Pain assessment

Question 1

why is pain assessment important

Answer 1

-its the primary reason why clients access health care in canada

Question 2

what is pain?

Answer 2

an unpleasent sensory and emotional experiecne associated with actual and potential tssue damage, or described in terms of such damage

Question 3

how is pain transmitted through the body

Answer 3

impulse, spinal cord, brain stem, thalamus, central structures of the brain, pain is processed

Question 4

what is nociceptive and neuropathic pain

Answer 4

• nociceptive - normal processing of stimulas, somatic, cutaneous, viscceral, referred
• neuropathic pain - abnormal processing of sensory input, tingling, numbness, pins and needles, diabetic or phantom limb pain

Question 5

what are the different classifications of pain?

Answer 5

• duration: acute (up to 3 months) or chronic

- frequency: continuous (arthritis) or intermittent/episodic

Question 6

what are the four components of pain?

Answer 6

• sensory/physical (action in pain nerves)
• beliefs (knowledge, expectations, fears)
• behavioral (the effect of pain of their physical and emotional coping strategies
• emotions (their mood is affected by everything else and affects everything else)

Question 7

what are the influencing factors with pain?

Answer 7

• Age
• Gender
• Culture
• Spiritual
• Family and social support
• The personal meaning of the pain
• Level of anxiety
• Coping style
• Fatigue
• Previous experience of pain and suffering

Question 8

what are some words that describe pain?

Answer 8

• Burning *
• Tingling
• Crushing
• Cramping
• Dull
• Fullness
• Gas-like
• Gnawing
• Heavy
• Electric*
• Pressure
• Radiating
• Sharp
• Sickening
• Shooting*
• Squeezing
• Stabbing
• Throbbing
• Pins and needles*
• Numbness*

Question 9

what are the physiological responses of acute pain?

Answer 9

• Heart rate increased
• Respiratory rate increased
• Blood pressure increased
• Palmar sweating (diaphoretic)
• Vomiting
• Pallor
• Crying
• Muscle tension
• Level of consciousness change

Question 10

do unconscious patients have pain?

Answer 10

we always assume they have pain and treat them for it

Question 11

what are the behavioral responses to pain?

Answer 11

• the observable actions to control/express pain
• depends on cognitive and linguistic ability
• vocalization, facial expression, posturing, decreased attention, irritability

Question 12

what does pain affect?

Answer 12

• sleep, emotions, concentration, relationships with others

- activities of daily living, physical activities, appetite

Question 13

what does poorly managed pain result in?

Answer 13

• increasd cortisol levels (stress)

- decreased immunity

Question 14

what are a nurses compentancies according to CNO?

Answer 14

-indentifis effect of own values, beliefs and experiencing in relationships with clients, and recognizes potential conflicts while ensuring culturally safe client care

Question 15

how does a nurse practice assessment and pain management?

Answer 15

-applies evidence - informed of pain prevention and management with clients in various states of health and illness using pharmacological and non-pharmacological measures

Question 16

what is the role of a nurse in assessments?

Answer 16

• essential member for proper diagnosis
• evaluate the treatment plan every time they assess vital signs
• advocate for what the individual wants

Question 17

when should nurses assess pain?

Answer 17

• on admission
• after a change in medical status
• before/during/after a procedure
• each new report of pain
• any time an unexpected intense pain associated with increased pulse, decreased blood pressure or fever

Question 18

what are the questions to ask during a pain assessment?

Answer 18

O – Onset: when did it start, how long does it last, how frequently do you feel it, is it all the time or some of the time?
L – Location: where is it, does it travel anywhere?
D – Duration: how long does it last?
C – Characteristics: how would you describe it? Burning, stabbing, aching
A – Aggravating: what makes it worse?
R – Relieving: what makes it better?
T – Timing: are you doing something in particular when it hurts, did it start slowly or suddenly, does it come and go or is it constant?
S – Severity: on a scale of 0-10 where 0 is no pain and 10 is the absolute worst you can imagine, what number is your pain now? At its worst?
U – Understanding or perception: what do you think is causing it? And if appropriate, what can you tolerate day to day?

Question 19

what is the numeric pain intensity scale

Answer 19

• 0 - Pain free
• 1 - Very minor annoyance - occasional minor twinges.
• 2 - Minor annoyance - occasional strong twinges.
• 3 - Annoying enough to be distracting.
• 4 - Can be ignored if you are really involved in your work, but still distracting.
• 5 - Can’t be ignored for more than 30 minutes.
• 6 - Can’t be ignored for any length of time, but you can still go to work and participate in social activities
• 7 - Makes it difficult to concentrate, interferes with sleep. You can still function with effort
• 8 - Physical activity severely limited. You can read and converse with effort. Nausea and dizziness set in as factors of pain
• 9 - Unable to speak. Crying out or moaning uncontrollably - near delirium.
• 10 - Unconscious. Pain makes you pass out.

Question 20

what is the family/cargivers role in assessment?

Answer 20

• give reports of pain if they are unable
• comforts their loved one
• encouraged to assist (feeling of helping)
• support is important and helps to relieve pain
• advocate for appropriate pain assessment and management

Question 21

how do you use tanners clinical judgement model in pain assessment?

Answer 21

noticing- monitor pain at every encounter, watch for subtle signs that a patient may be experiencing pain
interpreting- include the plan of care
responding- interventions may be non-pharmacological or include medical treatmens such as medications, surgery
reflecting - reflect on own values and beliefs about pain