Assessing Pain Flashcards

1
Q

Likert scale

A

rates pain from 1 (representing the least amount of pain) to 10 (the highest level of pain)

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2
Q

Use the PQRSTU mnemonic for pain assessment

A
P Provocative/Palliative
Q Quality
R Region/Radiation.
S Severity
T Timing.
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3
Q

P Provocative/Palliative

A

Assess for provocative or palliative factors. Ask the patient what makes the pain better or worse. Remember to consider the patient’s experience with OTC drugs, including herbals and topicals, that have helped to reduce the pain in the past.

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4
Q

Q Quality

A

Assess for the quality of the patient’s pain by using an open-ended cue such as “Tell me what your pain feels like.”

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5
Q

R Region/Radiation

A

Assess for the region of the pain and the areas to which it radiates by asking the patient to point out every area in which he or she feels pain.

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6
Q

S Severity

A

Assess the severity of the pain. To do so, use a valid pain rating scale appropriate to the patient’s age, developmental level, and comprehension. Remember to ask the patient to rate the level of pain before any interventions. Be sure to assess the amount of pain the patient is having when he or she is moving, and not just when the patient is lying in bed or sitting in a chair.

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7
Q

T Timing.

A

Assess the timing of the pain. Ask the patient if the pain is constant, intermittent, or a combination. Find out if the amount of pain increases at specific times of the day, while engaging in particular activities, or in specific locations.

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8
Q

U YoU

A

Pain is personal. Ask the patient, “How the pain is affecting you?” In particular, discuss the patient’s ability to perform the ADLs and ask how the pain has affected his or her work, relationships, and overall enjoyment of life.

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9
Q

Use percussion and auscultation if necessary to identify abnormalities, such as

A

lung crackles or an unusual mass.

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10
Q

When assessing the abdomen

A

always auscultate first and then follow with inspection and palpation.

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11
Q

Patients currently receiving opioids for chronic pain often require…

A

higher doses of analgesics to alleviate new or increased pain; this is tolerance, not an early sign of addiction. Be aware of individualized dosages, and ensure that all caregivers are aware of the dosages as well.

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12
Q

Nonpharmacologic

A

Some of these interventions are also classified as complimentary or alternative therapies, and there is evidence to support pain relief.
Use these interventions in combination with pharmacologic interventions, not in place of them.
Nonpharmacologic techniques diminish the physical effects of pain, alter a patient’s perception of pain, and provide a patient with a greater sense of control.

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13
Q

examples of effective nonpharmacologic measures.

A

Distraction, relaxation, guided imagery, and cutaneous stimulation such as massage and acupressure

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14
Q

Risk factors for pain

A

include having had an invasive procedure, having feelings of anxiety, and being unable to communicate their pain.

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15
Q

Pain assessment cannot be delegated to nursing assistive personnel (NAP). NAP may report…

A

patients’ comments or observations about their pain and provide selected nonpharmacological strategies, such as back massage, heat, cold, and elevation, per your instruction. How to eliminate environmental conditions that aggravate pain, such as excessive heat or noise in the room.

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16
Q

Be sure to inform NAP of the following

A

How to provide maximum rest periods; a written schedule listing rest periods for all staff to follow is ideal.
Turn and place the patient in a position of comfort at least every 2 hours, or remind the patient to turn himself or herself, using a pillow for splinting if needed.
Observe for behavioral signs of pain in the patient who is unable to self-report. Such signs may include moaning, groaning, facial grimacing, or guarding.
How to ask the patient to report the level of pain using the same pain-intensity scale chosen by the patient with you.
Report to you immediately any patient’s report of pain intensity above the predetermined goal and any nonverbal behaviors suggestive of pain.
Report to you immediately if they observe any signs of pain during patient transfer or other activities that may provoke pain.

17
Q

physical, behavioral, and emotional signs and symptoms of pain, include

A

Moaning, crying, whimpering, groaning, or other vocalization
Facial expressions of pain, such as grimacing or clenching the teeth
Diaphoresis
Guarding of a body part or muscle tension in the painful area
Decreased activity
Irritability
Any change in the patient’s usual behavior (or mental status changes)
Abnormal gait, such as shuffling, or abnormal posture, such as leaning or bending over while walking
Decreased gastrointestinal motility, nausea, vomiting or anorexia
Insomnia, fatigue or restlessness
Social withdrawal or feelings of depression, hopelessness, anger, or fear
Increased blood glucose level, caused by the stress of unrelieved pain
Symptoms that often accompany pain, such as headache and constipation