Week 7: Pain Assessment Flashcards
Define:
Brief Pain Inventory (BPI)
An assessment tool used to evaluate pain severity and its impact on daily activities, relationships, mood, and overall enjoyment of life.
What is…
Pain resulting from damage to the nervous system, often described as burning, shooting, or tingling.
Neuropathic Pain
Define:
LANSS (Leeds Assessment of Neuropathic Symptoms and Signs)
A tool used to assess neuropathic pain, focusing on sensory abnormalities like allodynia and altered pain thresholds.
What is…
A scale that assesses pain intensity based on verbal descriptions such as “mild,” “moderate,” or “severe.”
VRS (Verbal Rating Scale)
What is…
The process of planning and providing treatment to reduce pain and improve the quality of life. It includes assessment, the use of tools, treatment goals, and ongoing reassessment.
Pain Management
Define:
Pain Tolerance
The maximum level of pain that a person is willing or able to tolerate before seeking relief or experiencing functional limitations.
Define:
DN4 (Douleur Neuropathique 4)
A questionnaire that differentiates between nociceptive and neuropathic pain through both interview and physical examination, identifying conditions such as hypoesthesia and allodynia.
Define:
Self-Reported Measures
Methods of pain assessment where the child reports their pain using various tools such as verbal, numeric, or pictorial scales.
Define:
Neuropathic Pain
Pain resulting from damage to the nervous system, often described as burning, shooting, or tingling.
Define:
Allodynia
A condition where normally non-painful stimuli, such as light touch, cause pain.
Define:
VRS (Verbal Rating Scale)
A scale that assesses pain intensity based on verbal descriptions such as “mild,” “moderate,” or “severe.”
Define:
Verbal Rating Scale
A pain assessment tool that uses verbal descriptions, such as mild, moderate, and severe, to rate pain intensity.
What is…
Observations of a child’s behaviour, including changes in motor responses, facial expressions, crying, and sleep-wake patterns, to assess pain.
Behavioural Measures
A questionnaire that differentiates between nociceptive and neuropathic pain through both interview and physical examination, identifying conditions such as hypoesthesia and allodynia.
DN4 (Douleur Neuropathique 4)
What is…
A mnemonic used to guide pain assessment in children: Question the child, Use a pain rating scale, Evaluate behaviour and physiological changes, Secure parents’ involvement, Take the cause of pain into account, and Take action and evaluate results.
QUESTT Mnemonic
What is…
Pain that typically begins suddenly and is usually sharp in quality. It may be caused by a specific injury or illness and decreases as recovery occurs.
Acute Pain
Define:
Numerical Rating Scale (NRS)
A pain intensity scale where patients rate their pain on a scale of 0 to 10, with 0 representing no pain and 10 representing the worst possible pain.
Define:
Pain Catastrophizing Scale
A measure that evaluates the extent to which a person experiences exaggerated negative thoughts or feelings about their pain.
What is…
An updated version of the Wong-Baker FACES scale that focuses on pain intensity without attributing emotions to the faces.
Revised FACES Pain Rating Scale
What is…
Information reported by the patient about their pain experience, such as their feelings, perceptions, and self-reports of pain intensity.
Subjective Data
What is…
The process of evaluating a child’s pain using age-appropriate tools, as children do not express pain in the same way as adults.
Paediatric Pain Assessment
Define:
Nociceptive Pain
Pain caused by damage to body tissues, usually described as sharp, aching, or throbbing. It is a common form of acute pain.
What is…
A pain intensity scale where patients rate their pain on a scale of 0 to 10, with 0 representing no pain and 10 representing the worst possible pain.
Numerical Rating Scale (NRS)
Define:
Pain Catastrophizing Scale
A scale measuring the extent to which individuals have negative thoughts and feelings related to their pain, with higher scores indicating more significant impact and poorer outcomes.
What is…
A condition where the heart rate is abnormally high, often a physiological response to acute pain.
Tachycardia
Define:
Chronic Pain Scale
A scale assessing the severity of pain and the level of disability it causes, with higher scores indicating greater disability.
