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NURS 2910 > Pain Assessment > Flashcards

Pain Assessment Flashcards

1
Q

Pain is the most common reason to seek medical care in the U.S. T or F

A

TRUE

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2
Q

What is pain?

A
  • unpleasant sensory/ emotional experience
  • can have destructive effects
    -can warn of potential injury
  • multidimensional experience
  • pain can effect life/ job/ intimacy
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3
Q

Pain is NOT unique to each person T or F

A

FALSE

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4
Q

Origins of pain

A
  • cutaneous/ superficial
  • deep somatic
  • viseral
  • radiating/ referred
  • phantom
  • Psychogenic
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5
Q

Cutaneous/ superficial pain

A
  • short term pain
  • papercut, touch hot item
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6
Q

Deep Somatic pain

A
  • pain originating in ligaments, tendons, nerves, bones(fracture/ sprain)
  • more localized and achy feeling
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7
Q

Visceral pain

A
  • Deep internal pain receptors
  • tight/ pressure/ crampy
  • menstrual cramps
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8
Q

Radiating Pain

A
  • pain starts at origin and extends to other locations
  • sore throat> pain in ear, GERD
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9
Q

Phantom pain

A
  • Pain in the area that has been removed
  • amputations
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10
Q

Psychogenic pain

A
  • pain arise from mind
  • no physical cause
  • mental pain
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11
Q

Referred pain

A
  • Pain is distent from origin
  • heart attack> arm pain
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12
Q

Classifications of pain

A
  • By cause
  • By duration/ onset
  • Description
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13
Q

BY CAUSE: classification

A
  • Nociceptive
  • Neuropathic
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14
Q

BY DURATION/ONSET: classification

A
  • Acute> short term, less than 6mo
  • Chronic> long term, more than 6mo
  • Intractable> intense pain won’t go away
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15
Q

BY DESCRIPTION: classification

A
  • Quality> dull/stabbing
  • Periodically> episode come and go?
  • Intensity> mild/ moderate/ long lasting
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16
Q

Nociceptive Cause

A
  • Respond to stimuli that is potentially damaging
  • trauma, surgery, aching
  • Somatic> sin, muscles, bone, connective tissue pain
  • Viserable> organ pain
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17
Q

Neuropathic Cause

A
  • complex pain, often chronic
  • nerve injury> stroke/ tumor, diabetes
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18
Q

Physiology of pain terms

A
  • Transduction
  • Transmission
  • Pain perception
  • Pain modulation
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19
Q

Transduction

A
  • Activation of nociceptors by stimuli
  • Mechanical stimuli> external forces, friction on body
  • Thermal stimuli> heat/ cold
  • Chemical stimuli> external reason, lemon juice
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20
Q

Transmission

A
  • Conduction og pain message to spinal cord
  • A-delta fibers(fast)> sharp pain, last short time
  • C fibers(slow)> dull pain, last long time
  • connected to the spinal cord
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21
Q

Pain Perception

A
  • Recognizing and defining pain in cortex
  • perception of pain
  • different for everyone
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22
Q

Pain Modulation

A
  • Changing pain perception
  • facilitate or inhibit pain
  • endogenous analgesia or gate control theory
23
Q

Factors that influence pain

A
  • emotions
  • past experiences with pain
  • developmental stage
  • sociocultural status
  • communication skills
  • cognitive impairments
24
Q

Pediatric considerations with pain

A
  • Newborns have same sensitivity to pain as older infants
  • infants and small children respond to pain by crying
  • neonates> pain response may be subtle
  • chronic pain affect 15-20%
  • fetuses may feel pain as early as 20 weeks
  • children and infants> pain is assessed thru self- report, behavioral observations, or physiological measures
  • Wong-Baker FACES pain scale
  • Oral Sucrose
25
Q

Older Adult considerations with pain

A
  • 1 in 3 adults report having pain that interferes with normal functioning
  • cognitive impairment can prevent some older adults from reporting pain
  • importance of nonverbal cues
  • persistent pain is common
  • greater risk for undertreatment
  • risk of overtreament
  • poor pain management risk
26
Q

Collecting objective data: DURING EXAM

A
  • make sure you are using correct assessment tool
  • explain to client why we are rating their pain
  • ensure privacy
  • report clients behavior
  • understand different cultures response to pain
27
Q

