Concept 27: Pain

Question 1

nociceptors

Answer 1

cells of free nerve endings in the sensation of pain

found in all tissues except CNS

Question 2

nociception

Answer 2

transmit pain information through the somatosensory system

Question 3

acute pain

Answer 3

sudden onset and is typically clearly linked to a specific event injury or illness

tissue damage as a result of surgery, trauma, or burns

short-lived and diminish with normal healing

Question 4

chronic pain

Answer 4

lasting more than 3 months and may last for years

result from underlying medical conidition (pathology)

cancer from tumor growth or osteoarthritis pain from joint degeneration

Question 5

nociceptive pain

Answer 5

normal functioning of the noxious stimuli (tissue injury) that is being perceived as being painful aka eudynic pain

(sunburn, surgery, or trauma) described as aching, cramping, or throbbing

Question 6

somatic pain

Answer 6

sharp pain that is well localized to a specific are of injury

Question 7

visceral pain

Answer 7

arises from within the body cavity

most commonly the thorax, abdomen, and pelvis

respond to stretching, swelling, and oxygen deprivation and pain may radiate to other locations int he back or chest

Question 8

neuropathic pain

Answer 8

results from pathology or disease of the somatosensory system

pathologic

postherpetic neuralgia, diabetic neuropathy, phantom pain, post-stroke pain syndrome

burning, sharp, and shooting

Question 9

deafferentation pain

Answer 9

chronic and results from the loss of afferent input to the CNS.

may arise in the peripheral nerve avulsion or in the CNS from spinal lesion or multiple sclerosis

Question 9

neuralgia pain

Answer 9

lancinating and associated with nerve damage or irritation along the distribution of a single nerve

Question 9

sympathetic mediated pain

Answer 9

accompanied by edema, changes in skin blood flow, and abnormal sensation such as allodynia, hyperalgesia, and hyperpathia

Question 10

central pain

Answer 10

lesion in the CNS, usually imvolving spinothalamic cortical pathways, such as a thalamic infarct

burning, electrical quality

Question 11

mixed pain syndrome

Answer 11

painful condition and syndromes that are not easily categorized and are thought to be unique with multiple underlying and poorly understood mechanism

fibromyalgia and some low back and myofascial pain

Question 12

pain on physical functioning

Answer 12

none use of affected area and immobility can lead to muscle atrophy and joint contraction, which further promote pain and impair physical functioning.

sympathetic nervous system activation caused by acute pain decreases the release of digestive enzymes in the GI tract and slows digestion

pain med cause constipation can further impair GI function

Question 13

psychosocial consequence of pain

Answer 13

cause fear, anger, depression, anxiety, and reduced ability to maintain relationships, engage in normal activities, and continue to work.

pain untreated causes negative effects on every aspect of the patient’s life

pain treatment with opioids can include opioid use disorder, characterized by an overwhelming urge to use opioids even when they are no longer medically necessary to treat pain. addiction can effect every aspect of a person’s life, including their relationships, employment, and economic status.

Question 14

population at risk for pain

Answer 14

1. CRITICALLY ILL INFANTS –due to high number of procedures performed (neonatal ICU)

infants, toddlers, and preverbal children do not have the cognitive skills to report and describe pain.

2. OLDER ADULTS – pain increases with age

more common in acute care settings and outpatient settings such as nursing homes.

unable to report pain due to reluctance to report or unable due to illness or cognitive impairment.

3. SEX, RACE, AND ETHNICITY

WOMEN have a higher chance than men —lower thresholds, hormones

social factors influence access to pain treatment due to income, education, and geographic location

Question 15

numeric rating scale (NRS)

Answer 15

0-10 scale with no pain on one side , moderate pain in middle, and worst possible pain at the end of scale

Question 16

faces Pain Scale-Revised (FPS-R_

Answer 16

has six faces ranging from neutral facial expressions to one intense pain and are numbered 0, 2, 4, 6, 8, and 10

the patient is asked to choose the face that best describes their pain

valid and reliable use with children and adult

young children unable to quantify pain until approximately 8 years of age

Question 17

Wong-Baker FACES Pain Rating Scale

Answer 17

six cartoon faces with word descriptors ranging from smiling face on the left for no pain to frowning on the right for worst pain

numbered 0, 2, 4, 6, 8, and 10 or 0-5

used in adult and children as young as 3 years old.

Question 18

Verbal Discriptor Scale (VDS)

Answer 18

a series of different words or phrases to describe the intensity of pain
such as
no pain
moderate pain
severe pain
very severe pain

can be present horizontally or vertically

Question 19

breakthrough pain

Answer 19

determines whether the patient’s treatment is effective

aka pain flare

transitory exacerbation of pain in a patient has relatively stable and adequately controlled baseline pain

Question 20

incident pain

Answer 20

breakthrough pain is brief and precipitated by voluntary action such as movement

Question 21

idiopathic pain

Answer 21

not associated with any known cause and often lasts longer than the incident pain

Question 22

end of dose failure pain

Answer 22

episodes of pain that occurs beofre the next analgesic dose

Question 23

osteoarthritis pain

Answer 23

condition that cause cartilage in a joint to become stiff and lose elasticity

cartilage wears away causing tendon and ligament to rub against one another, resulting in pain

Question 24

trigeminal neuralgia

Answer 24

aka tic douloureux
neuropathic pain arising from teh trigeminal (V) cranial nerve

cause extreme sporadic burning or shock-like facial pain that can last seconds to minutes per episode.

Question 25

postherpetic neuralgia

Answer 25

develops after a case of shingles caused by the herpes zoster virus

thin blisters associated with shingles disappear within few weeks, but when the pain continues after the blisters have disappeared, the burning pain is known as postherpetic

Question 26

post stroke pain

Question 27

complex regional pain syndrom

Question 28

fibromyalgia