Pain Assessment Flashcards
Define acute pain
follows normal nociceptor activation pathway to the brain, cause is known and treatable, origin is tissue trauma, temporary (rapid onset, short duration), pain is specific and localized, serves as a warning of tissue damage and subsides with healing, behavioral and physiologic signs: rubbing, guarding, grimacing, brow wrinkling, lip biting, change in HR, RR, BP.
Define chronic pain
neuropathic; it follows an abnormal pathway for pain that results from nerve damage from anatomic and physiologic conditions and underlying diseases, cause may be unknown, treatment may not be helpful,develops slowly; discomfort has lasted longer than 6 months, pain is nonspecific and generalized, behavioral and physiologic signs include unusual sensations such as: burning, shooting pain, abnormal sensations that occur when there is no painful stimulus present.
Discuss the three components of the pain experience.
location, onset, duration, frequency, quality, intensity, precipitating and alleviating factors, associated symptoms.
Identify the major components the nurse will address when assessing pain.
P- provoked: what caused the pain? what makes it better or worse?
Q- quality: what does it feel like? dull, sharp, stabbing, burning, crushing?
R- region/radiation: where is the pain? is it always in one spot or does it spread?
S- severity: what is the intensity of pain on pain scale.
T- timing: when did it start? how often does it last? does it come and go or is it continuous?
What are appropriate nursing diagnoses for clients in pain?
activity intolerance, anxiety, ineffective coping, fatigue, fear, hopelessness, impaired physical mobility, imbalanced nutrition: less than body requirements, insomnia, powerlessness, chronic low self-esteem, impaired social interaction, spiritual distress.
A nurse is caring for a patient who is experiencing pain. For which most common psychological patient response to pain should the nurse assess?
- Experiencing fear related to loss of independence
- Developing an increased tolerance to the drug
- Asking for pain medication to relieve the pain
- Verbalizing the presence of nausea
- Psychological or affective responses to pain relate to feelings and emotional distress. Fear of being dependent on others or loss of self-control are psychological responses to pain.
A patient has a total abdominal hysterectomy for fourth-stage ovarian cancer. What should the nurse do first when on the second postoperative day this patient reports abdominal pain at level 5 on a 1-10 pain scale?
- Reposition the patient
- Offer a relaxing back rub
- Use distraction techniques
- Administer the prescribed analgesic
- Major abdominal surgery involves extensive manipulation of internal organs and a large abdominal incision that require adequate pharmacological intervention to provide relief from pain.
What is the most important for a nurse to consider when a patient reports the presence of pain?
- The extent of pain is directly related to the amount of tissue damage
- Behavioral adaptations are congruent with statements about pain
- Administering opioids for pain will eventually lead to addiction
- The person experiencing the pain is the authority about the pain
- Pain is a personal experience. Pain is whatever the person in pain says it is and exists whenever the person in pain says it exists.
A patient requests pain medication. What should the nurse do first when responding to this patient’s request?
- Use distraction to minimize the patient’s perception of pain
- Place the patient in the most comfortable position possible
- Administer pain medication to the patient quickly
- Assess the various aspects of the patient’s pain
- All the factors that affect the pain experience should be assessed, including location, intensity, quality, duration, pattern, aggravating and alleviating factors, and physical, behavioral, and attitudinal responses. Assessment must precede intervention.
Which statement by the patient to a nurse indicates a precipitating factor associated with pain?
- “I usually feel a little dizzy and think I’m going to vomit when I have pain.”
- “My pain usually comes and goes throughout the night.”
- “I usually have pain after I get dressed in the morning.”
- “My pain feels like a knife cutting right through me.”
- Anything that induces or aggravates pain is considered a precipitating factor of pain.
A patient has a history of severe chronic pain. Which is one of the most important guidelines associated with providing nursing care to this patient?
- Asking what is an acceptable level of pain
- Providing interventions that do not precipitate pain
- Determining the level of function that can be performed without pain
- Focusing on pain management intervention before pain becomes excessive.
- Administration of analgesics around the clock at regularly scheduled intervals or by long-acting controlled-release transdermal patches maintains therapeutic blood levels of analgesics, which limit pain at levels of comfort acceptable to patients.
What concept should the nurse consider when assessing a patient’s pain?
- The expression of pain is not always congruent with the pain experienced
- Pain medication can significantly increase a patient’s pain tolerance
- The majority of cultures value the concept of suffering in silence
- Most people experience approximately the same pain tolerance
- An obvious response to pain is not always apparent because psychosociocultural factors may indicate behavior. Fear of the treatment for pain, lack of validation, acceptance of pain as punishment for previous behavior, and the need to be strong, courageous, or uncomplaining are factors that influence behavioral responses to pain.
The nurse is performing an admitting interview. Which patient statement about pain causes the most concern?
- “I try to pretend that it is not part of me, but it takes a lot of effort.”
- “My pain medication works, but I’m afraid of becoming addicted.”
- “At home I take something for the pain before it gets too bad.”
- “They say my pain may get worse, and I can’t stand it now.”
- The level of pain tolerance is exceeded. The present pain must be relieved and the patient assured that future pain also will be controlled.
A nurse is assessing a patient in pain. What word might the nurse use when documenting the pattern of a patient’s pain?
- Tenderness
- Moderate
- Phantom
- Episode
- The word episode refers to an incident, occurrence, or time period; therefore, the word episode refers to patterns of pain and is concerned with time of onset, duration, recurrence, and remissions.
A nurse is assessing a patient experiencing acute pain. Which characteristic is more common with acute pain than with chronic pain?
- Self-focusing
- Sleep disturbances
- Guarding behaviors
- Variations in vital signs
- Acute pain stimulates the sympathetic nervous system, which responds by increasing pulse, respiration, and blood pressure. Chronic pain stimulates the parasympathetic nervous system, which results in lowered pulse and blood pressure.