Collecting objective data: PHYSICAL EXAM

A
  • General impressions> any sign of pain?
  • Vital signs
28
Q

Collecting objective data: GENERAL IMPRESSION

A
  • observe posture
  • facial expressions
  • face, legs, activity, cry, concolability
  • inspect joints and muscles
  • observe skin for scars, lesions, rashes, changes and discoloration
29
Q

Collecting objective data: VITAL SIGNS

A
  • Measure HR, RR, BP
  • Vital usually go up when in pain
30
Q

Bodies reaction to pain

A
  • Sympathetic> fight or flight(1st)
  • Parasympathetic> rest and digest(2nd)
31
Q

Impact of unrelieved pain on body systems

A
  • Cardiovascular> clotting, increase vitals
  • Musculoskeletal> impared muscle function
  • Respiratory> shallow breathing/ splinting, reduced air flow
  • Genitourinary
  • Endocrine
  • Gastrointestinal> Intestinal secretions
  • impacts the whole body, not just a focused system
32
Q

COLDSPAA

A
  • Character
  • Onset
  • Location
  • Duration
  • Severity
  • Pattern
  • Associated factors/ how it affects the patient
33
Q

Symptom analysis Mnemonic

A

COLDSPAA

34
Q

Assessing pain

A
  • obtain a complete pain history
  • location/ quality
  • intensity
  • aggravation/ alleviating factors
  • timing and duration
  • impact on ADLs and mobility
  • psychological and social factors
  • Pain> 5th vital sign
35
Q

Joint Commission Standards for pain management

A
  • Actively engage medical staff and hospital leadership in improving pain assessment and management, including strategies to decrease opioid use and minimize risk associated with opioid use
  • Provide at least one non-pharmacological pain modality when clincans determine need for pain treatment
  • include patients in plan and teach
  • assessing pain becomes second nature
36
Q

Pain Scales

A
  • Visual analogue scale(VAS)
  • Numeric rating scale(NRS)
  • Simple descriptor scale
  • Wong-Baker faces pain rating scale
  • FLACC pain scale
37
Q

Visual analogue scale(VAS)

A
  • patient point to level of pain on the scale
  • simple/ quick
  • best for adults with no cognitive imparements
38
Q

Numeric Rating Scale(NRS)

A
  • Most common to see
  • patient rate pain on scale 1 to 10
  • make sure patient can read/ count
39
Q

Simple descriptor scale

A
  • List of adjectives that describe pain/ intensity
  • Dementia patients/ cognitively impaired patients
  • Can modify to make simpler
40
Q

Wong-Baker faces pain rating scale

A
  • Best for cognitively impared adults and children
  • choose face that best describes feeling
  • explain each face/ emotion
  • for children 3+
41
Q

FLACC pain scale

A
  • Behavioral pain assessment scale
  • observe nonverbals in patients
  • pain observed by 5 categories
  • Face, Legs, Activity, Cry, Consolability
42
Q

Which pain assessment scale is most appropriate for a verbal, alert adult with no cognitive impairments

A

0-10 Numeric Pain Intensity Scale

43
Q

Which pain assessment scale is most appropriate for a 13-month-old patient

A

FLACC

44
Q

Nonverbal signs of pain

A
  • Facial expression, posture, body position
  • vital signs change
  • behavioral manifestations
  • pain as an expression of weakness
  • Assess for depression
45
Q

Nonpharmacological Measures: CUTANEOUS STIMULATION

A
  • Massage
  • Acupuncture
  • Acupressure
  • use of heat or cold
  • Spinal Cord Stimulator> chronic nuero pain
  • TENS/ PENS> short- term acute or chronic
46
Q

Nonpharmacological Measures: COGNITIVE-BEHAVIORAL INTERVENTION

A
  • Distractions
  • Guided imagery
  • Hypnosis
  • Therapeutic touch
  • Humor
    -Expressive writing
  • Animal Therapy
  • Diaphragmatic breathing
47
Q

Nonpharmacological Measures: IMMOBILIZATION

A
  • Splint
  • Cast
48
Q

Pharmacological Measures

A
  • Nonopioid> NSAIDS/ Acetaminophen
  • opioid analgesics> IV, transdermal, and epidural form
49
Q

Affinity Bias

A

Warm up to people to be perceived to be liked

50
Q

Halo Effect

A

Think everyone is a good person just because you like those people

51
Q

Perception Bias

A

Tendency to form stereotypes and assumptions

52
Q

Confirmation Bias

A

tendency to seek info that confirms existing beliefs

53
Q

Group thinking

A

bias occurs when someone tries to hard to fit in, bias occurs

NURS 2910 (16 decks)

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