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Health Assessment > Pain > Flashcards

Pain Flashcards

1
Q

Define Pain

A

An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage

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2
Q

What is a complication if pain is not addressed?

A

Undertreatment of pain can be detrimental to physical, mental, and physiological health
Acute pain may lead to chronic pain

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3
Q

What is acute pain?

A

Pain that lasts only through the expected recovery period from illness, injury, or surgery, whether it has a sudden or slow onset and regardless o the intensity

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4
Q

What is chronic pain?

A

Pain that is prolonged, usually recurring or persisting over 6 months or longer, and interferes wit functioning.

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5
Q

What are signs of physiologic pain?

A
  1. increased HR and BP
  2. sweating
  3. Pallor
  4. Anxiety
  5. Dilated pupils
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6
Q

What is phantom pain?

A

Pain that you feel in the spot where your limb was amputated.

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7
Q

Who are at risk for pain?

A 
All individuals.
However, specifically:
1. Neonates
2. Critically ill
3. Children
4. Elderly
5. PREGNANCY
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8
Q

What is done for pain control in labor?

A
  1. assessment of pain
  2. keeping safety as a priority
  3. Reassessment and evaluation
  4. Look or post med administration side effects
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9
Q

How would a nurse assess for pain?

A

Know the:

  1. location, onset, intensity, quality, and duration
  2. Alleviating and relieving factors
  3. Effect of pain on function and quality of life
  4. Comfort-function goal
  5. Associated manifestations
  6. Culture
  7. Past pain experience
  8. Past medical history
  9. Pain scales
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10
Q

What are some consequences of pain?

A
  1. pain triggers a stress response
  2. Increased endocrine activity
  3. The immune system is altered
  4. Cardiovascular system affected
  5. Changes in the respiratory system occur
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11
Q

What should the nurse do if there are physiological responses associated with pain?

A
  1. intervene and reduce the responses

2. plan comfort interventions for initial pain and changes in pain

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12
Q

What are some barriers to pain control?

A
  1. failure of patient to report pain, patient not discussing pain to worry about the progression of the disease, bearing pain is “tough”
  2. Belief that pain is inevitable, wanting to be good, cultural expectations not to report pain
  3. Fear of becoming an addict, regulations by the government on medications, prescribing minimal amounts of medication to prevent misuse
  4. side effects, financial barriers, delay in pain medication, POOR pain assessment, and lack of availability of controlled substances
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13
Q

What is deep somatic pain?

A

It occurs form ligaments, tendons, bones, blood vessels and nerves.
Ex: An ankle sprain

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14
Q

What is Visceral Pain?

A

Occurs when pain receptors in the abdominal cavity, cranium, and thorax are activated

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15
Q

What is referred pain?

A

Pain felt in a part of the body that is considerable removed or distant from the area actually causing the pain

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16
Q

What is intractable pain?

A

Pain that is highly resistant to relief.

Ex: Pain from an advanced malignancy

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17
Q

What is neuropathic pain?

A

Pain that is the result of current or past damage to the peripheral or central nervous system and may not have a stimulus, such as tissue or nerve damage, for the pain.

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18
Q

What does neuropathic pain feel like?

A

long lasting, unpleasant, burning, dull aching, with episodes of sharp shooting pain.

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19
Q

What are some symptoms of acute pain?

A

sympathetic nervous system responses:

  1. Increased Pulse
  2. Increased RR
  3. Elevated BP
  4. Diaphoresis (sweating)
  5. dilated pupils
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20
Q

What resolves acute pain?

A

healing

21
Q

How is the patient’s mood of they have acute pain?

A

they appear restless and anxious

Patient may exhibit behavior like crying, rubbing the area, and holding the area

22
Q

Does the sympathetic or parasympathetic nervous system respond to chronic pain?

A

parasympathetic

23
Q

What are the parasympathetic responses to chronic pain?

A
  1. Normal VS
  2. Dry, warm skin
  3. Pupils normal or dilated
24
Q

What is patient’s mood like when they have chronic pain?

A
  1. patient appears depressed and withdrawn
  2. patient often does not mention pain unless asked
  3. Pain behavior often absent
25
Q

Why are children a lifespan consideration for pain?

A

They may be less able than an adult to articulate their experience or needs related to their pain.

26
Q

What are some considerations of pain in children?

A
  1. Small children commonly will complain of a “tummy ache” or “my throat hurts”
  2. Preadolescent children will complain of stomach pain when they are gassy, if they are nauseated, or if they actually feel abdominal pain
  3. Children with sore throats often present a history of normal fluid intake but decreased solid food intake
  4. Anxious or frightened preschool and school-age children many complain of headache are stomachache
27
Q

What is the acronym for assessing pain?

A 
OLDCART and ICE
o= onsett
l= location
d= duration
c= characteristics
a= aggravating factors
r= relieving factors
t= treatment
 &
I= impact on ADLs
C= Coping strategies
E= Emotional response
28
Q

What are the types of pain scales mentioned in Jackie’s pain lecture?

A
  1. Wong-baker FACES pain rating scale
  2. The FLACC scale
  3. Comparative Pain scale
  4. Pain Assessment in Advanced Dementia (PAINAD)
29
Q

What is the FLACC scale?

