Chapter 8 *

Question 1

Pain is a highly unpleasant sensation that affects a person’s…

Answer 1

physical health, emotional health, and well-being.

Question 2

Pain comes from the Greek word poine meaning what?

Answer 2

“Penalty” implying the person is paying for something.

Question 3

McCaffery defined pain as…

Answer 3

“Whatever the experiencing person says it is, existing whenever he or she says it does.”

Question 4

Highly___ and Personal ___ must be assessed most accurately for treatment to be successful

Answer 4

Unpleasant: Sensation

Question 5

Can two people experience pain in the same way?

Answer 5

False; No two people experience pain in the same way.

Question 6

Pain is ___; however, it can produce ___ changes in the individual.

Answer 6

subjective; objective.

Question 7

What three theories have been developed to explain the conceptual and physiological aspects of pain?

Answer 7

Specific theory
Pattern theory
Gate Control theory

Question 8

Pain can be the _____ problem or associated with a specific diagnosis, treatment, or procedure.

Answer 8

Primary

Question 9

What are the three types of pain stimuli?

Answer 9

Mechanical
Thermal
Chemical

Question 10

What are the four types of Nociception?

Answer 10

Transduction
Transmission
Perception
Modulation

Question 11

Explain how transduction works?

Answer 11

Tissue injury triggers the release of Biochemical Mediators that sensitize nociceptors.

Question 12

Explain how transmission works?

Answer 12

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.

Question 13

What happens during perception?

Answer 13

The client becomes conscious of the pain.

Question 14

Explain Modulation.

Answer 14

Neurons in the brain stem send signals back down to the dorsal horn of the spinal cord.
Often described as the “descending system”.

Question 15

What are the two types of responses to pain?

Answer 15

Physiological

Psychosocial

Question 16

Pain may be described in terms of….

Answer 16

Duration, location, or etiology.

Question 17

When pain lasts only through the expected recovery period from illness, injury, or surgery, it is described as…

Answer 17

Acute pain.

Question 18

Prolonged pain, usually recurring or persisting over 6 months or longer, and interfere with functioning is what type of pain?

Answer 18

Chronic pain.

Question 19

Pain that originates in the skin or subcutaneous tissue is ___ type of pain.

Answer 19

Cutaneous.

Question 20

Somatic pain arises from ___, ___,___, and ___.

It diffuse and tends to last longer than than cutaneous pain.

Answer 20

Ligaments
Tendons
Bones
Blood Vessels

Question 21

Visceral pain results from stimulation of pain receptors in the ___ ___, ___, and ___.

Answer 21

Abdominal cavity
cranium
thorax

Question 22

Radiation pain is…

Answer 22

perceived at the source of the pain and extends to the nearby tissue.

Question 23

Referred pain is…

Answer 23

felt in a part of the body that is considerably removed from the tissues causing the pain.

Question 24

Intractable pain is…

Answer 24

highly resistant to relief.

Question 25

Neuropathic pain is...

Answer 25

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.

Question 26

Phantom pain is...

Answer 26

perceived in a body part that is missing or paralyzed by a spinal cord injury, is an example of neuropathic pain.

Question 27

Explain the phantom sensation.

Answer 27

the feeling that the missing body part is still present.

Question 28

Factors that influence pain.

Answer 28

Developmental stage, Psychosocial development, environment.

Question 29

The ___ and ___ ___ of a client will influence both the reaction to and the expression of pain.

Answer 29

age; developmental stage

Question 30

What external factors influence a person's ability to identify and seek relief for pain.

Answer 30

Clothing, items in the environment, support system, and role expectations.

Question 31

What internal considerations influence a person's ability to identify and seek relief for pain.

Answer 31

Individual perception, experiences related to pain, and anxiety.

Question 32

Pain assessments consist of two major components. What are they?

Answer 32

Pain history- to obtain facts from the client | Direct Observation- of behavioral and physiologic responses of the client.

Question 33

What does OLDCART stand for?

Answer 33

``` Onset Location Duration Characteristics of the pain Aggravating factors Relieving factors Treatment ```

Question 34

What does ICE stand for?

Answer 34

Impact on activities of daily living Coping strategies Emotional responses

Question 35

When are OLDCART and ICE used?

Answer 35

During the focused interview.

Question 36

Tools used for pain assessment are designed and classified as:

Answer 36

Unidimensional or multidimensional tools.

Question 37

Unidimensional tools are used to help determine the clients level of ___ pain.

Answer 37

Acute

Question 38

Why is the tool called unidimensional?

Answer 38

Because it assesses one aspect of pain.

Question 39

What are the three types of unidimensional tools?

Answer 39

Numeric rating scale Body Diagram tool Oucher scale

Question 40

The numeric rating scale asks the client to describe pain intensity with a ___.

Answer 40

number

Question 41

Describe the body diagram tool.

Answer 41

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.

Question 42

Describe the Oucher Scale and who it was designed for.

Answer 42

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.

Question 43

The multi dimension assessment tools asses...

Answer 43

two or more elements of pain.

Question 44

What are the two types of multidimensional tools?

Answer 44

McGill Pain Questionnaire and Brief Pain Inventory

Question 45

When is the McGill Pain Questionnaire used?

Answer 45

When pain is prolonged.

Question 46

The Brief Pain Inventory tool provides what type of information?

Answer 46

This tool provides information on pain and how pain interferes with the person's ability to function.

Question 47

What are the steps to the nursing process?

Answer 47

- Assessment - Diagnosis - planing - implementation - evaluating - Re-evaluate

Question 48

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.

Answer 48

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.