Chapter 20: Pain Management

Question 1

List four phases in the pain process.

Answer 1

Transduction, transmission, perception, & modulation

Question 2

Differentiate between pain perception, pain threshold, & pain tolerance.

Answer 2

Pain perception - the conscious experience of discomfort
Pain threshold - the point at which sufficient pain transmitting stimuli reach the brain
Pain tolerance - the amount of pain a person can endure

Question 3

Identify at least five types of pain.

Answer 3

Cutaneous pain; somatic pain; visceral pain; referred pain; neuropathic pain; phantom limb pain; chronic pain; acute pain

Question 4

Compare $ contrast acute pain & chronic pain.

Answer 4

Acute - discomfit hat gas a short duration; usually last for a few seconds up to six months; associated with trauma, including surgery, or some other recent identifiable etiology; severe initially but eases with healing & eventually disappears
Chronic - discomfort that lasts >six months; the longer the pain the more far reaching its effects

Question 5

Discuss the components of a basic pain assessment.

Answer 5

Onset, quality, intensity, location , & duration

Question 6

Identify at least three occasions when it is appt to perform a pain assessment & document the findings.

Answer 6

Admission, when taking VS, at least qshift when pain is a potential or actual problem

Question 7

Name four physiologic mechanisms for managing pain.

Answer 7

Interrupting pain; altering transmission at the spinal cord;

Question 8

Define pain.

Answer 8

An unpleasant sensation of “hurt” that is unrelievable through conventional methods

Question 9

Discuss three categories of drugs used alone or in combination to manage pain.

Answer 9

Nonopoiods -nonnarcotic; includes aspirin, acetaminophen,nonsteroidal anti inflammatory drugs (NSAIDs); relieve pain by altering neurotransmission peripherally at site of injuries
Opioids - when pain is no longer controlled by nonopoiods, it is combined with an opioids; interfere with central pain perception & generally are reserved for treating moderate to severe pain
Adjuvant - combined with analgesics to improve pain control
Botulinum toxin ( Botox) therapy - blocks acetylcholine; agent made from the bacterium C.diff.; candidates may experience local pain, bruising, or infection at the injection site

Question 10

Discuss two surgical procedures used when other methods of pain management are ineffective.

Answer 10

Rhizotomy - the surgical section info of a nerve root close to the spinal cord; prevents sensory impulses from entering the spinal cord & traveling to the brain
Cordotomy - surgical interruption pain pathways in the spinal cord; accomplished by cutting bundles of nerves

Question 11

Give several examples of nondrug/ nonpharmacological, nonsurgical methods for managing pain.

Answer 11

Educatuon, imagery, meditation, distraction, relaxation, heat & cold, transcutaneous electrical nerve stimulation (TENS), acupuncture/acupressure, per cutaneous electrical nerve stimulation (PENS), biofeedback, hypnosis

Question 12

Discuss the most common reason why clients request frequent administration of pain-relieving drugs.

Answer 12

Poorly controlled/uncontrolled pain

Question 13

Define addiction.

Answer 13

A pattern of compulsive drug use characterized by a continued craving for an opioid for effects other than pain relief

Question 14

Define placebo & explain the basis for its positive effect.

Answer 14

An inactive substance or Tx used as a substitute for an analgesic or conventional therapeutic measure; can relief pain, especially when clients have confidence in their healthcare providers