Ch. 11- Pain Assessment

Question 1

Where does visceral pain originate?

Answer 1

Large interior organs.

Question 2

What does visceral pain stem from?

Answer 2

-Direct injury or stretching.

Question 3

What does visceral pain typically end in?

Answer 3

-itis

Question 4

What is visceral pain?

Answer 4

Pain impulse transmitted by ascending nerve fibers along with nerve fibers of autonomic nervous system.

Question 5

What can also be present with visceral pain?

Answer 5

• Vomiting
• Nausea
• Diaphoresis

Question 6

What are sources of deep somatic pain?

Answer 6

• Blood vessels

- Musculoskeletal

Question 7

A deep somatic injury may result from what?

Answer 7

• Pressure
• Trauma
• Ischemia

Question 8

What is a source of cutaneous pain?

Answer 8

The skin.

Question 9

What is cutaneous pain described as?

Answer 9

-Superficial: sharp, burning sensation.

Question 10

What is referred pain?

Answer 10

Felt in one area, but originates from another area.

Question 11

What is the rationale of referred pain?

Answer 11

Both areas are affected by the same thing?

Question 12

Where may referred pain originate?

Answer 12

Visceral or somatic structures.

Question 13

What is neuropathic pain?

Answer 13

Pain due to a lesion or disease in the somatosensory system. (less typical)

Question 14

What does neuropathic impulses imply?

Answer 14

An abnormal processing of pain message that is difficult to assess and treat.

Question 15

When is neuropathic pain often perceived?

Answer 15

Long after site or injury heals.

Question 16

What is acute pain?

Answer 16

-Short-term and self-limiting, predictable

Question 17

What may cause acute pain?

Answer 17

Surgery, trauma, kidney stones

Question 18

What is chronic pain?

Answer 18

Pain continues for 6 months or longer.

Question 19

What are acute pain behaviors?

Answer 19

-Involves autonomic responses and has protective purposes. (Ex: guarding, moaning, pacing)

Question 20

What are chronic pain behaviors?

Answer 20

Persons with chronic pain may give little indication they are in pain.
(Ex: Changes in eating, sleep, interactions)

Question 21

What should you use when doing an initial pain assessment?

Answer 21

OLDCARTS

Question 22

How should you select pain assessment tools?

Answer 22

• Purpose
• Time involved in administration
• Pt. ability to comprehend and complete tool

Question 23

What tools are more useful for chronic pain conditions or particularly problematic acute pain problems?

Answer 23

Standardized tools.

Question 24

Pain scales are one-dimensional and are intended to do what?

Answer 24

Reflect pain intensity.

Question 25

Pain rating scales can indicate what?

Answer 25

• Baseline

- Track changes and responses to treatment

Question 26

What types of pain scales are there?

Answer 26

• Numeric rating
• Visual descriptor
• Visual analog

(Wong-Baker FACES Pain rating scale)

Question 27

How should you document a pain assessment?

Answer 27

1. Document chief concern in pt’s own words
2. Use mnemonic (OLDCARTS) to obtain more HPI info
3. Note if pain scale/tool is used
4. Document interventions
5. Reassess after one hour
6. Utilize same scale/tool and review pertinent OLDCARTS components
7. Assess for side effects of intervention used