module 3: pain management

Question 1

nursing assessment of pain?

Answer 1

• pain is whatever the patient says it is
• important to be alert to patients who deny pain when pain would be expected
• includes determining level of pain relief the acutely ill patient believes is needed to recover quickly or improves function

Question 2

pain behaviours?

Answer 2

-nonverbal and behaviour expressions of pain are not consistent or reliable indicators of the quality or intensity of pain and they should not be used t determine the presence of or severity of a pain

Question 3

in unconscious patients pain?

Answer 3

should be assumed to be present and treated

Question 4

is it wise to make judgements and formulate treatment plans based on behaviours that may or may not mean pain?

Answer 4

no!

Question 5

physiologic responses to pain include?

Answer 5

• tachycardia
• hypertension
• tachypnea
• pallor
• diaphoresis
• mydrasis
• hypervigilance
• increased muscle tone

Question 6

instruments for assessing perception of pain?

Answer 6

• only patient can accurately describe or assess his or her pain
• visual analogue scales and other intensity scaes
• faces pain scale

Question 7

instruments for assessing pain in patients with disabilities

Answer 7

• blind you can use braille

- deaf you can use interpreters

Question 8

identifying goals for pain management?

Answer 8

• shared and validated with patient
• consider: severity of pain, anticipated harmful effects of pain, anticipated duration of pain
• most successful: pharmacological and nonpharmacological means

Question 9

barriers to pain management?

Answer 9

• lack of education
• addiction fears
• confusion
• 6 breaths per minute is adequate

Question 10

goal of pain management?

Answer 10

relieving pain

Question 11

pharmacologic interventions of pain? (premed assessment)

Answer 11

close collaboration with HC providers

• allergies
• med history
• ethic

Question 12

massages for pain?

Answer 12

-gate control of pain proposes that stimulation of fibers that transmit nonpainful sensation can block or decrease transmission of pain impulse

Question 13

thermal therapies?

Answer 13

cold ice to injury immediately (only 15-20 mins at a time, avoid if bad circulation)
heat to increase blood flow- speed healing

Question 14

transcutaneous electrical nerve stimulation?

Answer 14

battery operated unit applied to skin: tingling, buzzing sensation acute and chronic pain

Question 15

distraction?

Answer 15

doesnt work for all pt, especially not severe

Question 16

relaxation techniques?

Answer 16

almost all pains benefit, abdominal breathing

Question 17

music therapy?

Answer 17

causes patients to have less pain and need less meds even after it stops

Question 18

what are neurologic and neurosurgical approaches to pain management?

Answer 18

• when usual methods are ineffective, these may be considered
• stimulation procedures and interruption of pain pathways

Question 19

what are stimulation procedures

Answer 19

intermittent electrical stimulation of a tract or center to inhibit pain impulse

• blocks painful stimuli
• TENS and dorsal spinal cord stimulation are most common

Question 20

interruption of pain pathways?

Answer 20

destructive procedures only used after other methods have failed

• can be interrupted at any point from origin to cerebral cortex
• some part of NS is purposely destroyed, usually near end of life

Question 21

cordotomy?

Answer 21

-division of certain tracts of spinal cord

Question 22

rhizotomy?

Answer 22

• sensory roots are destroyed where they enter the spinal cord
• mild sensory deficits and mild weakness

Question 23

what does a successful pain control plan include?

Answer 23

• establishing pain diagnosis
• treating cause of pain when possible
• optimizing analgesic use
• if needed, considering non-pharmacological interventions

Question 24

60-90% of patients with advanced cancer experience moderate to severe pain and..

Answer 24

over 40% receive inadequate treatment, leading to suffering

Question 25

each persons suffering is a?

Answer 25

unique experience