Pain

Question 1

Gate Control Theory of Pain

Answer 1

• sm/lg diameter nerve fibers conduct and inhibit pain stimuli toward brain
• gating mechanism determines the impulses that reach the brain

Question 1

Definition of pain is:

Answer 1

• whatever the pt describes
• a personal experience infuenced by biologic, psyc, and social
• learned through individual’s life experiences
• serves an adaptive role

Question 2

Transduction

Answer 2

activation of pain receptors

Question 2

Transmission

Answer 2

conduction along pathways (A delta/C delta fibers)

Question 3

Perception of pain

Answer 3

awareness of the characteristics of pain

Question 3

Modulation

Answer 3

inhibition of modification of pain

Question 4

Types of pain:

Answer 4

acute/chronic
localized/somatic/visceral/cutaneous/referred

Question 5

Localized pain

Answer 5

in a specific area

Question 6

Somatic

Answer 6

deep pain

Question 7

Visceral

Answer 7

abdomen/thorax not specific

Question 8

Cutaneous

Answer 8

superficial

Question 9

Referred pain

Answer 9

moves to a different area in the body (chest pain -> jaw/arm pain)

Question 10

Acute pain

Answer 10

rapid onset

Question 11

Chronic

Answer 11

intermittent/persistent
periods of remission and lasts beyond normal healing time

Question 12

nociceptive

Answer 12

normal pain process (broken bones)

Question 13

neuropathic

Answer 13

disease/lesion of CNS (not really injured CNS is injured and makes you percieve pain)

Question 14

Nociplastic

Answer 14

chronic primary pain with misdiagnosis

Question 15

Intractable

Answer 15

occurs when there is resistance to treatment

Question 16

Phantom pain

Answer 16

amputation and still feel pain in limb

Question 17

Behavioral response to pain

Answer 17

-voluntary
- stopping someone from touching/limping

Question 18

Physiologic

Answer 18

• involuntary
• gaurding reflex

Question 19

Affective pain response

Answer 19

-psychological

Question 20

What are cultural and ethnicity variables

Answer 20

family, biological sex, gender, age, religious beliefs, and spirituality

Question 21

Terms to describe quality of pain

Answer 21

sharp, dull, diffuse, visceral, shifting

Question 22

Severity terms

Answer 22

• severe or excruciating
• moderate
• slight/mild

Question 23

Periodicity

Answer 23

-continuous
- intermittent
- brief or transient

Question 24

NVPS

Answer 24

nonverbal pain scale
- restlessness 0-2
- muscle tension 0-2
- facial expression 0-2
- vocalization 0-2
- wound gaurding 0-2

Question 25

Behavioral Pain Scale and Checklist for Nonverbal indicators

Answer 25

same as NVPS

Question 26

Numeric Sedation Scale

Answer 26

S: sleep, easy to arouse: no action necessary
1: awake and alert; no action needed
2: occasionally drowsy, but easy to arouse; no action necessary
3: frequently drowsy, drifts off to sleep during conversation, reduce dosage
4: somnolent with minimal or not response to stimuli; discontinue opiod, maybe naloxone

Question 27

What are general principles for analgesic admin

Answer 27

-ongoing assessment
-management of breakthrough pain
- concern about prescription analgesic abuse

Question 28

What are some regimens for chronic pain

Answer 28

-give meds orally
- patient should controll the meds through PCA pump rather than PRN
- adjust dose to achieve max benefits w/ minimum side effects
- allow patients as much control as possible

Question 29

What is different in pain regimens with older adults?

Answer 29

-communication difficulties
- denial of pain
- altered physiologic response (renal/liver fail)

Question 30

How should the nurse teach about pain

Answer 30

• should include family/caregivers
• explain about pain scales
• safety teaching: no driving, alcohol, CNS depressants
• keep diary of pain/meds
  -do not take on an empty stomach