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also referred to as somatic or visceral pain; caused by injury to tissues; Somatic pain: sharp, localized sensation; Visceral pain: dull, throbbing or aching pain; responds well to conventional pain relief med |
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caused by injury to nerves; described as burning, shooting, or numb pain; less therapeutic success |
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Techniques for reducing pain |
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acupuncture, biofeedback, massage, heat or cold packs, meditation or prayer, relaxation therapy, art or music therapy, imagery, chiropractic manipulation, hypnosis, therapeutic or physical touch, TENS, energy therapies such as Reiki an Qi gong |
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endorphins, dynorphins, enkephalins; modify sensory info at the level of the spinal cord |
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Opioids (Narcotics)Analgesics |
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Definition
Drug of choice for mod to severe pain that cannot be controlled w/ other analgesics; interact w/ at least 6 types of receptors: mu (1 & 2), kappa, sigma, delta, epsilon; mu and kappa are most important |
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Definition
Uses: pain, general anesthesia, cough suppressant, anti-diarrhea; Teaching: report N/V/D, rash, yellowing of skin, abd. pain, tenderness or distention, change in stool color; report seizure activity |
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Nursing Considerations for Opioids |
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Definition
Check for Hx of severe respiratory disorders, increased ICP, seizures, liver or renal disease, allergies; Contraindications: acute asthma, upper airway obstruction |
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Definition
Narcan is one; used to reverse opioid OD; Side Effects: thirst, chills, fever, joint/muscle pain, CNS stimulation, drowsiness, dizziness, confusion, HA, N/V/D, rash, rapid pulse and respirations, pulmonary edema, wheezing |
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Nursing considerations for Narcan |
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Definition
check VS every 3-5 mins, obtain ABG levels, ECG, monitor for drowsiness, tremors, hyperventilation, V-tach, loss of analgesia; if giving for drug-dependence, monitor for S of w/drawal: cramping, vomiting, HTN, anxiety |
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Definition
drug of choice for mild to mod pain; Nrsg considerations: Hx of hypersensitivity, bleeding disorders, peptic ulcers, severe renal/hepatic disease, pregnancy; Side effects: nausea, abd pain, anorexia, dizziness, drowsiness |
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Term
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Definition
most common; muscles of head and neck tight from stress; effectively treated w/ OTC analgesics |
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most painful type of HA; throbbing or pulsating pain, sometimes preceded by an aura; pharmacological goals: to stop migraine in progress, and to prevent them; drug therapy most effective if begun before migraine becomes severe |
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Definition
triptans and ergot alkaloids (serotonin <5-HT> agents); therapy generally begins w/ NSAIDs or acetaminophen; next drug of choice is triptans (Imitrex); ergot alkaloids are final choice |
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Nrsg considerations for antimigraine therapy |
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Definition
Hx of MI, angina, HTN, renal or liver disease, diabetes, pregnancy; Assess AP, resp, BP, LOC, blurred vision, N/V; Side effects: dizziness, drowsiness, vasoconstriction, warming sensation, tingling, light-headedness, weakness, neck stiffness |
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Morphine (Astramorph, Duramorph) |
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Definition
binds with mu and kappa receptors to produce profound analgesia; euphoria, constriction of pupils, stimulation of cardiac muscle; used for acute and chronic pain, as preanesthesia, to relieve SOB w/ HF, acute chest pain from MI; Side effects: dysphoria, hallucinations, nausea, constipation, dizziness, itching sensation; OD= resp depression and cardiac arrest; tolerance and cross-tolerance can develop; dependence can deelop if high doses taken for long periods; Contraindications: may intensify or mask pain of gallbladder disease, avoid in cases of acute or severe asthma, GI obstruction, severe hepatic or renal impairment; causes orthostatic hypotension |
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Term
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Definition
opioid antagonist, blocks mu and kappa receptors; used for reversal of opioid effects; administer for RR < 10 bpm; minimal toxicity; reversal of effects of opioids may result in loss of analgesia, increased BP, tremors, hyperventilation, N/V, drowsiness; should not be used for resp depression caused by nonopioid meds; echinacea may increase risk of hepatotoxicity |
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Aspirin (Acetylsalicylic Acid, ASA) |
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Definition
