Acute v. Chronic Pain
Why are vital signs often normal in patients with chronic pain?
The body has adapted to the pain over time, so sympathetic responses are reduced.
What level of pain are opioids typically used to treat?
Moderate to severe pain.
Which condition is caused by autoimmune inflammation, chronic, systematic, and usually bilateral and symmetrical: OA or RA?
Rheumatoid arthritis
What type of immunity is provided by breast milk or IVIG?
Passive immunity
The body does not produce antibodies.
Antibodies are given (placenta, breast milk, IVIG such as HBIG). Effective immediately, but short-term.
PQRST
PROVOCATION/PALLIATION: what makes it better or worse
QUALITY: description of pain
REGION/RADIATION: Location and spread
SEVERITY: Intensity of pain
TIME: onset, duration, and pattern
What type of pain is associated with elevated heart rate and blood pressure?
Acute
What medication is commonly used for neuropathic pain?
Gabapentin
Morning stiffness lasting longer than 30 minutes is characteristic of which condition?
Rheumatoid arthritis
What cells are responsible for antibody production?
Why is bone marrow essential for immune function?
B lymphocytes
It produces B and T lymphocytes.
Signs and Symptoms of a blood transfusion reaction?
fever, chills, pain, respiratory distress
What is breakthrough pain?
Short-term bursts of pain that occur despite otherwise controlled pain.
What is a serious adverse reaction to opioid use that requires immediate intervention?
Respiratory depression.
What joint changes are seen in osteoarthritis of the hands?
Heberden’s nodes (DIP) and Bouchard’s nodes (PIP)
true or false
Red bone marrow produces B and T lymphocytes
True
Bcells mature in bone marrow B for bone
Tcells migrate to the thymus to mature
What does MRSA stand for?
What is the difference between HAI-MRSA and CA-MRSA?
Methicillin-Resistant Staphylococcus aureus
Resistant to many antibiotic classes
Resistant mainly to beta-lactams and macrolides:
Risk factors: athletes, IV drug use, military, homeless shelters, sharing towels/razors
What is the most reliable way to evaluate the effectiveness of a pain intervention?
Patient self-report using a validated pain scale.
Ice should be used for what type of condition?
Inflammation and joint pain (vasoconstriction)
Pain that worsens with activity and improves with rest is typical of which disorder?
Osteoarthritis
what are 3 AIDS criteria?
CD4 <200
OPPORTUNISTIC INFECTION
ADVANCED IMMUNE SYSTEM FAILURE
Greatest Risk factor for C diff?
ABX.
Why should patients be premedicated before physical therapy even if pain is acceptable?
To prevent pain escalation and promote participation and mobility.
Name two non-pharmacologic pain management strategies
Guided imagery, massage, relaxation techniques, dietary supplementation
What are DMARDs and what is a key safety concern with methotrexate?
Disease-modifying anti-rheumatic drugs; patients must report exposure to tuberculosis.
why?
Immunosuppression
opportunistic pneumonia that can be life threatening
PCPPneumocystis cranii/jirovecii (PCP)
purple lessons on the skin or mucous membrane that can involve the GI tract, lungs, and lymph nodes
Kaposi Sarcoma