Week 6

Question 1

What is an example of acute pain?

Answer 1

sprained ankle

Question 2

What is an example of chronic pain?

Answer 2

arthritis

Question 3

What does it mean when pain is classified according to its etiology?

Answer 3

classified according to its cause

Question 4

What is nociceptive pain?

Answer 4

Initiated by nociceptors that are activated by actual or threatened damage to the peripheral tissue and is representative of the normal pain process

Question 5

What is cutaneous pain?

Answer 5

Superficial pain usually involving the skin or subcutaneous tissue
An example is a paper cut

Question 6

What is somatic pain?

Answer 6

Diffuse or scattered
originates in tendons, ligaments, bones, blood, vessels, and nerves
Strong pressure on a bone or damage to tissue that occurs with a sprain causes somatic pain

Question 7

What is visceral pain?

Answer 7

AKA splanchnic pain
poorly localized
originates in body organs in the thorax, cranium, and abdomen
One of the most common types of pain produced by disease
occurs as organs stretch abnormally and become distended, ischemic, or inflamed

Question 8

What is neuropathic pain?

Answer 8

Pain caused by a lesion or disease of the peripheral or central nerves

Described as burning, electric, tingling, or stabbing

Question 9

What is transduction?

Answer 9

the activation of pain receptors

Question 10

What is transmission?

Answer 10

conduction along pathways (A-delta and C-delta fibers)

Question 11

What is perception of pain?

Answer 11

awareness of the characteristics of pain

Question 12

What is modulation?

Answer 12

inhibition or modification of pain

Question 13

What is bradykinin?

Answer 13

a powerful vasodilator that increases capillary permeability and constricts smooth muscle

Question 14

What are prostaglandins?

Answer 14

important hormone-like substances that send additional pain stimuli to the CNS

Question 15

What is Substance P?

Answer 15

sensitizes receptors on nerves to feel pain and also increases the rate of firing nerves

Question 16

What is the gate control theory of pain?

Answer 16

describes the transmission of painful stimuli and recognizes a relationship between pain and emotions
small and large diameter nerve fibers conduct and inhibit pain stimuli toward the brain
Gating mechanism determines the impulses that reach the brain

Question 17

What are physiologic responses to pain?

Answer 17

Decreased BP
muscle tension and rigidity
increased RR

Question 18

What are behavioral responses to pain?

Answer 18

moving away from painful stimuli
grimacing, moaning, and crying
restlessness
protecting the painful area and refusing to move

Question 19

What are affective (psychological) responses to pain?

Answer 19

withdrawal
stoicism
anger
depression
fatigue
hopelessness

Question 20

What affects modulation of pain

Answer 20

Neuromodulators- opioid chemical regulators that appear to have analgesic activity and alter pain perception
Endorphins, dynorphins, and enkephalins

Question 21

What are endorphins and dynorphins?

Answer 21

Pain blocking chemicals that have prolonged analgesic effects and produce euphoria
May be released when certain measures are used to relieve pain, such as skin stimulation and relaxation techniques, and when certain pain-relieving drugs are used

Question 22

What are enkephalins?

Answer 22

thought to reduce pain sensation by inhibiting the release of substance P from the terminals of afferent neurons

Question 23

What are nociceptors?

Answer 23

peripheral nerve fibers that transmit pain

Question 24

What is the pathway of pain sensation and relief?

Answer 24

nerve endings in burned finger
pain reaches dorsal horn
travels to thalamus then to cerebral cortex then to spinal cord
endorphins block pain

Question 25

What are general assessments of pain?

Answer 25

-pt’s verbalization and description of pain
-duration of pain
-location of pain
-quantity and intensity of pain
-quality of pain
-chronology of pain
-aggravating and alleviating factors
-physiologic indicators of pain
-behavioral responses
-effect of pain on activities and lifestyle

Question 26

What is the WONG-Baker FACES tool?

Answer 26

pain scale that uses a series of faces to rate pain
used on children above 3 years old

Question 27

What is the Beyer Oucher pain scale?

Answer 27

0-100 scale with 6 photographic images of children in pain
useful for older children

Question 28

What is the CRIES pain scale?

Answer 28

-Used on patients 0 to 6 months
Crying
Requires oxygen
increased vital signs
expression
sleepless

Question 29

What is the FLACC scale?

Answer 29

Face
Legs
Activity
Cry
Consolability

Scale used from 2 months to 7 years in children who are nonverbal and don’t have expressive communication

Question 30

How to diagnose pain?

Answer 30

-type of pain
-etiologic factors
-behavioral, physiologic, affective response
-other factors affecting pain process

Question 31

How do you manipulate pain experience factors?

Answer 31

remove or alter cause of pain
alter factors affecting pain tolerance
initiate nonpharmacologic relief measures

Question 32

What are examples of adjuvant drugs?

Answer 32

antidepressants
anticonvulsants

Question 33

What is the WHO 3-step analgesic ladder?

Answer 33

1st step- nonopioid, adjuvant
2nd step- opioid for mild to moderate pain, nonopioid, adjuvant
3rd step- opioid for moderate to severe pain, nonopioid, adjuvant

Question 34

What are pain management regimens for cancer or chronic pain?

Answer 34

give meds orally if possible
administer meds ATC rather than PRN
adjust the dose to achieve max benefit with minimal side effects
allow pts as much control as possible over the regimen