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Health Assessment > Pain Assessment > Flashcards

Pain Assessment Flashcards

1
Q

With the recent opioid epidemic and advances in pain research, there is a renewed emphasis.

A

on early multimodal pain management, nonpharmacologic options and nonopioid alternatives

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2
Q

What 3 factors can influence the patients response to prescribed pain treatment unrelated to actual pharmacological treatments

A

Perceived effective communication with physicians and nurses by the patient

Perceived responsiveness by the treating team

Perceived empathy by the treating team

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3
Q

what can. affect patietns response to painful stimuli

A

age, gender, ethnicity, socioeconomic and psychological factors, catastrophizing, culture/religion, genetics, previous experiences, patient perceptions and expectations

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4
Q

how often is depression and pain co-existing

A

30-60% of pain patients report depression

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5
Q

what disorders have been linked to the development of chronic pain`

A

mood disorders and psychiatric disorders

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6
Q

what is pain catastrophizing

A

an exaggerated cognitive response to anticipated or actual painful stimulus

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7
Q

what are tendencies of people who catastrophize in relation to pain

A

magnification of pain
rumination about their pain
feeling helpless in managing their pain

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8
Q

examples of catastrophizing: magnification

A

“I’m afraid the pain will get worse”

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9
Q

examples of catastrophizing: rumination

A

“i cant stop thinking about how much this hurts”

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10
Q

examples of catastrophizing: helplessness

A

“there is nothing I can do to reduce the intensity of my pain”

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11
Q

underlying etiology refers to the

A

source of the experienced pain
nociecpetive
inflammatory
neuropathic

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12
Q

antatomic locatoin

A

somatic
visceral

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13
Q

temporal nature refers to

A

the duration of pain
acute <3 months
chronic > 3 months
acute on chronic

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14
Q

intensitiy refers to the

A

degree of level of pain
(mild, moderate, severe)

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15
Q

example of nociceptive pain

A

bone fractures, surgical incision, acute burn

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16
Q

examples of inflammatory pain

A

appendicitis, RA, inflammatory bowel disease, late stage burn

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17
Q

examples of neuropathic pain

A

diabetic peripheral neuropathy, postherpetic neuralgia, chemotherapy-induced pain and radiculopathy

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18
Q

difference between somatic and visceral pain

A

somatic - musculoskeletal pain (bone, joint, connective tissues and deep tissues)
visceral - internal pain frominternal organs and tissues

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19
Q

which pain is well localized, sharp and worse with movement

A

somatic pain

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20
Q

which pain is described as poorly localized and vague deep aches, colicky, and/or cramping

A

visceral pain

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21
Q

what is the mechanism of somatic pain

A

a-delta fiber activity located in peripheral tissues

22
Q

what is the mechanism of visceral pain

A

c fiber activity located in deeper tissues

23
Q

name the type of pain and treatment: femur fracture

A

nociceptive pain
opioids and nonopioids

24
Q

name the type of pain and treatment: late stage burn healing

A

inflammatory pain
anti-inflammatory agents

25
Q

name the type of pain and treatment: post-herpetic neuralgia

A

neuropathic pain
tricyclics, SNRTs, GABA analogs or antidepressants

26
Q

name the type of pain and treatment: superficial burn

A

somatic pain
topical/and or local anesthetics, opiates, and non-opiates

27
Q

pain history elements and questiosn

A

detailed hx of current pain, and for chronic pain - previous pain hx, comorbidities, psychosocial and pyschiatric

28
Q

besides the basics of a pain assessment (OPQRST) what else should be assessed

A

functionality
*ADLs impaired
*does the patient work
*how does the patient cope

29
Q

OPQRST

A

onset
pallative or provacatoin
quality
region radiation
severity
timing

30
Q

pain assessment: physical findings

A

VS- elevated BP or HR
cues - positioning, crying, flushing, diaphoresis

31
Q

what should always be conducted with neuropathic pain

A

a sensory exam

32
Q

pedi tylenol dose

A

15mg/kg PO
PO Q4-6 Hr
max 90 mg/kg/day

33
Q

ketamine MOA

A

Block NMDA receptors, peripheral Na+ channels, and mu-opioid receptors providing sedation, amnesia, and analgesia

34
Q

when should pain level be reassesseed

A

after intervention
consider reassessing pain level 30 minutes after IV and 60 minutes after PO administration of a medication

35
Q

consequences of unrelieved acute pain

A

psychological impacts
chronic pain syndromes
mortality and morbidity

36
Q

Appropriate discharge planning should consider what interventions the patient has received during the visit and transportation home.

A

How will the patient safely arrive home? Consider patient transportation and driving precautions, especially after receiving a sedating medication
Are they ambulating at their baseline without assistance?
Could the treatment or medication still be exerting its effects (i.e. lethargy as a side effect of morphine)?

37
Q

Genetic polymorphisms and pain

A

Caucasian and African American populations have approximately equal proportions of fast and slow metabolizers, whereas nearly 90% of certain Asian groups are fast acetylators.

38
Q

Examples of somatic pain

A

lacerations, fractures, and pelvic pain.

39
Q

examples of visceral pain

A

appendicitis, peptic ulcer disease, diverticulitis, endometriosis, and ureteral stones.

40
Q

acute pain is defined as

A

lasting less than 3 months and is a neurophysiological response to noxious injury that should resolve with normal healing.

41
Q

chronic pain is defined as

A

lasting more than 3 months or beyond the expected course of an acute disease or after complete tissue healing. Chronic pain extends beyond the time of normal wound healing with the development of multiple neurophysiological changes in the central nervous system.

42
Q

examples of acute pain

A

post-operative pain, fractured bones, appendicitis, crush injury to finger, labor and delivery pain.

43
Q

examples of chronic pain

A

low back pain, neck pain, and chronic pancreatitis.

44
Q

what do pain scales not take into account

A

Pain scales DO NOT take into account patient genetics, past experiences, comorbidities, or other pain influencing factors.

45
Q

examples of acute on chronic pain

A

sickle cell exacerbation in a patient with sickle cell disease or an abscess in a patient with sickle cell disease.

46
Q

non-pharm interventions for pain

A
47
Q

4 tire analogy

A

medications is only one tire when it comes to pain management

48
Q

chronic pain vicious cycle

A
49
Q

what is PDMPs

A

prescription drug monitoring programs

50
Q

Pain catastrophizing shares similarities

A

Depression and anxiety

51
Q

what is pain catastrophizing associated with

A

outcomes such as pain severity, activity interference and disability, depression, changes in social support networks, more frequent healthcare visits, and opioid usage.

Health Assessment (16 decks)

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