NURS 121

jasmine's version from 2016-01-19 13:42

Section 1

Question Answer
3 Basic alterations in comfort caused by disease, illness, or injury Pain, fatigue, and sleep-rest disorders
Pain An unpleasant sensory and emotional experience associated with aactual or potential tissue damage, or described in terms of such damage
3 terms to describe pain Location, intensity, and quality
Intensity of Pain Mild, moderate, and severe
Quality of Pain Sharp, dull, etc.
Acute Pain Pain of varying severity, location, and etiology that lasts 3 months or less
Manifestations of Acute Pain Elevated blood pressure; increased heart rate; nausea and vomiting; sweating; rapid/shallow respirations; anxiety; and decreased function in ADLs
Interventions and Therapies for Acute Pain Pharmacologic pain management; For example: Opioid analgesics, non-steroidal anti-inflammatory drugs (NSAIDS), and non-opioid analgesics. Non-pharmacologic therapy; For example: Massage, diversionary therapies (i.e., music, involvement with hobbies, aroma therapy); and application of heat and cold
Chronic Pain Pain of vary severity, location, and etiology that’s more than 3 months even if intermittent
Manifestations of Chronic Pain Depression; irritability; impaired mobility and/or activity; and sleep disturbance
Interventions and Therapies for Chronic Pain Pharmacologic pain management; For example: Opioid and non-opioid analgesics, antidepressants, NSAIDS, and muscle relaxants. Non-pharmacologic therapy; For example: Guided imagery, massage, nerve stimulation units, chiropractic interventions, physical therapy, relaxation techniques, and positioning
Nociceptors Specialized pain receptors present on all body tissues with the exception of the brain; Sensory receptors respond to pain, sending signal along the sensory neurons to the spinal cord, where the signal is transmitted to the brain for interpretation. The brain then sends a signal back to the site of pain via motor neurons, causing the body to respond to the painful stimuli
Nociceptive Pain Example of this is a sunburn or paper cut; Pain resulting from external stimuli on an uninjured, fully functional nervous system
Neuropathic Pain Caused by nerve malfunction or injuries resulting from trauma, disease, chemicals, infections, and tumors; Nociceptive pain is often magnified in the presence of this pain
Breakthrough Pain A transient exacerbation of pain that occurs either spontaneously, or in relation to a specific predictable or unpredictable trigger, despite relatively stable and adequately controlled background pain
Pain Tolerance Maximum amount of pain a client will tolerate
Pain Threshold The point at which pain is initially felt
5 types of pain stimuli Biological (bacteria, viruses), Mechanical (shearing forces, fractures), Thermal (extreme heat and cold), Electrical (electrical burn and shock), and Chemical (cleaning solutions, tobacco smoke, acids/bases, and radiations)
Somatic Pain Example of this pain can be from a cut finger or an overstretched muscle; Originates from nociceptors located in the skin and musculoskeletal tissues; Typically localized and described as being sharp. It may be accompanied by swelling, cramping, or bleeding, and it usually responds well to mild analgesics
Visceral Pain Example of this pain is myocardial ischemia or urinary colic resulting from renal stones; Originates from internal body organs and the linings of body cavities in the chest, abdomen, and pelvic areas; Usually described as dull, deep , or aching; Often manifests as radiating or referred pain, and it responds best to opioid treatment
Referred Pain Example of this pain is back pain from pancreatitis or should pain from myocardial ischemia; It is sensed in a region other than the site of origin; It occurs when nerve fibers that innervate the injured region and nerve fibers from other regions of the body converge at the same level in the spinal cord

Section 2

Question Answer
Specificity Theory States that pain is a specific sensation that uses sensory neurons separate from other sensations such as heat and touch
Peripheral Pattern Theory States that all sensory nerve fiber endings are the same, and pain is felt only when the fibers are intensely stimulated; It is the responsibility of the brain to decipher differences in signals coming from these nerve fibers
The Gate Control Theory States that stimulation of small diameter-pain-fibers causes gates to open, whereas stimulation of large diameter-heat, cold, mechanical-fibers causes gates to close; The amount of activity in the small fibers versus the large fibers controls the overall perception of pain
Factors that control the gate in the Gate Control Theory Include physical factors, emotional factors, and behavioral factors

