Comfort and Pain management

Question 1

What is the Pain Process?

Answer 1

Transduction: Activation of pain receptors
Transmission: Conduction along pathways (A delta and C delta fibers)
Perceptions of pain: Awareness of the characteristics of pain
Modulation: Inhibition or modification of pain

Question 2

What is the pain threshold?

Answer 2

Minimum intensity of. stimulus that is perceived as painful

Question 3

What are neuromodulators?

Answer 3

Naturally present in spinal cord and brain
Block the release or production of pain transmitting substances
Examples: endorphins, dynorphins, enkephalins

Question 4

What do endorphins do?

Answer 4

Produced along the CNS pathway
Painblocking chemicals that have prolonged analgesic effects and produce euphoria

Question 5

What are dynorphins?

Answer 5

Type of endorphin
Has the most potent anagesic effect

Question 6

What are Enkephalins?

Answer 6

Less potent than endorphins
Reduce pain by inhibiting the release of substance P from the terminals of afferent neurons

Question 7

What is somatic pain?

Answer 7

Is diffuse or scattered
Tendons
Ligaments
Bones
Blood vessels
Nerves
Muscles

Question 8

What is visceral pain?

Answer 8

Poorly organized
Originates in body organs

Question 9

What is cutaneous pain?

Answer 9

Involves skin or subcutaneous tissue
A paper cut would be an example

Question 10

What is referred pain?

Answer 10

Originates in one part of the body and is perceived in an area distant to that part

Question 11

What are the responses to pain?

Answer 11

Behavioral (Voluntary)
Physiologic (Involuntary)
Affective (Psychological)

Question 12

Examples of Behavioral pain

Answer 12

Moving away
Grimacing, moaning, crying
Restlessness
Protecting the painful area

Question 13

Examples of physiologic pain

Answer 13

Increased blood pressure
Increased pulse and respiratory rate
Pupil dilation
Muscle tension

Question 14

Examples of affective pain

Answer 14

Exaggerated weeping
Withdrawal
Stoicism
Anxiety
Depression
Fear
Anger
Anxiety
Fatigue
Hopelessness
Insomnia
Powerlessness

Question 15

What is diffuse pain?

Answer 15

Covers a large area
Hard to point to a specific area without moving the hand over a large surface

Question 16

When is the adult nonverbal painscale used?

Answer 16

With patients who are unable to communicate verbally
Uses both observable behaviors and physiologic
Pt’s in ICU or with dimentia

Question 17

When is the Behavioral Pain Scale used? (BPS)

Answer 17

With patients who can’t verbalize
Focuses on observable behaviors and body movements

Question 18

When is COMFORT painscale used?

Answer 18

Younger kids?

Question 19

When is CRIES used?

Answer 19

Infants
0-6 months

Question 20

When is FLACC used?

Answer 20

Used in children and adults who are unable to self report their pain
Face
Legs
Activity
Cry
Consolability

Question 21

When is Oucher pain scale used?

Answer 21

Children 3-12

Question 22

When is wonk baker used?

Answer 22

Children

Question 23

What do the sedation scale numbers mean?

Answer 23

1: Pt alert and awake
2: Pt occasionally drowsy, easy to awake
3: Pt is frequently drowsy and hard to awake; reduce dosage
4: Pt is somnolent with minimal or no response to stimuli; use Noloxone

Question 24

What is the preffered route of medication for cancer or chronic pt?

Answer 24

Orally if possible

Question 25

What to avoid when taking analgesics?

Answer 25

Alcohol
Driving
Breastfeeding
Taking on empty stomach
Operating machinery
Keep a diary