Pain Assessment and Management Notes

Question 1

What is nociceptive pain?

Answer 1

The nervous system is functioning properly (somatic {skin/ muscles} or visceral {organs})

Question 2

What is neuropathic pain?

Answer 2

Damaged or malfunctioning nerves (burning, shocking, tingling, dull, achy)

Question 3

What factors affect pain experience?

Answer 3

1. Ethnic and cultural values
2. Developmental stage
3. Environment and support
4. Previous pain experiences
5. Meaning of pain
6. Emotional responses to pain

Question 4

What are the types of pain stimuli?

Answer 4

Mechanical
Thermal
Chemical

Question 5

List examples of mechanical pain stimulus

Answer 5

Trauma to body parts
Tumor
Muscle spasm
Blockage of body duct
Alterations in body tissues (pressure on pain recpetors)

Question 6

List examples of thermal pain stimuli

Answer 6

Extreme hold or cold like burns or frost bite

Question 7

List examples of chemical pain stimui

Answer 7

Tissue ischemia due to accumulated lactic acid or other chemicals in tissues

Question 8

With ethnic and cultural values, you must be able to recognize___________ differences

Answer 8

transcultural

Question 9

In the developmental stage of factors affecting pain experience, pain is more prevalent in which type of population?

Answer 9

The older population due to acute and chronic conditions

Question 10

How often should the nurse assess pain?

Answer 10

Depends on the situation and from the pt and by the nurse

Question 11

What s/e is aspirin associated with?

Answer 11

GI bleeding and Reyes syndrome

Question 12

What is the main difference between acetaminophen, NSAIDs, and and aspirin?

Answer 12

Inflammatory response

Question 13

What is unique about Celecoxib (Celebrex)?

Answer 13

Common NSAID
COX-2 Selective - needs a prescription

Question 14

What is a PCA?

Answer 14

PT Controlled Analgesia

Question 15

What does a PCA do?

Answer 15

PTs relieve their pain by self administering doses of analgesic via the IV.

Question 16

What are major problems using a PCA?

Answer 16

Programming issues
Requires 2 nurses to check
BIG concern is PCA by proxy (someone in the rooms pushes med for pt)

Question 17

When making the decision to prevent pain using PRN pain meds, how are they administered?

Answer 17

Around the clock or prior to potentially painful procedures

Question 18

What is the nature of pain?

Answer 18

• Location (locate the pain source, radiate or referred)
• Duration: Acute or chronic (3 months or more)
• Intensity: mild / moderate/ severe
• Etiology: nociceptive or neuropathic

Question 19

What is the difference between chronic and acute pain ?

Answer 19

Acute pain: increased pulse, BP, RR, dilated pupils. PT could be anxious. Less than 3 months.
Chronic: PT depressed, withdrawn, behavior absent, 3 months or more.

Question 20

What is the difference between pain threshold and pain tolerance?

Answer 20

Threshold - least amount of stimuli that is needed for someone to label a sensation of pain

Pain tolerants (tolerance) - max amount of painful stimuli that an individual is willing to withstand without seeking avoidance of the pain relief

Question 21

Describe the physiology of pain

Answer 21

Transmission - periphery to spinal cord to brain, then perceived
Perception - person becomes conscious of pain
Modulation - release of substance to help reduce painful impulses (which are endogenous opioids produced by body to help regulate and reduce pain)

Question 22

How do we respond to pain? especially unrelieved pain?

Answer 22

Interferes with sleep
Impairs Immune response
Slows healing process
Increases susceptibility to infection

Question 23

List the factors that affect pain experience?

Answer 23

Ethnic and cultural values (transcultural differences)
Developmental stage (pain is more prevalent in older population)
Environment and support people (hospital is unfamiliar and support groups are distracting to pain)
Previous pain experiences (personal or exposure to others)
Meaning of pain (acceptance of pain = +outcome // negative outlook = view pain as an inconvenience)
Emotional response to pain (anxiety // however anxiety decreases when pts believe they have control over pain)

Question 24

Using the pain hx assessment, the location is described as:

Answer 24

Pointing to the site and using land marks

Question 25

Using the pain hx assessment, the pain intensity and rating scales is described as

Answer 25

Numeric (0 -10)
FLACC (2 months - adolescence)
*Self report must be used to determine intensity
*record as reported

Question 26

Using the pain hx assessment, the pain quality is described as

Answer 26

The description the pt gives you
“Tell me what your discomfort feels like” Pt: tv static down my whole leg

Question 27

Using the pain hx assessment, the pattern is described as

Answer 27

Time of onset (when did the pain start)
Duration (how long have you had it)
Constancy (Do you have pain free periods)

Question 28

Using the pain hx assessment, the precipitating factors are described as

Answer 28

What causes the pain to happen? A storm (storms include precipitation; precipitation can cause pain)

Question 29

Using the pain hx assessment, the alleviating factors are described as

Answer 29

Hot
Cold
Immobility

Question 30

Using the pain hx assessment, the associated sx are described as

Answer 30

n/v/d
dizziness
SOB

Question 31

Using the pain hx assessment, the effect on ADL is described as

Answer 31

Sleep
Appetite
Working
(Can be used in nursing dx [problem] r/t ________)

Question 32

Using the pain hx assessment, the psychosocial is described as

Answer 32

Marital status
Social support
Home and work environment
Social status
Mood
Coping ability

Question 33

Nonpharmacologic methods to relieve pain

Answer 33

Massage
Acupressure
Immobilizing/ bracing
Distraction
Relaxion
Imagery
Biofeedback

Question 34

Does distraction (nonpharm cognitive behavioral intervention) work if pt is in pain?

Answer 34

No

Question 35

Opioid A/E include?

Answer 35

Bradypnea
Nausea
Orthostatic HTN
Urinary incontinence

Question 36

Morphine antagonist is

Answer 36

Nalaxone

Question 37

If pt has severe abdominal pain your number one priority is to _____________ first

Answer 37

Assess

Question 38

Opioids are given to pts with which types of pain?

Answer 38

Moderate (4-6)
Severe (7-10)

Question 39

Nonopioids, like NSAIDs are given to pts with which type of pain?

Answer 39

Mild (1-3)