220-comfort

Question 1

PAIN IS….

Answer 1

SUBJECTIVE

Question 2

barriers to prevent healthcare

Answer 2

poor assessment of pain
Inadequate knowledge of pain management
biases and judgement regarding pain

Question 3

the pain process

Answer 3

transduction- touches hot pan
transmission-signal to the brain
perception- ouch that is hot
modulaation- removes hand

Question 4

gate control of pain

Answer 4

using another stimulus to divert the perception of pain.

Question 5

categories of pain

Answer 5

duration
acute
chronic

Question 6

responses to pain

Answer 6

physical
behavioral
affective

Question 7

factors affecting pain experience

Answer 7

family, gender, age
environment and support from people
anxiety and other stressors
past pain experience

Question 8

pain assessment is

Answer 8

asking and believing the patient

Question 9

non verbal pain indicators

Answer 9

moaning
crying
grimacing
guard position
increased vs but not always especially with chronic pain
reduced social interactions
irritability
difficulty concentrating
changes in eating or sleeping

Question 10

when should pain be assessed?

Answer 10

at regular intervals
with each new report of pain
after pharmacological and non pharmacological intervention (access pain and sedation)

Question 11

pain scales used during assessment

Answer 11

FLACC IN EPIC
1-10 IN EPIC
Baker Wong Faces
Checklist of Non Verbal Indicators
PAINAD IN EPIP
Payen Behavior Pain Scale

Question 12

quality of pain based on source

Answer 12

somatic
visceral
neuropathic
cutaneous

Question 13

somatic

Answer 13

aching, deep, dull, gnawing, throbbing, sharp, stabbing

examples: muscle, tendon, bone injury

Question 14

visceral

Answer 14

cramping, squeezing, pressure (referred to distant sites)

examples: gallstones, kidney stones, pancreatitis

Question 15

cutaneous

Answer 15

superficial, skin or sub Q tissue cuts with sharp and burning sensation

Question 16

neuropathic

Answer 16

burning, numbness, radiating, shooting, tingling, touch sensitive

examples- herpes zoster, peripheral neuropathy

Question 17

pain assessment is not

Answer 17

relying on changes in VS
deciding what a patients pain is
deciding they do not have pain while sleeping
assuming they will tell you about pain

Question 18

what is the WHO 3 step analgesic ladder?

Answer 18

one: pain is increasing or persisting (treat with non opioid/adjuvant drugs)
two: pain is increasing or persisting (treat with opioid/ adjuvant for mild pain)
three: pain is increasing or persisting (treat with opioid/adjuvant for moderate to severe pain

freedom from pain

Question 19

morphine

Answer 19

considered the gold standard (nausea/vomiting common side effect)

Question 20

adjuvant drugs

Answer 20

anticonvulsants
tricyclic-antidepressants
steroids
anti-anxiety

Question 21

Patient controlled anesthesia (PCA)

Answer 21

must be alert to work the pump
patient is in control of pain
IV administration
max dose and locked out setting
can be used for continuous infusion

morphine, fentanyl, hydromorphone

Question 22

typical PCA order

Answer 22

5 mg (150mg in 30 ML)
each dose 1-3 mg
lockout every 8-15 mins
hour hour limit 30-70mg

Question 23

break through pain

Answer 23

flare up of moderate to severe pain that occurs even when the patient is taking around the clock ATC medication

Question 24

physical dependance

Answer 24

the body physiologically adapts to the presence of an opioid and suffers withdrawal if the opioid id suddenly withdrawn

Question 25

psychological dependence

Answer 25

a pattern of compulsive drug use characterized by continued craving for an opioid and the need to use the opioid for effect other then pain relief

Question 26

tolerance

Answer 26

common physiological result of chronic opioid use, a larger dose of opioid is required to maintain the same level of analgesia

Question 27

placebo

Answer 27

considered unethical, the use of a water pils to give the patients to trick their mind into thinking they got medication.

Question 28

F or M: pain is a natural component of aging process

Answer 28

myth

Question 29

F or M: pain is often unreported and leads to a higher risk for patient experiencing pain

Answer 29

Fact

Question 30

F or M: adverse effects of pain medication are more dramatic in elderly due to decreased liver and renal function (drugs metabolize and excreted slower)

Answer 30

fact