Pain, by definition, is a sensory and emotional experience associated with actual or potential tissue damage. The perception of pain is part of the clinical presentation in many disorders and is one of the hardest sensations for patients to cope with during the course of a disease or dysfunction.
The drugs involved in the management of severe pain, whether acute or chronic, all work in the central nervous system (CNS)—the brain and the spinal cord—to alter the way that pain impulses arriving from peripheral nerves are processed. These agents can change the perception and tolerance of pain.
The two major types of drugs are: the narcotics, the opium derivatives that are used to treat many types of pain; and the antimigraine drugs, which are reserved for the treatment of migraine headache. Migraine is a type of severe headache. Narcotic antagonists are used to block the effects of the narcotics in cases of overdose.
Pain is an unpleasant sensation and emotional experience. In many ways it is a subjective experience. The physiological processes that cause pain are perceived and reacted to in different ways because of learned experiences, cultural differences, and environmental stimuli.
Pain occurs whenever tissues are damaged. The injury to cells releases many chemicals, including kinins and prostaglandins, which stimulate specific sensory nerves. Pain can be acute or chronic. Acute pain occurs in response to recent tissue damage or injury. This type of pain makes a person aware of an injury and should lead to measures to care for the injury and teaches the person to avoid similar situations that could cause this pain. Chronic pain is constant or intermittent pain that keeps occurring long past the time the injured area would be expected to heal. Chronic pain can cause a stress reaction, interrupt much-needed sleep, and interfere with all of the activities of daily living.
Pain can also be classified by location. “Where does it hurt?” is a common question in assessing pain. Sometimes the location of the pain is a direct indicator of where the tissue damage has occurred. In some cases, so-called referred pain occurs. A person experiencing pain from damage to heart muscle may actually feel the pain in the neck or jaw. The sensation of pain is experienced in a different area of the body. Referred pain often follows predictable pathways, which helps health care providers figure out where the injury has occurred.
Pain can be further classified by originating source as nociceptive, neuropathic, or psychogenic. Nociceptive pain is caused by a direct stimulus to a pain receptor. Neuropathic pain is caused by nerve injury. Psychogenic pain is pain that is associated with emotional, psychological, or behavioral stimuli.
sensory – a. 感觉的，知觉的，感官的
emotional – a. 情绪的，情感的
experience – n. 经验，经历，感受
perception – n. 感知，知觉，感受
sensation – n. 感觉
peripheral nerves – 周围神经
tolerance – n. 耐受力，容忍
narcotic – a. n. 麻醉的，麻醉药品
opium – n. 麻醉剂，阿片
derivative – n. a. 衍生物，衍生的
antimigraine – a. 抗偏头痛的
migraine – n. 偏头痛
antagonist – n. 拮抗药
kinin – n. 激肽
prostaglandin – n. 前列腺素
referred pain – 牵涉痛
predictable – a. 可预报的
nociceptive – a. 伤害性的
neuropathic – a. 神经性的
psychogenic – a. 精神性的
1. Which term would the nurse use to document pain at one site that is perceived in other site?
A. Referred pain
B. Phantom pain
C. Intractable pain
D. Aftermath of pain
2. Which term refers to the pain that has a slower onset, is diffuse, radiates, and is marked by somatic pain from organs in any body activity?
A. Acute pain
B. Chronic pain
C. Superficial pain
D. Deep pain
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答案Answers
1. A. Referred pain Rationale: Referred pain is pain occurring at one site that is perceived in another site. Referred pain follows dermatome and nerve root patterns. Phantom pain refers to pain in a part of the body that is no longer there, such as in amputation. Intractable pain refers to moderate to severe pain that cannot be relieved by any known treatment. Aftermath of pain, a phase of the pain experience and the most neglected phase, addresses the client’s response to the pain experience.
2. D. Deep pain Rationale: Deep pain has a slow onset, is diffuse, and radiates, and is marked by somatic pain from organs in any body activity. Acute pain is rapid in onset, usually temporary (less than 6 months), and subsides spontaneously. Chronic pain is marked by gradual onset and lengthy duration (more than 6 months). Superficial pain has abrupt onset with sharp, stinging quality.
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