Section 3

Question Answer
End of Life Care that takes place when death is imminent
Manifestations of End of Life Loss of muscle tone; slowing of circulation; change in respirations; sensory impairments; and impaired metabolic processes
Interventions and Therapies for End of Life Palliative or aggressive care as chosen by client and family; maintenance of comfort; maintenance of hygiene; and psychosocial support for client and family
Fatigue Lack of energy or motivation with or without drowsiness
Manifestations of Fatigue Tiredness; Depression; Anxiety; Irritability; and Decreased cognition
Interventions and Therapies for Fatigue Pharmacologic therapy; For example: Sleeping aids, stimulants, antidepressants, and pain management. Non-pharmacologic therapy; For example: Improved sleep hygiene, nutritional supplements, relaxation techniques, and complementary alternative medicine (CAM) therapies
Acute Fatigue Manifests as normal tiredness associated with a single event, such as a poor night’s sleep, a stressful experience, or a n acute infection; Symptoms usually begin quickly and are also resolved quickly by adequate sleep-rest and resolution of the underlying cause of it
Chronic Fatigue More intense and lasts longer than acute, with a nearly constant state of weariness that diminishes energy and mental capacity; Often caused by long-term illnesses or medications used to treat chronic diseases
Chronic Fatigue Syndrome Refers to lasting more than 6 months, and is accompanied by muscle and joint pain, headaches, and sleep and memory problems
Fibromyalgia Widespread muscular and joint pain
Manifestations of Fibromyalgia Tenderness in the neck, spine, shoulders, and hips; Muscle spasm or stiffness; Chronic fatigue; and Sleep disturbances
Interventions and Therapies for Fibromyalgia Warm compresses or heat packs, massage, stretching exercises, fibromyalgia drugs, and good sleep hygiene
Sleep A state of unconsciousness and a decreased responsiveness to external stimuli
Sleep Loss Refers to a duration of sleep shorter than the recommended 7-8 hours per night for adults
Sleep Hygiene Refers to a variety of sleep practices that help individuals attain good-quality sleep at night so they can be alert during the day
Good Sleep Hygiene Includes maintaining a regular sleep and awake pattern, performing bedtime rituals, providing a restful environment, and promoting comfort and relaxation
Narcolepsy A condition in which the individual experiences excessive daytime sleepiness even with adequate nighttime sleep, resulting in sleep attacks and cataplexy
Sleep-Rest Disorders The inability to fall asleep or stay asleep, or a sleep disturbance that causes lack of adequate rest
Manifestations of Sleep-Rest Disorders Sleep loss, insomnia, narcolepsy, sleep apnea, and parasomnias
Interventions and Therapies of Sleep-Rest Disorders Improved sleep hygiene, pharmacologic therapies, relaxation techniques, and assistive breathing devices (i.e., CPAP)

Section 4

Question Answer
Katharine Kolcaba’s Comfort Theory The immediate state of being strengthened by having the needs for relief, ease, and transcendence addressed in the four contexts of holistic human experience: physical, psychospiritual, sociocultural, and environmental
3 basic independent categories of teaching clients about lifestyle changes for promotion of comfort Sleep hygiene, psychosocial well-being, and relaxation therapy
Inflammation More often than not leads to pain
Nursing Implications for Inflammation Assess pain in clients with this, and provide pharmacologic treatments as ordered; Offer comfort measures such as ice or heat, and promote adequate sleep and rest
Mobility This is decreased often caused by pain, injury, or disease
Nursing Implications for Mobility Assist with this and activities of daily living, encouraging adequate sleep and rest; Offer pharmacologic treatments as ordered
Tissue Integrity This is a risk for pain, inflammation, and infection
Nursing Implications for Tissue Integrity Assess this for breakdown, and promote mobility; Assist with repositioning as needed, and monitor for signs and symptoms of infection
Grief and Loss This is caused by a loss or expected loss of a loved one to name just process that results in this to include emotional distress
Nursing Implications for Grief and Loss Use therapeutic communication techniques, and encourage expression of emotions; Facilitate referrals to counselors and support groups
Ethics Physicians may be reluctant to prescribe opioids based on race, ethnicity, or history of addiction
Nursing Implications for Ethics Advocate for the provision of adequate pain relief to all clients, and provide culturally sensitive care; Offer non-pharmacologic comfort measures to all clients