Pain

Question 1

Most reliable indicator of pain?

Answer 1

Always is the patients-self report

Question 2

Role of the Nurse

Answer 2

• Ethical responsibility to relieve pain and the suffering it causes
• Provide individualized nursing interventions
• Improve pain management
• Multimodal and inter-professional approaches are necessary
• Informed by evidence
• Nurses most advocate for policies to assure access to all effective modalities

Question 3

Types of Pain

Answer 3

Acute ( Short, severe )
Chronic ( Persistent, long term )

Question 4

Nociceptive

Answer 4

Tissue pain
Somatic- C.T
Visceral- Organ

Question 5

Neuropathic

Answer 5

Nerve malfunctions or is injured

Question 6

Phantom Pain

Answer 6

Brain sends messages of pain, but it does not exist

Question 7

Consequences of Untreated Pain

Answer 7

• Prolonged stress response
• Decreased GI motility
• Cardiovascular instability
• Metabolic imbalance

Question 8

Individual Risk Factors for Pain

Answer 8

• Many OLDER adults have chronic pain
• Physiological changes/ aging affect perception and expression of pain
• Drug interaction: More/ Different medications

Question 9

Barriers to Pain Management

Answer 9

-Inadequate knowledge of healthcare providers
- Fear of pain meds
- Noncompliance
- Financial barriers

Question 10

Elements of Pain Assessment

Answer 10

Patients self report of pain!
- Location
- Intensity
- Quality
- Onset
- Alleviating factors
- Effect of pain
- Comfort status

Question 11

Pain Quality

Answer 11

Stabbing, burning, itchy, cramping, aching, tender, numb, throbbing etc

Question 11

Behavioral Signs of Pain

Answer 11

• Facial expressions
• Change in activity
• Assessment tools
• Restlessness
• Crying ( In children )

Question 12

PQRSTU

Answer 12

• Provoking and relieving factors
• Quality of pain
• Region or radiation
• Severity / Intesnity
• Time: Onset, duration, frequency
• Understanding: Effects, meanings, symptoms

Question 13

How does the nurse assess for breakthrough pain?

Answer 13

Meds, pain level, vitals

Question 14

How does the nurse conduct a pain reassessment?

Answer 14

Ask them!

Question 15

What are common challenges with pain assessment?

Answer 15

Subjective, pain tolerance, talking barrier

Question 16

Pain Across Lifespan: Infants

Answer 16

• Unable to articulate pain
• Display behavioral responses
• Physiologic Responses: Decrease in growth and development, decreased immune, decreased appetite, increased sensitivity ( through past expierneces )

Question 17

Infants

Answer 17

FLACC Scale

Question 18

Toddlers

Answer 18

FLACC Scale, faces pain scale

Question 19

Children

Answer 19

Faces pain scale, numeric pain scale

Question 20

FLACC Scale

Answer 20

If client is nonverbal, or unable to complete faces pain scale

Question 21

Elderly:

Answer 21

Older adults that are unable to articulate pain-
- PAINAD: Dementia
- Like FLACC patients ^

Question 22

Pharm Interventions

Answer 22

Adjuvants, NSAIDS, Tylenol, Weak opioids, strong opioids

Question 23

Non Pham Interventions

Answer 23

• Massage
• Acupuncture
• Thermal ( Heat and Cold )

Question 24

WHO Pain Ladder

Answer 24

Pain starting slow, gradually increasing
1. Pain persisting
2. Opioid for mild to moderate pain
3. Freedom from cancer pain ( opioid from severe pain )

Question 25

Chronic Osteoarthritis Pain

Answer 25

-Diagnosis: X ray, blood tests
-Interventions: Mobility management, pain mangement
-Surgical Interventions: Severe pain, immobility

Question 26

Surgical Pain ( Acute )

Answer 26

Before Surgery: Assess
- Pain level
- Medications
- Risk factors
- Teach ab post op pain ( what to expect )

After Surgery:
- Reassess pain level
- Prioritize comfort
- Encourage early mobilizations

Question 27

Post Op Pain

Answer 27

Oral: Pills
Transdermal: Fentanyl patch
Patient Controlled Analgesia: PCA Pump
Nerve Block: For chronic pain
- Must check RR before administering opioids

Question 28

Wrong Baker Faces

Answer 28

Used for children
Or Numeric