Define:
Functional Pain Assessment
A type of pain assessment that evaluates the impact of pain on a person’s ability to perform daily activities and physical movements, such as mobility or breathing.
What is…
A tool used to evaluate the level of anxiety an individual experiences in relation to their pain, with higher scores indicating higher anxiety and potentially increased stress levels.
Pain Anxiety Symptom Scale
Define:
Multi-dimensional Tools
Pain assessment tools that capture multiple facets of pain, such as its intensity, quality, and emotional impact. They provide a more comprehensive understanding of the patient’s pain experience.
What is…
A pain assessment tool that uses verbal descriptions, such as mild, moderate, and severe, to rate pain intensity.
Verbal Rating Scale
What is…
Alterations in the body’s physical state, such as changes in heart rate (HR), respiratory rate (RR), blood pressure (BP), and posture, which may indicate pain.
Physiological Changes
Define:
Faces Pain Rating Scale
A scale where the child selects a face that best represents the intensity of their pain, recommended for children age 3 years and older.
What is…
A pain assessment mnemonic that stands for Provocation/Palliation, Quality, Region/Radiation, Severity, and Timing, used to evaluate different aspects of a patient’s pain.
PQRST
Define:
Physiological Changes
Alterations in the body’s physical state, such as changes in heart rate (HR), respiratory rate (RR), blood pressure (BP), and posture, which may indicate pain.
Define:
Uni-dimensional Tools
Pain assessment tools that measure one aspect of pain, typically pain intensity. Examples include numeric or verbal rating scales.
What is…
A tool used to assess pain based on facial expressions, leg movement, activity, crying, and consolability, with a score from 0-10 indicating pain severity.
FLACC Behavioural Scale
What is…
A lack of emotional expression, which can be a behavioral symptom of persistent pain.
Flat Affect
Define:
OPQRSTUV
An expanded version of the PQRST pain assessment tool, including Onset, Provocation/Palliation, Quality, Region/Radiation, Severity, Timing, Understanding, and Values.
Define:
FLACC Behavioural Scale
A tool used to assess pain based on facial expressions, leg movement, activity, crying, and consolability, with a score from 0-10 indicating pain severity.
What is…
Pain assessment tools that capture multiple facets of pain, such as its intensity, quality, and emotional impact. They provide a more comprehensive understanding of the patient’s pain experience.
Multi-dimensional Tools
What is…
The maximum level of pain that a person is willing or able to tolerate before seeking relief or experiencing functional limitations.
Pain Tolerance
Define:
Persistent (Chronic) Pain
Pain that continues for a long duration, often for months or years, and may not have a clear cause or resolve even after treatment.
What is…
A scale where the child selects a face that best represents the intensity of their pain, recommended for children age 3 years and older.
Faces Pain Rating Scale
What is…
A scale that assesses the degree of anxiety a patient feels regarding their pain, particularly fear that the pain will persist or worsen.
PASS (Pain Anxiety Symptom Scale)
What is…
A scale used to assess the impact of chronic pain on a person’s functional abilities and daily activities.
Chronic Pain Grade
Define:
Subjective Data
Information reported by the patient about their pain experience, such as their feelings, perceptions, and self-reports of pain intensity.
What is…
A tool that assesses the sensory, emotional, and evaluative dimensions of pain, offering a comprehensive view of the patient’s pain experience.
McGill Pain Questionnaire (MPQ)
Define:
Pain Management
The process of planning and providing treatment to reduce pain and improve the quality of life. It includes assessment, the use of tools, treatment goals, and ongoing reassessment.
What is…
Methods of pain assessment where the child reports their pain using various tools such as verbal, numeric, or pictorial scales.
Self-Reported Measures
What is…
A diagnostic tool used to differentiate between neuropathic and nociceptive (tissue damage-related) pain.
DN4 (Douleur Neuropathique 4)
Define:
Sympathetic Nervous System Activation
A physiological response to acute pain characterized by increased heart rate, blood pressure, and other physical signs of stress.