inhibits prostaglandin synthesis in process of pain and inflammation, mild to mod relief of fever; anticoag, reduces risk of colorectal cancer; anticoag properties are irreversible, should be dc'd 1 week before elective surgery; excreted in urine and affects urine testing for glucose and other metabolites; at high doses it may cause gastric discomfort and bleeding; Contraindications: should not be given to clients on anticoag therapy; garlic, ginger, gingko may increase bleeding |
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Definition
acts by causing vasoconstriction of cranial arteries; subc terminates pain in 10-20 mins, can be repeated 60 mins after (max of 2 per day), oral meds should be taken asap after migraine begins; may produce cardiac ischemia, HTN, dysrhythmias, or MI; nurse should monitor LOC and observe for seizures; Side Effects: dizziness, drowsiness, warming sensation, usually not severe; Contraindications: clients w/ recent MI, Hx of angina pectoris, HTN, diabetes; gingko, ginseng, echinacea, St. John's wort may increase toxicity |
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Definition
creams, sprays, suppositories, drops, and lozenges; applied to mucous membranes (eyes, lips, gums, nasal membranes, throat); very safe unless absorbed; used for sunburn, insect bites, hemorrhoids, sore throat, minor wounds |
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clients are conscious but insensitive to pain and unconnected w/ surroundings; also called neuroleptanalgesia; Innovar is a common drug for this state and is a combo of fentanyl and droperidol |
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Definition
injected into the CSF; affects large, regional area such as the lower abd and legs; monitor for presence of spinal HA |
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Definition
usually associated w/ excessive use of and local injury to the skeletal muscle; may also be caused by overmedication of antipsychotics, epilepsy, hypocalcemia, pain, and debilitating neurological disorders; clients may experience inflammation, edema, and pain, loss of coordination and reduced mobility |
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Definition
single, prolonged contraction |
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multiple, rapidly repeated contractions |
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Definition
condition in which certain muscle groups remain in a continuous state of contraction, usually resulting from damage to the CNS; the contracted muscles become stiff w/ increased muscle tone; S/Sx: mild to severe pain, exaggerated deep tendon reflexes, muscle spasms, scissoring, and fixed joints; Tx: P.T. and meds; Meds: Botox, Myobloc, Quinamm |
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Definition
drug of choice for Parkinson's; precursor of dopamine synthesis; increases biosynthesis of dopamine in nerve terminals; up to 6 months for max effects; abrupt w/drawal can result in Parkinsonian crisis or neuroleptic malignant syndrome; Side Effects: uncontrolled and purposeless movements, involuntary movements, loss of appetite, N/V; Contraindicated in narrow-angle glaucoma |
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Definition
naturally degraded in the synapse by AchE; when AchE is inhibited, Ach levels increase and produce a more profound effect on the receptor |
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Definition
indirect acting parasympathomimetic; used to treat Alzheimer's; goal is to improve function in ADLs, behavior, and cognition; these drugs only slow the progression; an increased level of Ach is only effective if there are functioning neurons present; all AchE inhibitors used for AD have equal efficacy; side effects: N/V/D |
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Term
EPS (extrapyramidal symptoms) |
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Definition
develop for the same neurochemical reasons as Parkinson's; may be induced by antipsychotics; may occur suddenly and become a medical emergency; client's muscles may spasm or become locked up; fever and confusion; can be treated w/ parenteral Benadryl; untreated acute episodes can be fatal |
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Term
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Definition
act through a blockade of dopamine receptors; may induce EPS; phenothiazines are antipsychotics |
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Term
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Definition
treat Parkinson's; block the effect of Ach; act on the CNS; side effects: dry mouth, blurred vision, tachycardia, urine retention, constipation; used early in disease when Sx are less sever; take w/ food or milk, avoid driving d/t drowsiness; contraindicated in narrow-angle glaucoma, MG, obstruction of urinary or GI tract |
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Nursing Considerations for Parkinson's |
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Definition
monitor clients on therapy for excessive daytime sleepiness, eye twitching, involuntary movements, hand tremors, fatigue, anxiety, mood changes, confusion, agitation, N/V, anorexia, dry mouth, constipation; assist client w/ ADLs; urine and perspiration may darken |
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