Pain Assessment: The 5th Vital Sign- Ch. 10

Question 1

Pain is subjective..

Answer 1

“It is whatever the person says it is, exciting wherever the person says it does”

Question 2

Pain assessment requires what?

Answer 2

Attention- respond to pain relief methods, to the side effects of medications, what else can be done if it doesn’t go away?

Question 3

Alternative/holistic pain relieving methods

Answer 3

Music 
Decompress pressure/relive pressure- chest tube, catheter, NG
Anti-anxiety medications (Xanax)
Positioning 
Heat/cold application 
Oxygenation

Question 4

Two types of pain “pathways”

Answer 4

Nocioceptive

Neuropathic

Question 5

Nocioceptive pain- used to describe how a noxious stimuli are perceived as pain (injury occurs in the fibers)
Where are nocioreceptors located?
How are they stimulated?

Answer 5

Originates from the CNS or PNS

• skin, joints, connective tissue, muscles, thoracic viscera, abdomen
• stimulated by direct mechanical or thermal trauma; chemical mediators are released from the site of tissue damage

Question 6

Four concepts of nocioceptive pain?

Answer 6

Transduction
Transmission
Perception
Modulation

Question 7

Transduction

Rx: modify the source of pain

Answer 7

Stimulus takes place in the periphery fibers

-to modify the source of pain: local/topical analgesia, anti inflammatory, aspirin, NSAIDs

Question 8

Transmission

Rx: block the transmission of pain to the CNS

Answer 8

Pain moves from spinal cord to brain. To modify mover my of pain to CNS: narcotics, opioids, local analgesics, anti inflammatory, aspirin NSAIDs

Question 9

Perception

Rx: alter the central perception of pain

Answer 9

Awareness of pain sensation, to modify awareness of pain: mediation, music, distraction, hypnosis, acupuncture

Question 10

Modulation

Rx: modulate the inhibition of pain in the CNS

Answer 10

Inhibition of pain

To inhibit pain: all of the above, analgesics, general anesthetic, morphine, fetynyl

Question 11

Neuropathic pain- a pain caused by disease or injury that affects the somatosensory nervous System

Answer 11

• abnormal
• doesn’t follow the phases of nocioceptive pain
• most difficult to treat and assess
• pain is felt long after injury heals
• phantom pain, diabetic neuropathy, shingles, chemo, FM, sciatica

Question 12

Sources of pain

Answer 12

Visceral- large organs
Deep somatic- muscles, joints, tendons, blood vessels
Cutaneous- skin/superficial
Referred pain

Question 13

Referred pain

Answer 13

Pain that is felt in one area but originates in another location

Question 14

Two types of pain?

Answer 14

Acute and chronic

Question 15

Acute pain

Answer 15

Short term 
Activates ANS- change in vitals 
Self limiting 
Ends after injury 
Protective qualities 
Malignant

Question 16

Chronic pain

Answer 16

Long term 
Malignant 
Cancer 
Doesn't stop after healing 
No protecting quality 
Level of pain higher 
Low activity 
Low appetite 
Normal vital signs

Question 17

Pain in the elderly

Answer 17

Not normal aging process
Common ppl > 65 yr
Indicates pathology or injury
Check for objective data whil assessing