Comfort and Pain Management Part 1

Question 1

What is pain?

Answer 1

an unpleasant sensory and experience associated with actual or potential tissue damage

Question 2

What is important to remember about the concept of pain?

Answer 2

pain is whatever the person experiencing states it is
- PAIN IS SUBJECTIVE

Question 3

bradykinin

Answer 3

a powerful vasodilator that increases capillary permeability and constricts smooth muscle

Question 4

prostaglandins

Answer 4

important hormone like substances that send additional pain stimuli to the CNS

Question 5

substance P

Answer 5

sensitizes receptors on nerves to feel pain and also increases the rate of firing of nerves

Question 6

transduction

Answer 6

activation of pain receptors

Question 7

transmission

Answer 7

conduction along pathways

Question 8

perception of pain

Answer 8

awareness of the characteristics
ex. oich, knowing that you have pain

Question 9

modulation

Answer 9

inhibition or modification of pain

Question 10

pain threshold

Answer 10

minimum intensity of a stimulus that is perceived as painful

Question 11

adaptation

Answer 11

the body adapts to painful stimuli when introduced slowly

Question 12

neuromodulators

Answer 12

natural opioid compounds that reduce pain through binding opioid receptors in the CNS

Question 13

endorphins, dynorphins, enkephalins

Answer 13

pain blocking chemicals that relieve pain

Question 14

acute pain

Answer 14

• rapid onset
• varies in intensity (mild to severe)
• warns person of damage
• usually due to an injury or surgery

Question 15

chronic pain

Answer 15

• lasts beyond the normal healing period
• interferes with ADLs
• typically lasts more than 6 months
• periods of remission or exacerbation occur
• pain can be mild or severe
• can cause depression, frustration, anger

Question 16

location of pain

Answer 16

generalized or localized

Question 17

cutaneous pain

Answer 17

• superficial
• localized
  ex. papercut

Question 18

somatic pain

Answer 18

• deep pain that is scattered or diffused
• generalized
• ligaments, tendons, nerves
• longer lasting
  ex. sprain, arthritis, ligament tears

Question 19

visceral pain

Answer 19

• originates in a body organ
• generalized
  ex. GI infection, labor pain

Question 20

referred pain

Answer 20

occurs in an area that is distant from original site

Question 21

nociceptive pain

Answer 21

• most common
• aching pain
• receptors respond to mechanical, thermal, or chemical
• somatic and visceral

Question 22

neuropathic pain

Answer 22

• nerve pain
• pain that is caused by lesions
• PNS/CNS injuries
• burning, numbness
• typically chronic
  ex. PVD from diabetes with peripheral neuropathy

Question 23

nociplastic pain

Answer 23

• pain that we do not understand, can’t be explained
• no cause
• CNS
  ex. fibromyalgia

Question 24

intractable pain

Answer 24

• pain that is chronic and highly resistant to pain relief
• have to use non pharmacological interventions a lot of the time

Question 25

phantom pain

Answer 25

- without demonstrated physiologic or pathologic substance ex. phantom limb pain

Question 26

psychogenic pain

Answer 26

- physical cause for the pain cannot be identified ex. pain resulting from a mental event

Question 27

True or false: it is better to control pain without meds

Answer 27

false

Question 28

True or false: it is better to deal with pain than side effects of the meds

Answer 28

true, depends on side effect

Question 29

true or false: I will become addicted to pain meds

Answer 29

false, not always but it can happen depending on the med

Question 30

true or false: wait until the pain is "bad" before asking for pain meds

Answer 30

false, you want to get ahead of the pain

Question 31

true or false: it is normal to have severe pain after surgery

Answer 31

false

Question 32

assessing pain

Answer 32

- pt's self report in their own words - report of family member or another person close to pt - nonverbal behaviors: restlessness, grimacing, crying, clenching fistsm protecting the painful area - physiologic measures: increased blood pressure and pulse

Question 33

aggravating factors of pain

Answer 33

- what triggers pain - what makes pain worse

Question 34

alleviating factors of pain

Answer 34

what makes pain better

Question 35

What factors of pain have an effect on activities and lifestyle?

Answer 35

- physical - social - mental - overall quality of life

Question 36

Behavioral responses to pain

Answer 36

- posture, gross motor - facial features - verbal expressions

Question 37

physiologic responses to pain

Answer 37

- vital signs - skin color - perspiration - pupil size - nausea - muscle tension - anxiety

Question 38

What is the most common pain scale that is used?

Answer 38

numeric: 0-10

Question 39

Children in pain

Answer 39

- irritability and restlessness - crying, screaming, or other verbal expression of pain - grimacing, grinding of teeth, clenching fists - touching or grabbing painful body part - kicking, thrashing, attempting to move away from painful stimulus

Question 40

Nursing interventions for pain

Answer 40

- establishing trusting nurse-patient relationship - manipulating factors affecting pain experience - initiating nonpharmacologic pain relief measures - managing pharmacologic interactions - complementary and alternative relief measures - considering ethical and legal responsibility to relieve pain - teaching patient about pain