A

A scale used for nonverbal patient. It includes 5 categories (Face, Legs, Activity, Cry, and Consolability). In each of these categories they are ranked 0-2. (0 being no signs of visible pain, and 2 being visible signs of pain)

30
Q

What medications are appropriate for pain relief during the first stage of labor?

A

First stage:

  1. opioid agonist analgesics,
  2. opioid agonist-antagonist analgesics
  3. epidural analgesia
  4. epidural anesthesia
  5. combined spinal-epidural (CSE analgesia)
  6. Nitrous oxide
31
Q

What medications are appropriate for pain relief during the second stage of labor?

A
  1. epidural analgesia
  2. Combined spinal-epidural (CSE) analgesia
  3. Nitrous oxide
  4. Local infiltration anesthesia
  5. pudendal block
  6. Spinal anesthesia
32
Q

what medications are appropriate for pain relief during vaginal birth?

A
  1. epidural analgesia
  2. Epidural anethesia
  3. Combined spinal-epidural (CSE) analgesia
  4. nitrous oxide
  5. local infiltration anesthesia
  6. Pudendal block
  7. Spinal anesthesia
33
Q

What medications are appropriate for pain relief during Cesarean Birth?

A
  1. Epidural anesthesia
  2. Spinal block anesthesia
  3. General anesthesia
34
Q

What pain occurs during the first stage of labor and what are the causes?

A

internal visceral pain that can be felt as back and leg pain
Causes:
1. dilation, effacement, and stretching of the cervix
2. Distention of the lower segment of the uterus
3. Contractions of the uterus with resultant uterine ischemia

35
Q

What pain occurs during the second stage of labor?

A

Pain that is somatic and occurs with fetal descent and expulsion

36
Q

What pain occurs during the third stage of labor?

A

Pain with the expulsion of the placenta is similar to pain experienced during the first stage

37
Q

What pain occurs during the fourth stage of labor?

A

Pain is caused by distention and stretching of the vagina and perineum incurred during the second stage with a splitting, burning, and tearing sensation.

38
Q

What is the pain perception and behavior of an infant?

A
  1. Perceives pain
  2. Responds to pain with increased sensitivity
  3. Older infant tries to avoid pain; for example, turns away and physically resists
39
Q

What are the selected nursing interventions for an infant in pain?

A
  1. give a glucose pacifer

2. Use tactile stimulation. Play music or tapes of a heartbeat

40
Q

What are the pain perceptions and behaviors of a toddler and preschooler?

A
  1. Develops the ability to describe pain and its intensity and location
  2. Often responds with crying and anger because child perceives pain as a threat to security
  3. Reasoning with child at this stage is not always successful
  4. May consider pain a punishment
  5. Feels sad
  6. May learn there are gender differences in pain expression
  7. Tends to hold someone accountable for the pain
41
Q

What are the selected nursing interventions for a toddler/preschooler in pain?

A
  1. Distract the child with toys, books, pictures. Involve the child in blowing bubbles as a way of “blowing away the pain”
  2. Appeal to the child’s belief in magic by using a “magic” blanket or glove to take away pain
  3. Hold the child to provide comfort
  4. Explore misconceptions about pain
42
Q

What are the pain perceptions and behaviors for a school-aged child?

A
  1. Tries to be brave when facing pain
  2. Rationalizes in an attempt to explain the pain
  3. Responsive to explanations
  4. Can usually identify the location and describe the pain
  5. With persistent pain, may regress to an earlier stage of development
43
Q

What are the selected Nursing Interventions for a school-aged child in pain?

A
  1. Use imagery to turn off “pain switches”
  2. Provide a behavioral rehearsal of what to expect and how it will look and feel
  3. Provide support and nurturing
44
Q

What are the pain perceptions and behaviors of an adolescent?

A
  1. May be slow to acknowledge pain
  2. Recognizing pain or “giving in” may be considered a weakness
  3. Wants to appear brave in front of peers and not report pain
45
Q

What are the selected nursing interventions for an adolescent in pain?

A
  1. Provide opportunities to discuss pain
  2. Provide privacy
  3. Present choices for dealing with pain. Encourage music or TV for distraction
46
Q

What are the pain perceptions and behaviors for an adult?

A
  1. Behaviors exhibited when experiencing pain may be gender-based behaviors learned as a child
  2. May ignore pain because to admit it is perceived as a sign of weakness or failure
  3. Fear of what pain means may prevent some adults from taking action
47
Q

What are the selected nursing interventions for an adult in pain?

A
  1. Deal with any misconceptions about pain
  2. Focus on the patient’s control in dealing with the pain
  3. Allay fears and anxiety when possible
48
Q

What are the pain perceptions and behaviors of an older adult?

A
  1. Many have multiple conditions presenting with vague symptoms
  2. May perceive pain as part of the aging process
  3. May have decreased sensations or perceptions of the pain
  4. Lethargy, anorexia, and fatigue may be indicators of pain
  5. May withhold complaints of pain because of fear of the treatment, fear of any lifestyle changes that may be involved, or fear of becoming dependent
  6. May describe pain differently, that is, as “ache”, “hurt”, or “discomfort”
  7. May consider it unacceptable to admit or show pain
49
Q

What are the selective nursing inventions for an older adult in pain?

A
  1. Thorough history and assessment is essential
  2. Spend time with the patient and listen carefully
  3. Clarify misconceptions
  4. Encourage independence whenever possible

Health Assessment (14 decks)

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