Chapter 8 * Flashcards
Pain is a highly unpleasant sensation that affects a person’s…
physical health, emotional health, and well-being.
Pain comes from the Greek word poine meaning what?
“Penalty” implying the person is paying for something.
McCaffery defined pain as…
“Whatever the experiencing person says it is, existing whenever he or she says it does.”
Highly___ and Personal ___ must be assessed most accurately for treatment to be successful
Unpleasant: Sensation
Can two people experience pain in the same way?
False; No two people experience pain in the same way.
Pain is ___; however, it can produce ___ changes in the individual.
subjective; objective.
What three theories have been developed to explain the conceptual and physiological aspects of pain?
Specific theory
Pattern theory
Gate Control theory
Pain can be the _____ problem or associated with a specific diagnosis, treatment, or procedure.
Primary
What are the three types of pain stimuli?
Mechanical
Thermal
Chemical
What are the four types of Nociception?
Transduction
Transmission
Perception
Modulation
Explain how transduction works?
Tissue injury triggers the release of Biochemical Mediators that sensitize nociceptors.
Explain how transmission works?
Pain impulse travels from the peripheral nerve fibers to the spinal cord, then ascends to the brain stern and thalamus, and then to the somatic sensory cortex.
What happens during perception?
The client becomes conscious of the pain.
Explain Modulation.
Neurons in the brain stem send signals back down to the dorsal horn of the spinal cord.
Often described as the “descending system”.
What are the two types of responses to pain?
Physiological
Psychosocial
Pain may be described in terms of….
Duration, location, or etiology.
When pain lasts only through the expected recovery period from illness, injury, or surgery, it is described as…
Acute pain.
Prolonged pain, usually recurring or persisting over 6 months or longer, and interfere with functioning is what type of pain?
Chronic pain.
Pain that originates in the skin or subcutaneous tissue is ___ type of pain.
Cutaneous.
Somatic pain arises from ___, ___,___, and ___.
It diffuse and tends to last longer than than cutaneous pain.
Ligaments
Tendons
Bones
Blood Vessels
Visceral pain results from stimulation of pain receptors in the ___ ___, ___, and ___.
Abdominal cavity
cranium
thorax
Radiation pain is…
perceived at the source of the pain and extends to the nearby tissue.
Referred pain is…
felt in a part of the body that is considerably removed from the tissues causing the pain.
Intractable pain is…
highly resistant to relief.
Neuropathic pain is…
the result of current or past damage to the peripheral or central nervous system and may not have a stimulus, such as tissue or nerve damage, for the pain. Neuropathic pain is long lasting; is unpleasant; and can be described as burning, dull, and aching.
Phantom pain is…
perceived in a body part that is missing or paralyzed by a spinal cord injury, is an example of neuropathic pain.
Explain the phantom sensation.
the feeling that the missing body part is still present.
Factors that influence pain.
Developmental stage, Psychosocial development, environment.
The ___ and ___ ___ of a client will influence both the reaction to and the expression of pain.
age; developmental stage
What external factors influence a person’s ability to identify and seek relief for pain.
Clothing, items in the environment, support system, and role expectations.
What internal considerations influence a person’s ability to identify and seek relief for pain.
Individual perception, experiences related to pain, and anxiety.
Pain assessments consist of two major components. What are they?
Pain history- to obtain facts from the client
Direct Observation- of behavioral and physiologic responses of the client.
What does OLDCART stand for?
Onset Location Duration Characteristics of the pain Aggravating factors Relieving factors Treatment
What does ICE stand for?
Impact on activities of daily living
Coping strategies
Emotional responses
When are OLDCART and ICE used?
During the focused interview.
Tools used for pain assessment are designed and classified as:
Unidimensional or multidimensional tools.
Unidimensional tools are used to help determine the clients level of ___ pain.
Acute
Why is the tool called unidimensional?
Because it assesses one aspect of pain.
What are the three types of unidimensional tools?
Numeric rating scale
Body Diagram tool
Oucher scale
The numeric rating scale asks the client to describe pain intensity with a ___.
number
Describe the body diagram tool.
The body diagram tool presents an outline of the body. The individual is asked to mark the picture showing the location of the pain. Shading of the body parts by the client will describe the intensity of the pain.
Describe the Oucher Scale and who it was designed for.
The Oucher Scale has been designed for children. Pictures of faces ranging from neutral to distressed are presented, and the child selects the one representing his or her level of pain.
The multi dimension assessment tools asses…
two or more elements of pain.
What are the two types of multidimensional tools?
McGill Pain Questionnaire and Brief Pain Inventory
When is the McGill Pain Questionnaire used?
When pain is prolonged.
The Brief Pain Inventory tool provides what type of information?
This tool provides information on pain and how pain interferes with the person’s ability to function.
What are the steps to the nursing process?
- Assessment
- Diagnosis
- planing
- implementation
- evaluating
- Re-evaluate
Which statements are true regarding the evaluation and management of pain?
Select all that apply.
It should be expected that the older adult client will always have some pain.
The nurse should be able to reason with a toddler who is in pain.
The nurse is the best judge of a client’s pain.
Fatigue and unplanned weight loss may be signs of pain in the older adult.
Nonpharmacological therapies such as massage and stress management strategies may be effective in decreasing pain.
Fatigue and unplanned weight loss may be signs of pain in the older adult.
Nonpharmacological therapies such as massage and stress management strategies may be effective in decreasing pain.