Define:
Paediatric Pain Assessment
The process of evaluating a child’s pain using age-appropriate tools, as children do not express pain in the same way as adults.
What is…
Excessive sweating, often associated with the body’s response to acute pain or stress.
Diaphoresis
Define:
Acute Pain
Pain that typically begins suddenly and is usually sharp in quality. It may be caused by a specific injury or illness and decreases as recovery occurs.
What is…
A measure that evaluates the extent to which a person experiences exaggerated negative thoughts or feelings about their pain.
Pain Catastrophizing Scale
What is…
An expanded version of the PQRST pain assessment tool, including Onset, Provocation/Palliation, Quality, Region/Radiation, Severity, Timing, Understanding, and Values.
OPQRSTUV
Define:
Physical Functional Ability Questionnaire (FAQ5)
A tool assessing various aspects of a person’s functioning, where a higher score indicates less disability.
Define:
PASS (Pain Anxiety Symptom Scale)
A scale that assesses the degree of anxiety a patient feels regarding their pain, particularly fear that the pain will persist or worsen.
Define:
Objective Data
Information that can be measured or observed during a pain assessment, such as heart rate, blood pressure, and behavioral signs.
Define:
Diaphoresis
Excessive sweating, often associated with the body’s response to acute pain or stress.
What is…
A tool assessing various aspects of a person’s functioning, where a higher score indicates less disability.
Physical Functional Ability Questionnaire (FAQ5)
Define:
Visual Analogue Scale (VAS)
A pain measurement tool where patients mark their level of pain on a continuous line, usually 100mm in length, between two endpoints representing “no pain” and “worst pain imaginable.”
Define:
Pain Anxiety Symptom Scale
A tool used to evaluate the level of anxiety an individual experiences in relation to their pain, with higher scores indicating higher anxiety and potentially increased stress levels.
Define:
Chronic Pain Grade
A scale used to assess the impact of chronic pain on a person’s functional abilities and daily activities.
Define:
PQRST
A pain assessment mnemonic that stands for Provocation/Palliation, Quality, Region/Radiation, Severity, and Timing, used to evaluate different aspects of a patient’s pain.
Define:
Initial Pain Assessment Tool
A tool designed to guide healthcare professionals through an initial assessment of a patient’s pain, including location, intensity, quality, and impact on daily life.
What is…
The study of the disordered physiological processes that cause, result from, or are otherwise associated with a disease or injury. In this context, it refers to the biological processes related to pain.
Pathophysiology
What is…
Pain assessment tools that measure one aspect of pain, typically pain intensity. Examples include numeric or verbal rating scales.
Uni-dimensional Tools
Define:
DN4 (Douleur Neuropathique 4)
A diagnostic tool used to differentiate between neuropathic and nociceptive (tissue damage-related) pain.
Define:
Flat Affect
A lack of emotional expression, which can be a behavioral symptom of persistent pain.
Define:
Behavioural Measures
Observations of a child’s behaviour, including changes in motor responses, facial expressions, crying, and sleep-wake patterns, to assess pain.
Define:
Revised FACES Pain Rating Scale
An updated version of the Wong-Baker FACES scale that focuses on pain intensity without attributing emotions to the faces.
What is…
A type of pain assessment that evaluates the impact of pain on a person’s ability to perform daily activities and physical movements, such as mobility or breathing.
Functional Pain Assessment
What is…
A tool used to assess neuropathic pain, focusing on sensory abnormalities like allodynia and altered pain thresholds.
LANSS (Leeds Assessment of Neuropathic Symptoms and Signs)
Define:
Pathophysiology
The study of the disordered physiological processes that cause, result from, or are otherwise associated with a disease or injury. In this context, it refers to the biological processes related to pain.
What is…
The point at which a stimulus is perceived as painful. It varies among individuals and even within the same individual over time.
Pain Threshold
What is…
An assessment tool used to evaluate pain severity and its impact on daily activities, relationships, mood, and overall enjoyment of life.
