Pain Management within the Acute Setting

Question 1

Name all the classifications of pain.

Answer 1

• acute
• chronic
• cancer related
• neuropathic
• intractable
• referred
• phantom

Question 2

Explain chronic pain.

Answer 2

• results from the body’s inability to prevent interpretation of pain signals
• continuous or regular pain that extends three months or more
• does not respond to normal treatment
• inadequately controlled acute pain can lead to chronic pain

Question 3

Explain cancer related pain.

Answer 3

• can be acute or chronic
• pain usually result of tumour involvement
• defined by particular pain characteristics

Question 4

Explain neuropathic pain.

Answer 4

• affects the nervous system
• distressing pain
• need early diagnosis

Question 5

Explain intractable pain.

Answer 5

• resistant to relief

Question 6

Explain referred pain.

Answer 6

• pain referred to another body part

Question 7

Explain phantom pain.

Answer 7

• pain felt in a body part that is missing

Question 8

Explain the difference between pain threshold and pain tolerance.

Answer 8

Pain threshold is the amount of pain stimulation the person needs before feeling pain, whilst pain tolerance is the maximum amount and duration of the pain that a person is willing to endure.

Question 9

Our assessment of pain should be subjective. What does this include?

Answer 9

• location
• onset and duration
• quality
• intensity
• aggravating

Question 10

When working with children nurses commonly use QUESTT. What does QUESTT stand for?

Answer 10

• Q - question the child
• U - use a pain scale
• E - evaluate behaviour and psychological changes
• S - secure parents involvement
• T - take cause of pain into account
• T - take action and evaluate results

Question 11

Name each of the following pain scales from top to bottom.

Answer 11

• descriptor scale
• numerical scale
• visual analogue scale

Question 12

Explain PQRST.

Answer 12

• P - precipitating factors
• Q - quality
• R - region and radiation
• S - signs and symptoms/severity (pain score)
• T - time and response to treatment

Question 13

Our pain assessment findings are always subjective and objective. What factors are taken into consideration with objective findings? Give three explains of each.

Answer 13

• Physiologic
  
  • tachycardia
  • hypertension
  • diaphoresis
  • tachypnoea
  • muscle tension
  • pallor
  • parid speech/elevated pitch OR slow monotone
  • nausea/vomiting
  • increased BGL
• Behavioural
  
  • immobility
  • withdrawal
  • rubbing a body part
  • grimacing
  • restlessness
  • writhing
  • unusual posture
  • extreme quietness
  • groaning
  • crying
• Emotional (this can also be considered subjective)
  
  • fear/anxiety
  • depression
  • anger/aggression
  • hopelessness
  • powerlessness
  • fatigue/exhaustion
  • feelng of being punished
  • frustration