Foundations of Nursing - Chapter 21: Pain Management, Comfort, Sleep & Rest

Vocabulary flashcards covering pain management, analgesics, patient-controlled analgesia, positioning, comfort, and the physiology and stages of sleep from Foundations of Nursing Chapter 21.

Pain

An unpleasant sensory and emotional experience.

Analgesics

Medicines that relieve pain.

Acetaminophen (Tylenol)

A medication that lowers pain and fever but is not a strong anti-inflammatory; excessive amounts can cause liver damage (hepatotoxicity), with an absolute maximum adult limit of $4{,}000\,\text{mg}$ in $24\,\text{hours}$.

Hepatotoxicity

Liver damage, which can occur from taking too much acetaminophen.

NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)

Medications (such as ibuprofen, naproxen, ketorolac, celecoxib, oxaprozin, and aspirin) that reduce pain and inflammation by lowering prostaglandin production, but weaken stomach protection and risk stomach irritation, ulcers, and GI bleeding.

Aspirin

An NSAID that decreases platelet aggregation (clumping) and increases bleeding risk; it prevents certain clots from forming but does not dissolve an existing clot.

Opioids

Strong analgesics (such as morphine, hydromorphone, fentanyl, oxycodone, codeine, and meperidine) that act on receptors in the central nervous system to reduce pain, whose priority risk is respiratory depression.

Respiratory Depression

A state in which breaths become dangerously slow or shallow, representing the primary safety concern when administering opioids.

Naloxone

An opioid antagonist medication that can reverse opioid effects when indicated for severe sedation or respiratory depression.

Meperidine (Demerol)

An opioid analgesic whose active metabolite can cause tremors, agitation, or seizures (neurotoxicity), particularly in patients with impaired kidney function.

Adjuvant Medications

Medications not primarily classified as pain relievers (such as gabapentin, pregabalin, and duloxetine) that are used to treat neuropathic (nerve) pain.

Tolerance

A state in which the same dose of a medication produces less of an effect after repeated use.

Physical Dependence

A physiological state where the body adapts to a drug such that abruptly stopping or rapidly reducing the dose causes withdrawal symptoms.

Withdrawal

Symptoms that develop following an abrupt cessation or rapid reduction of a drug after physical dependence has developed.

Addiction

Compulsive use of a substance despite harm; it is clinically distinct from physical dependence.

Tapering / Weaning

Gradually reducing the dosage of a medication over time when clinically appropriate.

Patient-Controlled Analgesia (PCA)

A pump system that allows a patient to self-administer a prescribed dose of pain medication (often an opioid) by pressing a button.

Basal Rate

A continuous infusion setting on a PCA pump that delivers medication constantly when ordered.

Bolus Dose

An additional amount of medication delivered through a PCA pump when the patient presses the dosing button.

Lockout Interval

A safety feature on a PCA pump that establishes a required minimum time between delivered doses, limiting how frequently medication can be administered.

Intravenous (IV) Route

Medication delivery directly into a vein that immediately enters the systemic circulation and usually works rapidly.

PO (By Mouth) Route

Medication administration swallowed and absorbed through the gastrointestinal tract, where many drugs undergo first-pass metabolism in the intestine and liver.

Epidural Route

Medication delivery directly into the epidural space; opioids administered through this route can still cause respiratory depression.

Scheduled Medications

Medications prescribed to be administered at regular, designated times rather than on an as-needed basis.

PRN Medications

Medications prescribed to be given as needed according to specific clinical indications and provider orders.

Neuropathic Pain

Nerve-related pain often described as burning, tingling, shooting, or electric sensations, such as burning feet in patients with diabetes.

Shearing

A mechanical force that occurs when skin and deeper tissues slide and shift in opposite directions, such as when a patient slides down in bed.

Foley Catheter Patency

The condition of a urinary catheter being open, unobstructed, and continuously draining urine without retention.

Rest

A state of relaxation while remaining awake.

Sleep

A natural, recurring state that supports physical recovery, energy restoration, learning, and memory consolidation.

NREM N1

The initial, light sleep stage of non-rapid eye movement sleep.

NREM N2

The established sleep stage of non-rapid eye movement sleep.

NREM N3

The deep, slow-wave sleep stage of non-rapid eye movement sleep.

REM (Rapid Eye Movement) Sleep

A sleep stage marked by rapid eye movements that is especially associated with vivid dreaming.

Pineal Gland

An endocrine gland that secretes melatonin to help regulate the body's natural sleep-wake cycle.

Melatonin

A hormone produced by the pineal gland that assists in regulating sleep timing and the circadian sleep-wake schedule.

Prednisone

A corticosteroid medication that may interfere with rest and contribute to insomnia.

Lasix (Furosemide)

A diuretic medication that promotes increased urination, which can interrupt a patient's sleep.

Sleep Deprivation

Insufficient quantity or poor quality of sleep resulting in fatigue, irritability, poor concentration and memory, slowed reflexes, impaired coordination, poor judgment, and increased risk for falls.