Pain

Question 1

Comfort and Pain are

Answer 1

subjective

Question 2

Pain is no longer considered a symptom of an illness but is considered a

Answer 2

separate disease

Question 3

pain is

Answer 3

1. most common reason why patient seeks healthcare 2. whatever your patient says it is

Question 4

nature of pain

Answer 4

physical, emotional, cognitive, and subjective

Question 5

stimulis

Answer 5

can be physical and mental

Question 6

physiology of pain

Answer 6

4 processes of nociceptive (normal) pain

Question 7

4 processes of nociceptive (normal) pain:

Answer 7

transduction, transmission, perception, modulation

Question 8

transduction

Answer 8

the process of converting thermal, chemical, or mechanical energy to electrical energy; begins in the periphery

Question 9

Once transduction is complete, ____________ of the pain impulse begins. *

Answer 9

transmission

Question 10

When cellular damage occurs, pain-sensing substances

Answer 10

called excitatory neurotransmitters (such as prostaglandins, potassium, histamine, and substance P) surround the pain fibers and begin spreading the pain message – causing an inflammatory response.

Question 11

*Pain fibers enter the

Answer 11

spinal cord – ends within the gray matter where cell bodies, axons, and dendrites are located.

Question 12

Within the dorsal horn, _________ is released, and causes

Answer 12

substance P; causing a synapse from the afferent / sensory peripheral nerves to nerves within the spinothalamic tract

Question 13

*Two types of peripheral nerve fibers conduct painful stimuli:

Answer 13

(1) the fast, myelinated “A” fibers send sharp, localized and distinct sensations that localize the source of pain and detects its intensity. (2) the very slow, small, unmyelinated “C” fibers relay impulses that are poorly localized, aching, burning, and persistent. *(Trace the transmission of the pain stimulus.)

Question 14

perception

Answer 14

is the point at which a person is aware of pain

Question 15

The somatosensory cortex identifies

Answer 15

the location and intensity of pain.

Question 16

The association cortex determines

Answer 16

how we feel about the pain.

Question 17

modulation

Answer 17

The inhibition of pain impulse *(What happens when the brain perceives the pain?)

Question 18

Protective Reflex:

Answer 18

“A” Fibers send sensory impulses to the spinal cord - synapse occurs - motor impulses travel via the reflex arc along efferent / motor nerve fibers back to a peripheral muscle near the site of stimulation. Bypassing the brain. Contraction of the muscles leads to a protective withdrawal from the source of pain.

Question 19

Gate-Control Theory of Pain:

Answer 19

Pain impulses can be regulated or blocked by gating mechanisms located along the central nervous system. Closing a gate is the basis for pain relief interventions.

Question 20

Pain Threshold

Answer 20

is the point at which a person feels pain. Stress, exercise, and other factors that increase the release of endorphins will increase an individuals pain threshold. Massage & therapeutic touch are also supported by this theory

Question 21

sympathetic stimulation -

Answer 21

increased respirations & heart rate; elevated B/P; increased glucose; diaphoresis; muscle tension; dilated pupils; decreased GI motility. Pain of low to moderate intensity and superficial pain elicit the fight or flight reaction.

Question 22

parasympathetic stimulation -

Answer 22

decreased heart rate & B/P; rapid-irregular breathing; pallor; muscle tension. Usually seen when pain is continuous, severe, or deep – involving visceral organs (heart, gall bladder, kidneys).

Question 23

Over time, the individual adapts to the change and the physical signs will return to normal; therefore,

Answer 23

clients in pain will NOT ALWAYS have changes in vital signs.

Question 24

Once pain is experienced, a cycle of events begins and may alter one’s ___________________________ if left untreated.

Answer 24

cycle of life

Question 25

Clients may choose not to report pain if:

Answer 25

1. could be inconvenience to others (elderly) 2. loss of self control (men or culturally)

Question 26

Client’s ability to tolerate pain influences

Answer 26

the nurse’s perception of the degree of discomfort. Clients with low tolerance may be perceived as “whiners”.

Question 27

Recognizable behavioral signs that reflect pain (for both verbal and non-verbal clients):

Answer 27

body movements, facial expressions, crying, restlessness, holding certain body part, clenching the jaw

Question 28

acute pain -

Answer 28

identifiable cause; short duration; autonomic activity (tachycardia, diaphoresis)

Question 29

chronic pain -

Answer 29

no identifiable cause; greater than 3 months; may not respond to treatment or will respond best to round-the-clock treatment; fatigue, insomnia, depression

Question 30

cancer pain -

Answer 30

acute or chronic; nociceptive or neuropathic; may be “referred” to another site

Question 31

pain by inferred pathology -

Answer 31

somatic or visceral, central or peripheral

Question 32

Normal pain is subdivided:

Answer 32

somatic pain and visceral pain

Question 33

somatic pain -

Answer 33

(musculoskeletal); localized aching or throbbing

Question 34

visceral pain -

Answer 34

(internal organs); poorly localized aching, cramping

Question 35

Neuropathic pain -

Answer 35

from abnormal or damaged pain nerve; abnormal processing of sensory input.

Question 36

Centrally generated pain –

Answer 36

injury to the peripheral nervous system (phantom pain); injury to central nervous system (burning pain below level of SCI)

Question 37

Peripherally generated pain –

Answer 37

polyneuropathy (diabetic neuropathy); mononeuropathy (nerve root compression or trigeminal neuralgia)

Question 38

idopathic pain -

Answer 38

of unknown cause or excessive for pathological condition

Question 39

Knowledge, Attitudes & Beliefs:

Answer 39

Subjective nature of pain; Nurse’s response to client’s report of pain ; Prejudices and misconceptions -