Brief Pain Inventory (BPI)
What is…
Information that can be measured or observed during a pain assessment, such as heart rate, blood pressure, and behavioral signs.
Objective Data
Define:
Tachycardia
A condition where the heart rate is abnormally high, often a physiological response to acute pain.
Define:
QUESTT Mnemonic
A mnemonic used to guide pain assessment in children: Question the child, Use a pain rating scale, Evaluate behaviour and physiological changes, Secure parents’ involvement, Take the cause of pain into account, and Take action and evaluate results.
What is…
A tool designed to guide healthcare professionals through an initial assessment of a patient’s pain, including location, intensity, quality, and impact on daily life.
Initial Pain Assessment Tool
What is…
A condition where normally non-painful stimuli, such as light touch, cause pain.
Allodynia
What is…
A pain measurement tool where patients mark their level of pain on a continuous line, usually 100mm in length, between two endpoints representing “no pain” and “worst pain imaginable.”
Visual Analogue Scale (VAS)
What is…
A scale measuring the extent to which individuals have negative thoughts and feelings related to their pain, with higher scores indicating more significant impact and poorer outcomes.
Pain Catastrophizing Scale
Define:
Pain Threshold
The point at which a stimulus is perceived as painful. It varies among individuals and even within the same individual over time.
What is…
A physiological response to acute pain characterized by increased heart rate, blood pressure, and other physical signs of stress.
Sympathetic Nervous System Activation
What is…
Pain that continues for a long duration, often for months or years, and may not have a clear cause or resolve even after treatment.
Persistent (Chronic) Pain
Define:
McGill Pain Questionnaire (MPQ)
A tool that assesses the sensory, emotional, and evaluative dimensions of pain, offering a comprehensive view of the patient’s pain experience.
What is…
Pain caused by damage to body tissues, usually described as sharp, aching, or throbbing. It is a common form of acute pain.
Nociceptive Pain
What type of data does an initial pain assessment include?
Subjective and objective data.
What should a pain management plan incorporate?
Pain tools, beliefs about pain, expectations, coping mechanisms, and family perspectives.
What is the core principle regarding a patient’s report of pain?
The patient’s self-report is the most reliable indicator of pain.
Why aren’t physiological and behavioral signs always reliable for pain assessment?
They are not specific to pain.
What must be considered when assessing pain in patients with communication difficulties?
Special assessment approaches and including family in the process.
What types of tools are used for acute pain assessment?
Uni-dimensional tools, such as numeric and verbal scales.
What distinguishes multi-dimensional pain assessment tools?
They gather both quantitative and qualitative information.
How does acute pain differ from persistent pain in duration?
Acute pain decreases as recovery occurs, while persistent pain does not typically go away.
What physiological changes may accompany acute pain?
Increased heart rate, respiratory rate, and blood pressure.
What are common behavioral symptoms of persistent pain?
Fatigue, withdrawal from social interaction, and reduced physical activity.
What is the primary goal of treatment for acute pain?
To control and eventually eliminate the pain.
What is the main objective of treatment for persistent pain?
Pain control to enhance function and quality of life.
What is a functional pain assessment?
Assessing pain both at rest and during movement to gauge its full impact.
What are some examples of uni-dimensional pain scales?
Numerical, visual analogue, and verbal rating scales.
What is the Numerical Rating Scale (NRS)?
A scale from 0 to 10 used to rate pain intensity.
Why is reassessment important after providing pain treatment?
To evaluate the effectiveness of the intervention.
What are some multi-dimensional pain assessment tools?
PQRST, OPQRSTUV, and Initial Pain Assessment Tool.
What does P in PQRST stand for?
Provocation/Palliation.
What does the U in OPQRSTUV represent?
Understanding/impact on the patient.
What is the purpose of the Initial Pain Assessment Tool?
To guide healthcare professionals in assessing a patient’s pain comprehensively.
What aspect of pain is addressed by both PQRST and OPQRSTUV?
Severity, including intensity and impact.
Why is consistency important when using pain intensity scales?
It allows accurate comparison of pain levels over time.
