Pain and Comfort (Final)

Question 1

Pain

Answer 1

Universal but very individual experience

Under-recognized, misunderstood, and inadequately treated

Question 2

Pain Defention

Answer 2

-An unpleasant, subjective, sensory, and emotional experience often associated with actual or potentail tissue damage

Question 3

Nursing and Pain

Answer 3

-Nurses are responsible legally and ethically to assess and manage pain

Question 4

Nociception

Answer 4

Observable activity in the nervous system in response to an adequate stimulus

Question 5

4 stages of pain

Answer 5

1. Transduction
2. Transmission
3. Perception
4. Modulation

Question 6

Acute Pain

Answer 6

-Usually a protective mechanism

-Short duration and limited tissue damage

-If not treated can threaten recovery

-May progress to chronic pain

Question 7

Chronic pain

Answer 7

-Not protective

-Not same symptoms

-More than 3-6 months

-Highly correlated with suicede

Question 8

Goal of treating chronic pain

Answer 8

Treat to improve functional status

Question 9

Hard to see physiological symptoms to what kind of pain?

Answer 9

Chronic pain

Question 10

Nociceptive Pain

Answer 10

-Arises from pain receptors

-Usually responsive to opioids/analgesia

Question 11

Description of nociceptive pain

Answer 11

Aching, gnawing, pounding

Question 12

Neuropathic Pain

Answer 12

Injury to nerves or abnormal processes of sensory input

Treat with adjuvant analgesics

Question 13

Description of Neuropathic Pain

Answer 13

Burning, shooting, electrical, abnormal sensation

Question 14

Nociceptive Pain types

Answer 14

Somatic: In bones, joints, muscles, skin or connective tissue

Visceral: Internal organs, often associated with referred pain

Cutaneous: In skin or subcutaneous tissue

Question 15

Idiopathic pain

Answer 15

Form of chronic pain without know cause

Pain that exceeds typical pain levels associated with clients condition

Question 16

Acute pain often activates with NS

Answer 16

Sympathetic nerovous system

Flight or fight

Tachy-hypertension-anixety-diaphoresis-muscle tension

Question 17

Behavioral response to pain

Answer 17

Grimacing, moaning, flinching, guarding

Question 18

Chronic pain response

Answer 18

Physiological not common

Fatigue, depression, decreased level of functioning

Question 19

Research has shown what about nurses and pain

Answer 19

That nurses subjective opinions about what a patient says about their pain impacts how they decide to treat it

Nursing assumptions limit their ability to offer pain relief

Acknowledging personal prejudices or misconceptions helps address patient problems more professionally

Question 20

Bottom line

Answer 20

Pain is what the patient says it is and we must assess it and treat it as such

Question 21

Factors that influence the pain experience

Answer 21

-Age

-Fatigue

-Genes

-Cognitive/Neurologic Function

-Previous pain experinces

-Support systems

-Spirituality

-Anxiety/Fear

Question 22

Cultural Aspects of Pain

Answer 22

-Cultural Beliefs and vaules affect how individuals cope with pain

-When pain threatens a persons role, they may not acknowledge the pain

-Some cultures find it normal to be very demonstrative about pain

-Make sure that we are assessing pain in a persons native language

Question 23

Basic Pain Assessment

Answer 23

-Subjective and objective data

-Assess, reassess, then assess again

-Patient is the ONLY authority

-Can assess behavioral responses and physiological indicators

Question 24

Vertical and Horizontal Pain Scale

Question 25

Know the pain assessment in the second pain VO’s

Question 26

PQRSTU

Question 27

Goals of Pain Management

Answer 27

-Patient and care team decide on an acceptable level of pain

Lots of education go into this

Sometimes 0 is achievable, sometimes it is not. Consider baseline

Question 28

Pain Treatment Interventions

Answer 28

-Multi dimensional

-Individualized

-Incorporates all aspects of patient concerns

-Use what patient believes in

-Keep open mind and keep trying

Question 29

Non-Pharmacological Measures

Answer 29

-Relaxation and Guided Imagery

-Distraction

-Music

-Cutaneous Stimulation

If moderate or serve pain then use pain medications first