Pain Management – Chapter 8 Lecture

Thirty vocabulary flashcards covering definitions, physiology, assessment, and management concepts from Chapter 8 on Pain.

Pain

An unpleasant sensory and emotional experience associated with actual or potential tissue damage (IASP).

McCaffrey's definition of pain

"Pain is whatever the person experiencing it says it is and exists whenever they say it does."

Nociceptor

A specialized sensory receptor that detects noxious or potentially harmful stimuli and initiates pain signals.

Afferent pathways

Ascending nerve pathways that transmit pain impulses from peripheral sites to the spinal cord and brain.

Efferent pathways

Descending nerve pathways that modulate or inhibit pain signals traveling toward the brain.

Endorphins

Endogenous opioid-like peptides released by the brain that bind to opioid receptors and reduce pain perception.

Enkephalins

Small opioid peptides in the CNS that help inhibit nociceptive transmission and raise the pain threshold.

Gate-control theory

Theory stating that stimulation of large-diameter fibers can close a spinal "gate," blocking small-fiber pain impulses.

Pain threshold

The minimum intensity at which a stimulus is perceived as painful.

Pain tolerance

The maximum level of pain a person is willing or able to endure.

Acute pain

Short-term nociceptive pain that warns of tissue damage and subsides with healing.

Chronic pain

Pain persisting or recurring for more than 6 months, often serving no protective purpose.

Neuropathic pain

Pain caused by nerve damage and abnormal neural processing, often described as burning or shooting.

Nociceptive pain

Pain that follows the normal physiologic pathway from nociceptor activation to the brain.

Sympathetic nervous system response to pain

Physiologic changes such as increased blood pressure, pulse, respirations, dilated pupils, perspiration, and pallor.

Parasympathetic nervous system response to pain

Physiologic effects including constipation and urinary retention in response to pain.

Nonpharmacologic interventions

Pain-management strategies that do not involve drugs, e.g., heat, cold, massage, relaxation, TENS, distraction.

Transcutaneous electrical nerve stimulation (TENS)

Low-voltage electrical stimulation through the skin that reduces pain by closing the pain gate.

Opioid analgesics

Drugs such as morphine, fentanyl, and hydromorphone that relieve pain by activating central opioid receptors.

Nonopioid analgesics

Pain relievers without opioid activity, including aspirin, acetaminophen, and NSAIDs.

Adjuvant analgesics

Medications not primarily classified as analgesics but useful for certain pain syndromes, e.g., muscle relaxants, anticonvulsants.

Tolerance (opioid)

Normal physiologic adaptation in which larger doses are required over time to produce the same pain relief.

Physical dependence (opioid)

Physiologic adaptation that produces withdrawal symptoms if the opioid is abruptly discontinued.

Addiction

Psychological compulsion to use a drug for its mind-altering effects; rare (<1%) in patients using opioids solely for pain control.

Pain assessment

Systematic evaluation including patient report, pain characteristics, site examination, coping methods, and documentation.

Fifth vital sign

Recognition of pain assessment as an essential routine measurement alongside temperature, pulse, respiration, and blood pressure.

Heat therapy

Application of warmth for up to 30 minutes to decrease pain, improve circulation, and relax muscles.

Cold therapy

Application of ice or cooling pads for about 15 minutes to reduce tissue injury, swelling, and pain.

Guided imagery

Use of mental visualization techniques to shift focus away from pain and promote relaxation.

Relaxation techniques

Methods such as deep breathing and progressive muscle relaxation that decrease muscle tension and autonomic arousal to ease pain.