NURSING 2349 Final Exam Study Guide | Latest Update 2023/2024

NURSING 2349 Final Exam Study Guide | Latest Update 2023/2024.. What somatic pain? Examples?  Pain that originates from the bones, joints, muscles, skin, and connective tissue o In the skin and superficial structures - sharp, pulsatile, and well-localized o In the deep structures – dull, aching, pulsatile, not well localized o Examples: burns, lacerations, fractures, infections, inflammatory conditions, 6. What is visceral pain? Example?  Pain arising from the body organs or gastrointestinal tract o Intermittent, achy, crampy pain – poorly localized o Examples: Menstrual cramps, GI pain, appendicitis, gall stones, angina, bowel distention, pancreatitis 7. Describe referred pain? Example?  Transfer of visceral pain sensations and deep somatic pain through the autonomic nervous system to a part of the body distant from the actual origin of the pain o Pain felt in area other than where stimulus occurs o Example: myocardial infarction felt in the jaw or down the left arm 8. What is breakthrough pain? Examples?  A transitory increase in pain that occurs in addition to persistent pain o Commonly seen in advanced stages of cancer and late-stage diseases such as AIDS. o Acute "flare up" of pain in a patient who is on regular doses of pain medication for persistent pain. o Treated by "rescue" pain meds. These are quick acting meds that don't stay in the body long...e.g. quick release morphine. o *Think cancer pain 9. Know differences between acute and chronic pain, S/S, examples of each and treatment options of each.  Acute pain: usually short term and quick onset. Responds well to treatment. Can be a new flare up during chronic pain. o S/S: Increases systolic BP, increased HR and force of contraction, increased respirations, dilated blood vessels to brain, increased alertness, dilated pupils, rapid speech o Example: burn, muscle injury, fractured bone, surgical wound o Treatment: Acetaminophen, NSAIDs, Opioids, Adjuvants o *goal is to find and remove underlying cause  Chronic pain: Sudden or slow onset of mild to severe pain that is usually long term – typically slow onset. Poorly localized, hard to treat. Pain that lasts more than 6 months. o S/S: mild to severe pain that does not go away as expected after illness or injury, described as shooting, burning, aching, or electrical pain, discomfort, soreness, tightness, or stiffness. o Example: migraine headaches, sickle cell crisis, osteoarthritis, rheumatoid arthritis, cancer pain, fibromyalgia o Treatment: Physical therapy, occupational therapy, NSAIDs, nerve blocks, opioids, nonsteroidal anti-inflammatory drugs 10. Describe prolonged stress response and the cascade of harmful effects to the body system-wide.  Chronic stress that disrupts nearly every system in the body: o Suppress immune system o Upset digestive and reproductive systems o Increase risk of heart attack and stroke o Speeds up the aging process  Can cause psychiatric illnesses such as anxiety disorders, clinical depression, and PTSD  Prolonged stress can result in crisis and burnout (p. 259) o Crisis: an event that drastically changes the person’s routine that is perceived as a threat to self. Usual coping mechanisms are ineffective, resulting in anxiety and inability to function adequately. 5 phases of crisis: precrisis, impact, crisis, adaptive, postcrisis o Burnout: person cannot cope effectively with physical and emotional demands of the workplace May result in grief, moral distress, guilt, physical illness, negative attitude, and maladaptive coping techniques (alcohol use, smoking…) 11. Know how to assess pain in a patient. What questions should you be asking?  Ask: what makes it better/worse, does it interfere with daily function, how often, intermittent/constant, where is it located, what is the quality of the pain, is there a pattern, when did it begin, how would you rate it (pain scales), have you had this type of pain before, what have you tried to relieve it. 12. How does pain affect vital signs?  Acute pain o Increases BP, HR, respirations oDilated pupils oDilated blood vessels to brain causing increased alertness o Rapid speech  Chronic pain oDecreased pulse rate o Changeable breathing patterns o Withdrawal o Constricted pupils o Slow/monotone speech  Behavioral response o Withdrawing from painful stimuli o Moaning o facial grimacing o crying o agitation o guarding  Psychological response o Anxiety oDepression o Anger o fear 13. Physiologic dependence involves what? What would the physiologic S/S be when opioids are removed from a patient who has a history of opioid abuse?  Involves emotional-motivational withdrawal symptoms such as a state of unease or dissatisfaction, a reduced capacity to experience pleasure, or anxiety, upon cessation of drug use or engagement in certain behaviors.  Early S/S o Watery eyes, runny nose, sweating, running, anxiety or irritability, poor sleep, muscle pain  Later S/S o Cramping, diarrhea, vomiting, increased BP & HR, restlessness, shakiness, chills, sweating, gooseflesh, dilated pupils 14. What is tolerance? How does it differ from abuse?