What is the role of family in pain assessment?
They can provide insight and help in assessing pain, especially in patients with communication difficulties.
What is a common physical sign of acute pain?
Sweating (diaphoresis).
What are the common psychological symptoms of persistent pain?
Flat affect and withdrawal from social interactions.
What should not be relied on when assessing pain?
Physiological and behavioral signs like tachycardia or grimacing.
When is acute pain usually expected to subside?
As healing occurs or the underlying cause resolves.
What does a uni-dimensional tool measure?
One dimension of pain, such as intensity.
What type of pain is commonly assessed using uni-dimensional tools?
Acute pain.
What are examples of uni-dimensional pain scales?
Numerical rating scale, visual analogue scale, verbal rating scale.
What physiological changes are often associated with acute pain?
Increased heart rate, respiratory rate, and blood pressure.
What is the most commonly used pain scale?
The numerical rating scale (NRS).
What does the Q in PQRST stand for?
Quality – what the pain feels like and how it can be described.
What does the S in PQRST stand for?
Severity – the intensity of pain on a scale, typically 0-10.
What tool is frequently used in research but not often in clinical pain assessment?
The visual analogue scale (VAS).
What does the T in OPQRSTUV refer to?
Treatment – medications and treatments used and their effectiveness.
What does the V in OPQRSTUV stand for?
Values – the patient’s goals and acceptable level of pain.
How is persistent pain assessment different from acute pain assessment?
It adds elements to identify the extent of the pain.
What process is used in persistent pain assessment?
A cyclical process of assessment and reassessment.
What tools are commonly used to assess persistent pain initially?
NRS, VAS, or VRS.
What type of tool is always used for persistent pain assessment?
A multi-dimensional tool.
What are some differences in presentation between acute and persistent pain?
Acute pain shows sympathetic responses like increased heart rate, while persistent pain shows parasympathetic responses like normal vital signs.
What is the typical behavior of patients with acute pain?
Restless, anxious, and exhibiting pain behavior like crying or holding the area.
What is the typical behavior of patients with persistent pain?
Depressed, withdrawn, and often not mentioning pain unless asked.
What is included in the assessment of persistent pain?
Symptoms, effects on activities, history, medications, and physical examination.
Why is duration a key factor in persistent pain?
Persistent pain continues beyond normal healing time and is unpredictable.
What signs are absent in persistent pain that are present in acute pain?
Clinical signs of sympathetic overactivity.
Why is the location and description of persistent pain important?
To understand its origin and characteristics.
What kind of sensory descriptors are used for persistent pain?
Sharp, throbbing, burning, shooting, stabbing.
What are some additional questions used in persistent pain assessment?
“Does pain increase with activity?” or “Does pain wake you?”
What are the two main multi-dimensional tools for assessing persistent pain?
The Brief Pain Inventory and the McGill Pain Questionnaire.
What areas of function does the Brief Pain Inventory assess?
General activity, mood, walking ability, work, relationships, sleep, and enjoyment of life.
How is the Brief Pain Inventory administered?
It can be self-administered or done over the phone with a health professional.
What aspects does the McGill Pain Questionnaire evaluate?
Sensory, affective, evaluative, and temporal aspects of pain.
What type of pain does the LANSS pain scale assess?
Neuropathic pain.
What does the Pain Catastrophising Scale measure?
The impact of prolonged pain on the patient’s mindset.
What does the PASS (Pain Anxiety Symptom Scale) assess?
The level of anxiety related to pain.
What does the DN4 tool help identify?
Whether the pain is neuropathic or nociceptive.
What does the Chronic Pain Grade tool assess?
The impact of pain on the individual’s functioning.
Why is it important to be objective in pain assessment?
To avoid preconceived ideas and provide holistic care.
Why is it important to use a multi-dimensional pain tool for persistent pain?
To capture the complex nature and various dimensions of persistent pain.
What types of factors should be considered when assessing persistent pain?
Exacerbating or relieving factors, impact on daily life, and any patterns in the pain.
