Pain lecture

Question 1

what is pain

Answer 1

The International Association for the Study of Pain define pain as:
* “ an unpleasant sensory or emotional experience associated with actual or potential tissue damage, or described in terms of such
damage”
Pain is :
* Unpleasant
* A sensory experience
* An emotional experience
* A warning signal

Question 2

when is pain experienced, what is protective mechanism

Answer 2

• Pain is common-experienced by everyone at some point in their life
• Protective mechanism- as it makes the patient aware that tissue damage;
• is occurring
• has occurred
• is about to occur
• Different classifications occur and the classification used depends on the cause, timeframe and nature of the pain
• Pathopysiology is complex
• Perception is multi-factorial

Question 3

factors influencing pain

Answer 3

age
cause
coping strategies

Question 4

factors affecting threshold - lowered

Answer 4

Insomnia, fatigue
Discomfort, pain (presence or fear of recurrence)
Anxiety, depression, sadness
Fear, anger, social and mental isolation
Boredom

Question 5

factors affecting threshold - highered

Answer 5

Sleep, rest
Relief of symptoms
Sympathy, anxiolytics, antidepressants
Companionship, understanding
Diversional activity, occupational therapy

Question 6

what are the three classifications of pain

Answer 6

clinical
Temporal
Neurophysiological

Question 7

clinical pain

Answer 7

This describes the severity in terms of:
* Mild
*Moderate
* Severe
Can be influenced by previous experience

Question 8

temporal pain

Answer 8

Acute
Chronic
* Persists or progresses over a long period of
* Accident trauma, sudden illness,
time
after surgery
* Cancer. Diabetes.
* Neuropathic disorders.
* Expected to diminish over time
* Aids. Arthritis.
* Nervous system is intact and
* Chronic pathological process
damage is usually self limiting
* Autonomic nervous svstem adapts
* Accompanied by autonomic
* Can affect
hyperactivity
* Personality
* lifestyle
* ^ BP, sweating and flushing
* Functionality
Pain is divided into two main categories according to its origin and duration

Question 9

Neurophysiological

Answer 9

lacerations, arthritic pain, post-operative pain
* Can be:
* Somatic; sharp localised and has an external cause ,e.g. a stab wound
* Visceral; poorly localised, dull and diffuse and can be periodic, can also be referred e.g. heart attack

Question 10

Non-nociceptive

Answer 10

• Caused by continuing or previous damage to nerves
• Neuropathic pain
• Surgery
• Trauma
• Medical conditions
• Phantom limb pain
• Post- herpetic neuralgia
• Trigeminal neuralgia
• Diabetic neuropathy

Question 11

Causes of pain

Question 12

assessment of pain

Answer 12

HCPs should use an assessment tool appropriate for the type of pain, clinical setting and the individual.
* Key point; assessment should be made by the sufferer and their report listened to.
* Assessment strategies include
* Communication
* Examination
* Observation
* Measurement

Question 13

communication- assessment of pain

Answer 13

Need to be able to explain pain mechanisms in a way the patient can understand
* Question and listen to establish information about the patients pain experience and history:
* ocation
* intensity
* frequency
* duration
* whether it is relieved by medicines and if so which ones and for ho

Question 14

assessment of pain- observation

Answer 14

Grimace
* Roll around in agony
* Shout
* Sit still
* Be Quiet
* Observations mav also include respiratory rates and blood pressure