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Nurse Assessment > Pain Assessment > Flashcards

Pain Assessment Flashcards

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1
Q

What is the fifth vital sign?

A

Pain

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2
Q

What is pain defined as?

A

An unpleasant sensory and emotional experience associated with, or resembling with, actual or potential tissue damage.

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3
Q

Pain is subjective. What does this mean?

A

It is whatever the person says it is, existing wherever the person says it does.

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4
Q

What are nociceptors?

A

Designed to detect painful sensations from the periphery and transmit them to the CNS.

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5
Q

Where are nociceptors located?

A

Within the skin, joints, connective tissue, muscle, and in the thoracic, abdominal and pelvic viscera.

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6
Q

When does nociceptive pain develop?

A

When functioning and intact nerve fibers in the CNS and periphery are stimulated.

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7
Q

Is nociceptive pain triggered by inside or outside events of the nervous system?

A

outside of the nervous system. The actual nervous system is intact when nociceptive pain is triggered.

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8
Q

What are the four stages of nociception in order?

A

Transduction
Transmission
Perception
Modulation

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9
Q

What happens in the transduction phase?

A

Noxious stimulus takes place in the periphery and then moves to the spinal cord.

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10
Q

What happens in the transmission phase?

A

Pain moves from the spinal cord to the brain.

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11
Q

What happens in the perception phase?

A

Conscious awareness of pain sensations

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12
Q

What happens in the modulation phase?

A

Inhibition of pain sensation; built-in mechanism to control intensity of pain.

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13
Q

What are the four basic approaches to treating pain?

A
  1. We can modify the source of pain (transduction)
  2. We can attempt to modify the movement of the painful stimuli (transmission)
  3. We can modify the awareness of pain in the CNS (perception)
  4. We can block the transmission of pain to the CNS (modulation)

We use pharmaceuticals for all other approaches except for perception.

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14
Q

What is neuropathic pain?

A

Abnormal processing of pain messages. Does not follow the predictable phases of nociceptive pain.

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15
Q

What level is neuropathic pain at?

A

It is at the neurochemical level.

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16
Q

What are characteristics of neuropathic pain?

A

Minor stimuli can cause significant pain

The most difficult type of pain to assess and treat

Pain is perceived long after injury (chronic)

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17
Q

Can nociceptive pain change into neuropathic pain?

A

Yes, when the nociceptive pain is poorly controlled.

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18
Q

What are sources of pain?

A

Visceral pain
Deep somatic pain
Cutaneous pain
Referred pain

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19
Q

What is referred pain?

A

Pain that is felt at a particular site, but originates in another location.

Ex. UTI patients have pain in their lower back not pelvic area.

20
Q

Is acute pain short-term or long-term?

A

short term

21
Q

T/F acute pain is self-limiting and dissipates after injury heals.

A

TRUE

22
Q

T/F acute pain follows an unpredictable trajectory but has a self-protective role.

A

FALSE
Acute pain follows a predictable trajectory and has a self-protective role.

23
Q

What does acute pain activate?

A

The autonomic nervous system (ANS), and this type of pain is involuntary.

24
Q

Will vital signs show indication of acute and chronic pain?

A

Will show an indication of acute pain, but not with chronic pain. Physical findings will not correspond with the level of pain that chronic pain patients have.

25
Q

How long does pain have to continue to be considered chronic?

A

6 months or greater. It continues beyond the expected time of dissipation.

26
Q

T/F Chronic pain does not stop when the injury heals.

A

True. It will continue on greater than the expected dissipation time.

27
Q

Why may your physical findings not correspond with the level of chronic pain?

A

Usually, chronic pain patients have lived with the pain so long that it no longer feels as painful as it looks.

28
Q

T/F in cancer pain, an increase in pain is often a sign of increasing disease.

A

TRUE. The more the cancer grows, the more overwhelmed the body is, and increased pain develops.

29
Q

Does malignant pain (cancer related) have an acute or chronic pain component?

A

Both. It has a component of acute pain as it is trying to serve as a protective purpose, but this pain usually lasts longer than 6 months so it is still chronic.

30
Q

What kind of symptoms are experienced with acute pain?

A

Diaphoresis
Anxiety
Restlessness or stillness
Moaning

31
Q

What are the symptoms of chronic pain?

A

Normal vital signs (IMPORTANT TO KNOW)
Skin warm and dry
Depressed, withdrawn
Anxiety
Anger, irritability
Substance abuse (opioids)
no protective behaviors
bracing, rubbing
sighing
appetite change
reduced activity

32
Q

Is pain common in people greater than 65 years old?

A

Yes, but it is not a normal part of aging. It should not be considered something that must be tolerated.

33
Q

T/F Dementia affects the ability to feel pain.

A

FALSE.

Dementia does NOT affect a person’s ability to feel pain, but it does affect the person’s ability to report it.

34
Q

What kind of data do we use primarily to assess pain?

A

Subjective data

35
Q

What type of pain assessment tool do we use?

A

Initial pain assessment (McCaffery)

36
Q

What type of objective data can we use as a part of the pain assessment?

A

vital signs
the appearance of anxiety level
are they clutching a specific area?
facial expressions
physical examination
percussion
palpating to induce a pain response

37
Q

What type of pain would cholecystitis (gallbladder disease) cause?
A somatic
B visceral
C cutaneous
D chronic

A

B visceral

38
Q

What anticipated finding regarding patients with chronic pain should guide a nurse’s care planning?
A Patients with chronic pain have trouble sleeping
B Patients with chronic pain show elevated blood pressures
C Patients with chronic pain need less medication
D Patients with chronic pain show few or no outward signs of pain.

A

D Patients with chronic pain show few or no outward signs of pain.

39
Q

Truth or Myth: You have to have physical signs for pain to exist

A

Myth

40
Q

Truth or Myth: Self-reporting is the most accurate indicator of pain

A

Truth

41
Q

Truth or Myth:Prolonged use of narcotics pain medication leads to addiction

A

Myth.

Not all patients will become addicted from prolonged use but will have a physical dependency.

42
Q

Truth or Myth: Older adults have a decreased pain sensation

A

Myth

43
Q

Select the appropriate pain scale: A confused elderly patient with dementia with a broken hip

A

Not numerical pain scale

44
Q

Select the appropriate pain scale: A 20 year-old who had four wisdom teeth extracted

A

Use numeric scale

45
Q

Select the appropriate pain scale: A 50 year-old person with chronic rheumatoid arthritis

A

Not numeric but a scale that assesses how it affects their function like the brief pain inventory

Nurse Assessment (6 decks)

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