What are common signs of neuropathic pain?
Shooting, burning, stabbing sensations, and allodynia.
What is the Brief Pain Inventory used for besides initial assessment?
For patient reviews and ongoing monitoring of pain.
What does the McGill Pain Questionnaire ask the patient to describe?
The location, pattern, and intensity of their pain, using specific sensory and affective descriptors.
What are the three pain scores provided by the McGill Pain Questionnaire?
Sensory, affective, and total pain scores.
What is allodynia in the context of neuropathic pain?
Pain due to a stimulus that doesn’t usually provoke pain, like light touch.
What is the main use of the Pain Catastrophising Scale?
To assess the psychological impact of persistent pain and the feeling that pain will never end.
What does the DN4 tool specifically evaluate?
It helps differentiate between neuropathic and nociceptive pain.
What are some signs that suggest the presence of neuropathic pain?
Burning, numbness, and weakness in the affected area.
Why can’t children be assessed for pain like adults?
They don’t demonstrate behaviors in the same way and younger children can’t verbalize their pain.
What is important to consider when assessing a child’s pain?
The child’s developmental level and using appropriate tools.
What type of pain measures are used with children?
Self-reported measures, behavioral measures, and physiological changes.
What role do parents play in paediatric pain assessment?
They help identify behaviors that aren’t normal for the child.
What behaviors may indicate pain in toddlers compared to older children?
Age-related behavioral changes, like crying or motor responses.
Why should physiological changes be used cautiously when assessing pain in children?
They are not reliable on their own to assess pain.
What does the QUESTT mnemonic stand for in paediatric pain assessment?
Question the child, Use a pain scale, Evaluate behavior/physiological change, Secure parents’ involvement, Take cause of pain into account, Take action.
What is the Faces pain rating scale?
A pictorial tool where children pick a face representing their pain level.
What age group is recommended for the Faces pain scale?
Children 3 years and older.
What does the FLACC scale measure?
Behavioral indicators of pain including facial expressions, activity, and consolability.
What is the main revision in the revised Wong-Baker FACES pain scale?
It removes emotional words like “happy” and focuses on how much the child is hurting.
What are some effects of unrelieved acute pain on a child’s development?
Increased stress, anxiety states, altered temperament, and vulnerability to persistent pain.
What is the Physical Functional Ability Questionnaire used for?
It measures a person’s functioning, with higher scores indicating less disability.
What does the Pain Catastrophizing Scale assess?
It assesses thoughts and feelings associated with pain, with higher scores indicating greater impact.
What does the DN4 questionnaire help distinguish?
It differentiates between nociceptive and neuropathic pain.
What does the Pain Anxiety Symptom Scale measure?
It measures anxiety levels related to pain, with higher scores indicating greater anxiety.
What is the Chronic Pain Scale used for?
It measures both pain severity and the extent of disability caused by the pain.
What is one of the key challenges in assessing pain in children?
a) Children always exaggerate their pain
b) Children often cannot verbalize their pain
c) Children do not experience severe pain
d) Children are easy to assess for pain
b) Children often cannot verbalize their pain
Why is pain assessment challenging in older adults?
a) They often under-report their pain
b) They frequently overestimate their pain
c) They have a high pain tolerance
d) They don’t feel pain as strongly
a) They often under-report their pain
What tool is commonly used for non-verbal patients to assess pain?
a) Numeric rating scale
b) Wong-Baker FACES
c) FLACC scale
d) Verbal scale
c) FLACC scale
What can complicate pain assessment in non-verbal patients?
a) Reliance on subjective reporting
b) Overemphasis on pain behaviors
c) Difficulty interpreting facial expressions
d) Limited availability of pain medications
c) Difficulty interpreting facial expressions
Why can emotional factors complicate pain assessment?
a) They make patients less likely to report pain
b) They don’t impact pain perception
c) They can amplify the sensation of pain
d) They cause pain to disappear temporarily
c) They can amplify the sensation of pain
Which of the following is a psychological factor that can affect pain perception?
