Lesson 5

Question 1

When does nociceptive pain develop?

Answer 1

Develops when functioning and intact nerve fibers in the periphery and the CNS are stimulated (triggered by events outside the NS from actual or potential tissue damage)

Question 2

Where does somatic pain come from?

Answer 2

The joints, bones, muscles, and other soft tissues

Question 3

Where does visceral pain come from?

Answer 3

The internal organs

Question 4

What are the 4 phases of nociceptive pain?

Answer 4

Transduction, transmission, perception, modulation

Question 5

Is nociceptive pain predictable and time-limited based on the extent of the injury?

Answer 5

Yes

Question 6

Can nociceptive pain turn into neuropathic pain?

Answer 6

Yes, over time when pain has been poorly controlled

Question 7

What is neuropathic pain?

Answer 7

Pain that does not adhere to the typical and predictable phases of nociceptive pain

Question 8

Neuropathic pain implies an ____ of the pain message from an injury to the nerve fibers.

Answer 8

Abnormal processing

“Pain caused by a lesion or disease of the somatosensory nervous system”

Question 9

Which pain is more difficult to assess and treat?

Answer 9

Neuropathic

Question 10

Describe acute pain behaviors

Answer 10

• Short term
• Self limiting
• Follows a predictable trajectory
• Dissipates after injury heels
• Self protective (warns individual of actual or threatened tissue damage)

Question 11

When is chronic pain diagnosed?

Answer 11

When pain continues for 6 months or longer (can last 5, 10, 15, or 20 years beyond initial instance of pain)

Question 12

How is chronic pain behaviors divided into?

Answer 12

Malignant and nonmalignant

Question 13

In chronic pain, does pain stop when the injury is heeled?

Answer 13

No

Question 14

Myth: Clients with chronic pain must be malingering

Answer 14

Pain indicates pathology or injury and should not be considered a “normal process of aging” and not something to tolerate or accept later in life

Question 15

Myth: Clients with demential do not feel pain

Answer 15

People with demential DO fee pain. The somatosensory cortex is generally unaffected by demential of the Alzheimer type (must assess body language instead of verbal communication for pain)

Question 16

Myth: Infants don’t experience pain to the same degree that adults do

Answer 16

Infants have the same capacity for pain as adults

-Sensory fibers and neurotransmitters are developed by 20 weeks of gestation

Question 17

For infants and pain, when are inhibitory neurotransmitters sufficient?

Answer 17

Until birth at full term

Question 18

A ____ infant is rendered more sensitive to painful stimuli.

Answer 18

Preterm

Question 19

When do you use the 0-10 pain scale?

Answer 19

It is a numerical scale used on ages 7+

Question 20

When do you use the NIPS pain scale?

Answer 20

Infants 0-3 months

Question 21

When do you use the faces pain scale?

Answer 21

3-7

Question 22

What does the FLACC pain scale stand for?

Answer 22

Faces, legs, activity, cry, consolability

Question 23

When do you use the FLACC behavior pain scale?

Answer 23

Ages 3 months- 7 years old; or individuals who are unable to communicate their pain

Question 24

What is the “gold standard” of pain assessment?

Answer 24

Self-report; Pain is SUBJECTIVE and cannot be measured with a device
-Nurses need to listen to the patient’s description of pain and ask questions regarding the pain, to understand how to best help the patient (PQRST is helpful)

Question 25

What does PQRST stand for?

Answer 25

P-provacation and palliation (when is it worse? when is it better?)
Q- quality and quantity (Describe what it feels like)
R- Region and radiation (Show me the location where it hurts)
S- Severity (0-10 pain scale)
T- Timing (when did it start to hurt? how long does it last?

Question 26

When should the nurse undergo a thorough pain assessment?

Answer 26

When the pain is so unbearable, nurses can abbreviate the PQRST method
If the patient just had surgery on their leg and wake up and are crying out in pain, you do not need to ask once again where the pain is. You would know. That is what it means by an “abbreviated PQRST”

Question 27

What is the most important vital sign?

Answer 27

Pulse oximetry

Question 28

What are the 5 things the pulse oximetry can show us?

Answer 28

CO
BP
Oxygen saturation
Blood gas analysis
HR
-Basically it lets us know how well blood is being pumped from the heart

Question 29

Why is tachypnea alone not a good indicator of hypoxemia?

Answer 29

Tachypnea can have many origins

Ex: tachypnea is a normal response to fever, fear, or exercise

Question 30

Why is cyanosis not a good indicator of hypoxemia?

Answer 30

Cyanosis can be a nonspecific sign

Question 31

What are the most common causes of an inaccurate pulse oximetry reading?

Answer 31

Movement
Ambient light
Cold extremities (from decreased blood flow)
Nail polish

Question 32

What is a normal O2 saturation level?

Answer 32

93-100%

Question 33

What is an abnormal O2 saturation level?

Question 34

When looking at O2 Saturation levels, what must you consider?

Answer 34

If they are on oxygen
How much oxygen they are being given
Respiration rate