Lecture 10 Pain

Question 1

Vital Signs

Answer 1

• Temp: diaphoresis with acute pain
o Pain doesn’t really affect temperature

• Pulse:
o Tachycardia with acute pain
o Bradycardia with unrelieved, severe pain

•	Resps: 
o	Shallow & increased with acute pain
o	Irregular with severe pain
o	Not enough expansion
	Pneumonia 

•	BP: 
o	Increased with acute pain
o	May decrease with severe pain
•	NOTE: Pt’s in pain may not show changes to V/S
o	Body adapts to pain

Question 2

Pain Pathway

Answer 2

• Nocioception = 4 phases of pain

1. Transduction- pain sensation is detected in periphery & sent to spinal cord
2. Transmission- the pain impulse moves from the spinal cord to the brain
3. Perception- consciously aware of pain
4. Modulation- slowing/blocking of pain impulse by neurotransmitters

• Tissue create action potential so body can acknowledge pain
• Right side feels pain on left and vice versa
• Only the brain can perceive the pain but not actually at the site

Question 3

Types of pain

Answer 3

• Acute – short term and self limiting
o Sympathetic response so you can act right away
• Chronic – last > 6 months, persistent, severe, excruciating, unrelieved pain

Question 4

Sources of Pain 4

Answer 4

1. Nociceptive pain- caused by tissue injury
   • Visceral pain- arises from internal organs
   o Severe
   • Somatic pain
   o Superficial- arises from skin & subcut tissues
   o Deep- arises from joints, tendons, muscle & bone
2. Neuropathic pain- caused by nerve damage
   • Abnormal
   • Diabetic pain
3. Referred Pain- originates at one location but is felt at another
4. Idiopathic Pain- chronic pain with no identifiable cause

Question 5

• Infants

* Older adults

Answer 5

o Can and do feel pain
 Skin to skin contact
 Breast feeding
 Sucrose can reduce pain of babies up to a year old

o Pain is not part of normal aging
o Complicated health problems may lead to vague reports of pain