Chapter 9: Pain

Question 1

unpleasant sensory and emotional experience, primarily associated with tissue damage

Answer 1

Pain

Question 2

What is pain

Answer 2

-Pain is WHATEVER the patient says it is

Question 3

Physiologic pain response:

Answer 3

-Anxiety, sleeplessness, confusion, fear
-Facial grimace, cries/moans
-Tachycardia, tachypnea, decreased GI & renal
-Objective indicators can be used if patient report not possible (unconscious, sedated)

Question 4

-Acute pain=

Answer 4

Less than 6 months

Question 5

-Chronic pain=

Answer 5

Greater than 6 months

Question 6

Ways to access Pain

Answer 6

Interview patient about pain symptoms
(COLDSPA)

Question 7

Ways to access Pain

Answer 7

Interview patient about pain symptoms
(COLDSPA)

Question 8

What’s COLDSPA

Answer 8

-Character: describe pain (sharp,throbbing)
-Onset: when did it start?
-Location: where is it? Does it radiate/spread?
-Duration: how long? Does it recur?
-Severity: rate the pain (0 - 10 scale)
-Pattern: continuous or intermittent? frequency?
-Associated factors: other symptoms w/pain?
-Factors that relieve/increase pain?
-Any treatment thus far? Effective?

Question 9

What does the “C” stand for in COLDSPA

Answer 9

-Character: describe pain (sharp, throbbing, etc.)

Question 10

What does the “O” stand for in COLDSPA

Answer 10

-Onset: when did it start?

Question 11

What does the “L” stand for in COLDSPA

Answer 11

-Location: where is it? Does it radiate/spread?

Question 12

What does the “D” stand for in COLDSPA

Answer 12

-Duration: how long? Does it recur?

Question 13

What does the “S” stand for in COLDSPA

Answer 13

-Severity: rate the pain (0 - 10 scale)

Question 14

What does the “P” stand for in COLDSPA

Answer 14

-Pattern: continuous or intermittent? frequency?

Question 15

What does the “A” stand for in COLDSPA

Answer 15

-Associated factors: other symptoms w/pain?
-Factors that relieve/increase pain?
-Any treatment thus far? Effective?

Question 16

Emotional or mental pain; refers to pain originating from the persons psychological dimensions and has been found in underlying suicidal behavior. This mental pain is separate from criteria for depression, but depression can cause emotional pain as well.

Answer 16

Psychological pain

Question 17

The process of somatization, when psychological pain becomes physical.
Somatization involves transferring or converting uncomfortable feelings into physical symptoms, which may be more tolerable. Examples include limb paralysis, sensory loss, seizures (often called pseudoseizures).

Answer 17

Psychosomatic or psychogenic pain

Question 18

Pain caused by nerve receptors detecting harmful stimuli. The receptors react to mechanical, chemical, or thermal stimuli that may cause damage to skin, muscles, bones, or connective tissue. Nociceptive pain is the most common type of pain. It may be somatic, visceral, or radicular, depending on the location.

Answer 18

Nociceptive pain

Question 19

Results from damage or dysfunction of any level of the nervous system (peripheral nerves, spinal cord, or brain). Nerve function may change at the site of the damage, affecting one or more nerves or the central nervous system. About 30% of neuropathies are caused by diabetes.

Answer 19

Neuropathic pain

Question 20

Has two aspects: inflammatory and immune responses accompanying and causing both nociceptive and neurologic pain; and inflammatory pain syndromes, such as back pain, shoulder pain, arthritis, rheumatoid arthritis, fibromyalgia, and migraine. In many types of pain, inflammatory pain is involved and may enhance the sensation of pain.

Answer 20

Inflammatory pain

Question 21

Occurs when nerves in the internal organs in the chest, abdomen, intestines, or pelvis are stimulated. Visceral pain
feels vague, not localized, with a sensation of a deep squeeze, pressure, or aching

Answer 21

Visceral pain

Question 22

Generated by stimuli at the nerve root at its connection to the spinal nerves.

Answer 22

Radicular pain

Question 23

A sensation of pain in a body region distant from the actual source of the painful stimulus.

Answer 23

Referred pain

Question 24

Pain in a part of the body that has been removed, such as a leg.

Answer 24

Phantom pain

Question 25

Is more than one type of pain. Cancer may have little to no pain. When pain occurs, the first pain is often related to tumor pressure on nerves, bones, or other body organs. Cancer treatments (chemotherapy and radiation) also cause their own pain responses. Cancer pain may be acute or chronic. Types of pain in cancer include nerve pain, bone pain, tissue pain, and the pain may be referred or phantom (pain in a part of the body that has been removed). Inflammatory pain is often a significant part of cancer pain, both nociceptive and neuropathic.

Answer 25

Cancer pain

Question 26

Acute (occurs suddenly and does not last longer than 6 months) versus chronic (persistent, ongoing; lasts longer than 6 months)

Answer 26

Classification Categories for Pain
Duration

Question 27

Central (develops from spinal cord or brain injury, stroke, or multiple sclerosis versus peripheral (originates from the peripheral part of the nervous system, i.e., trigeminal neuralgia, polyneuropathies, or radiculopathies

Answer 27

Classification Categories for Pain
Location

Question 28

What VS findings would you expect with a patient who is reporting pain sharp,
8/10 abdominal pain?

Answer 28

-High Heart rate/pulse
-High Respiratory rate
-High Blood pressure

Question 29

Is the patient still having pain if vitals are all “normal”?
How would these factors impact your pain assessment?

Answer 29

-Acute v. chronic pain
-Cognitive/mental status
-Patient culture
-Patient developmental level