Lecture 2.2 - Pain Management

Question 1

What is pain

Answer 1

Whatever and whenever the person experiencing pain says it is

Question 2

What are the five dimensions of the pain process?

Answer 2

Sensory, physiological, affective, behavioural, cognitive

Question 3

What is chronic pain?

Answer 3

Pain that persists 3+ months secondary to a chronic disorder or nerve damage after healing is complete.

Question 4

What is intractable pain?

Answer 4

A pain state that is severe and has no cure

such as refractory angina

Question 5

What is neuropathic pain?

Answer 5

Pain that is related to malfunctioning or damaged nervous tissue

Question 6

What are the two kinds of nociceptive pain?

Answer 6

Nociceptive pain is directly related to tissue damage.

Somatic
–> skin, muscle, bone

Visceral
–> heart, bowel, organs

Question 7

What is the difference between pain threshold and pain tolerance?

Answer 7

Pain threshold
–> process of recognizing defining, and responding to pain

Pain tolerance
–> Most pain level an individual can tolerate before taking actions

Question 8

How is neuropathic pain usually described?

Answer 8

Usually described as burning, shooting, stabbing or electrical

Question 9

Which medication are used to manage neuropathic pain?

Answer 9

Opioids, antiseizure meds, antidepressants

good combo is gabapentin and Celebrex

Question 10

What does the V in pain assessment stand for?

Answer 10

Values
–> Stressors, spiritual pain

Question 11

What is the goal of a pain assessment?

Answer 11

To describe the client’s sensory, affective, behavioural, cognitive, and sociocultural pain experience in order to implement pain management techniques or identity the client’s goal for therapy.

Question 12

What is breakthrough pain?

Answer 12

Transient pain that is moderate or severe that occurs between doses of scheduled doses of analgesia.

Question 13

Which analgesic is most likely to cause constipation?

Answer 13

Codeine

Question 14

What is titration?

Answer 14

Use the smallest effective dose to provide effective pain releif.

Question 15

What medications are used for conscious sedation?

Answer 15

Ketamine and midazolam d/t amnesiac and dissociative properties

Question 16

What is the purpose of adjuvant analgesia?

Answer 16

Enhance effects of opioids, have analgesia effects of their own, counteracts adverse effects of other analgesics.

adjuvants should aim to cause a 20-60% decrease in opioid use

Question 17

Why should IM analgesia be avoided?

Answer 17

Painful, damages tissues, slowly absorbed

Question 18

What is meant by the suffix contin?

Answer 18

Long-acting

Question 19

How many points on the NRS pain scale should be decreased by effective analgesia?

Answer 19

at least 2 point difference (30% decrease in pain levels)

Question 20

How to evaluate effectiveness of analgesia?

Answer 20

–> Patient’s goals
–> pain rating (2 points)
–> Patient requests analgesia st onset of pain
–> Patient able to initiate own deep breathing and relaxation breathing in conjunction w analgesia

Question 21

Reassess effects of pain interventions within ___ mins of administration and document effects.

Answer 21

30

Question 22

When do we need to intervene for pain?

Answer 22

Pain score higher than 4 or unacceptable to the patient

Patient cannot do ADLs

Patient cannot mobilize/deep breath or cough d/t pain