Exam 1 Study Guide
Acute Pain- anticipated and predicted. Less than 6 months
Chronic pain- constant and recurring without reason. More than 6 months
Nociceptive pain-
Somatic pain- nerves in skin, tissues, bones, and blood vessels. localized
Visceral- internal organs in body cavities thats not localized
Pain assessment-
O- onset. When did it start
P- provokes/palliating. What makes it worse or better
Q- Quality. What does it feel like
R- Radiates. Does the pain move anywhere
S- Severity. On a scale. 0-10, Faces, FLACC
T- Time/treatment. Does it happen at a specific time of day and what makes it better
U- Understanding
V- Values
Assessment scales-
0-10- 9 years and older
Faces- 3 years and up. Nonverbal adults
Flacc- 2 months-7 years. 5 categories, 0-2 points each category
Face- relaxed to quivering and clenched
Legs- normal to kicking or drawn up
Activity- quiet to arched/jerking
Cry- no crying to steady crying
Consolability- calm to inconsolable
Pain assessment-
Ask if they are comfortable
Pain assess.
Anticipate pain for whatever they are there for or present medical interventions
Medicate before medical interventions (wound care, physical therapy, turning)
Observe for behavioral cues of pain/discomfort
Alterations in vital signs
Chronic pain pts- used to pain and have a higher pain tolerance/ way of living
Reassess- ask about their pain threshold
, Comfort exemplars-
Renal Calculi causes
Hyperparathyroidism Renal tubular acidosis Cancers (e.g., leukemia, multiple myeloma) Dehydration Granulomatous diseases (e.g.,
sarcoidosis, tuberculosis), which may cause increased vitamin D production by the granulomatous tissue Excessive intake of vitamin D
Excessive intake of milk and alkali Myeloproliferative diseases such as polycythemia vera, which produce an unusual proliferation of blood
cells from the bone marrow Intestinal bypass surgery
Cognition Exemplars-
Delirium-
Patho- Acute, sudden and reversible
● Neurotransmitter imbalance
● Inflammation
● Reduced cerebral oxygenation
● Metabolic disturbances
Causes-
● UTI, Pneumonia, Infection
● Opioids, anticholinergics
● Dehydration
● Electrolyte imbalance
● Surgery/anesthesia
● Alcohol withdrawal
Signs and Symptoms-
● Sudden confusion
● Fluctuating alertness
● Hallucinations
● Agitation OR Lethargy
● Poor attention
● Disorganized thinking
Diagnostics/Labs-
● CAM (Confusion Assessment Method)
● Lab tests
● Review Meds
● Identify cause
Treatment-
● IV fluids
● O2 if needed
● Adjust meds
● Antipsychotics (severe agitation ONLY)
Alzheimer's Disease
Patho- Plaques and tangles in the brain
● Leads to neuronal death and brain atrophy
Acute Pain- anticipated and predicted. Less than 6 months
Chronic pain- constant and recurring without reason. More than 6 months
Nociceptive pain-
Somatic pain- nerves in skin, tissues, bones, and blood vessels. localized
Visceral- internal organs in body cavities thats not localized
Pain assessment-
O- onset. When did it start
P- provokes/palliating. What makes it worse or better
Q- Quality. What does it feel like
R- Radiates. Does the pain move anywhere
S- Severity. On a scale. 0-10, Faces, FLACC
T- Time/treatment. Does it happen at a specific time of day and what makes it better
U- Understanding
V- Values
Assessment scales-
0-10- 9 years and older
Faces- 3 years and up. Nonverbal adults
Flacc- 2 months-7 years. 5 categories, 0-2 points each category
Face- relaxed to quivering and clenched
Legs- normal to kicking or drawn up
Activity- quiet to arched/jerking
Cry- no crying to steady crying
Consolability- calm to inconsolable
Pain assessment-
Ask if they are comfortable
Pain assess.
Anticipate pain for whatever they are there for or present medical interventions
Medicate before medical interventions (wound care, physical therapy, turning)
Observe for behavioral cues of pain/discomfort
Alterations in vital signs
Chronic pain pts- used to pain and have a higher pain tolerance/ way of living
Reassess- ask about their pain threshold
, Comfort exemplars-
Renal Calculi causes
Hyperparathyroidism Renal tubular acidosis Cancers (e.g., leukemia, multiple myeloma) Dehydration Granulomatous diseases (e.g.,
sarcoidosis, tuberculosis), which may cause increased vitamin D production by the granulomatous tissue Excessive intake of vitamin D
Excessive intake of milk and alkali Myeloproliferative diseases such as polycythemia vera, which produce an unusual proliferation of blood
cells from the bone marrow Intestinal bypass surgery
Cognition Exemplars-
Delirium-
Patho- Acute, sudden and reversible
● Neurotransmitter imbalance
● Inflammation
● Reduced cerebral oxygenation
● Metabolic disturbances
Causes-
● UTI, Pneumonia, Infection
● Opioids, anticholinergics
● Dehydration
● Electrolyte imbalance
● Surgery/anesthesia
● Alcohol withdrawal
Signs and Symptoms-
● Sudden confusion
● Fluctuating alertness
● Hallucinations
● Agitation OR Lethargy
● Poor attention
● Disorganized thinking
Diagnostics/Labs-
● CAM (Confusion Assessment Method)
● Lab tests
● Review Meds
● Identify cause
Treatment-
● IV fluids
● O2 if needed
● Adjust meds
● Antipsychotics (severe agitation ONLY)
Alzheimer's Disease
Patho- Plaques and tangles in the brain
● Leads to neuronal death and brain atrophy
