue damage due to body's autonomic withdrawal reflex
What is neuropathic pain?
spontaneous & hypersensitive pain associated with damage to or pathologic
changes in PNS or CNS
considered chronic nonmalignant pain
What is malignant pain?
associated with progressive disease that is life-threatening such as cancer, AIDS,
progressive neurologic diseases, end-stage organ failure, & dementia
What is inflammatory pain?
contributes to pain hypersensitivity that serves to prevent contact or movement of
injured part until healing is complete, reducing further damage
What is nociplastic pain?
due to abnormal processing or function of CNS in response to normal stimuli
ex: fibromyalgia, IBS
, What are some non-pharmacological approaches to pain?
psychological interventions for acute pain include imagery (picturing oneself in a
safe place, peaceful place) & distraction (listening to music or focusing on breathing)
psychological interventions for chronic pain include relaxation, biofeedback,
cognitive behavioral therapy, psychotherapy, support groups, & spiritual counseling
physical therapy such as heat, cold, water, ultrasound therapy, TENS, massage, &
therapeutic exercise
What is the World Health Organization's (WHO) three-step ladder approach to
pain management?
guidelines for selection of therapeutic agents is based on pain intensity - mild,
moderate, severe
What is the approach to mild pain (rate 1-3/10)?
nonopioid analgesic w/ regular scheduled dosing
ex: acetaminophen 1,000 mg Q 6 hrs; ibuprofen 600 mg Q 6 hrs
What is the approach to moderate pain (rate 4-6/10)?
add opioid to the nonopioid w/ regular scheduled dosing
ex: acetaminophen 325 mg + codeine 60 mg Q 4 hrs; acetaminophen 325 mg +
oxycodone 5 mg Q 4 hrs
What is the approach to severe pain (rate 7-10/10)?
switch to high-potency opioid w/ regular scheduled dosing
ex: morphine 10 mg Q 4 hrs; hydromorphone 4 mg Q 4 hrs