a) Age
b) Stress
c) Diet
d) Genetics
b) Stress
How does culture influence pain assessment?
a) It only affects how patients express pain
b) It doesn’t affect pain at all
c) It impacts both expression and experience of pain
d) It affects only healthcare providers’ perception of pain
c) It impacts both expression and experience of pain
Which of the following physiological factors can influence pain?
a) Hormonal changes
b) Mood disorders
c) Job satisfaction
d) Family support
a) Hormonal changes
What role do previous pain experiences play in current pain perception?
a) No influence
b) Increased sensitivity to pain
c) Decreased sensitivity to pain
d) They can both increase or decrease pain perception
d) They can both increase or decrease pain perception
How can gender influence pain perception?
a) Women always feel more pain than men
b) Men report pain more often than women
c) Gender differences in pain perception are complex and influenced by biological and psychological factors
d) There is no difference in pain perception between genders
c) Gender differences in pain perception are complex and influenced by biological and psychological factors
What is a common physiological change associated with acute pain?
a) Decreased heart rate
b) Increased heart rate
c) Lower respiratory rate
d) Decreased blood pressure
b) Increased heart rate
Which of the following is a typical response to pain in the skin?
a) Sweating
b) Flushing
c) Dryness
d) Change in color
a) Sweating
What change in muscle tone is often associated with pain?
a) Muscle relaxation
b) Increased muscle tension
c) Atrophy
d) Decreased muscle tension
b) Increased muscle tension
How does blood pressure typically change in response to acute pain?
a) Increases
b) Decreases
c) Remains unchanged
d) Fluctuates irregularly
a) Increases
What physiological change might occur in chronic pain?
a) Hypotension
b) Increased cortisol levels
c) Muscle hypertrophy
d) Decreased cortisol levels
b) Increased cortisol levels
Which of the following is a subjective element of pain assessment?
a) Heart rate
b) Facial expressions
c) Pain intensity rating by the patient
d) Skin color
c) Pain intensity rating by the patient
Which pain assessment tool is subjective?
a) FLACC scale
b) Numeric rating scale (NRS)
c) Blood pressure reading
d) Heart rate monitoring
b) Numeric rating scale (NRS)
What is an objective element in pain assessment?
a) Patient’s description of the pain
b) Heart rate increase
c) Verbal pain score
d) Description of pain’s impact on daily life
b) Heart rate increase
Which tool combines subjective and objective elements for assessing pain in children?
a) Wong-Baker FACES scale
b) FLACC scale
c) Numeric pain scale
d) Verbal rating scale
b) FLACC scale
What is an important factor in combining objective and subjective pain assessments?
a) Objective measures should be prioritized
b) Subjective measures are more reliable
c) Both types of data provide a complete picture of pain
d) Objective data alone is sufficient
c) Both types of data provide a complete picture of pain
What is the primary difference between acute and chronic pain assessment?
a) Acute pain requires less detail
b) Chronic pain focuses more on the emotional and functional impact
c) Chronic pain is less challenging to assess
d) Acute pain assessment focuses solely on physiological changes
b) Chronic pain focuses more on the emotional and functional impact
Which tool is commonly used for assessing acute pain in children?
a) FLACC scale
b) DN4 scale
c) Chronic Pain Scale
d) Physical Functional Ability Questionnaire
a) FLACC scale
What tool is specifically designed to distinguish between nociceptive and neuropathic pain?
a) Wong-Baker FACES scale
b) Pain Catastrophizing Scale
c) DN4 questionnaire
d) Numeric pain scale
c) DN4 questionnaire
Which scale assesses the psychological impact of chronic pain?
a) Pain Anxiety Symptom Scale
b) FLACC scale
c) Numeric pain scale
d) Wong-Baker FACES scale
a) Pain Anxiety Symptom Scale
What is an important component of chronic pain assessment?
a) Measuring the intensity of pain
b) Evaluating its impact on quality of life
c) Focusing only on the physical symptoms
d) Ignoring emotional factors
b) Evaluating its impact on quality of life
Identify the type of pain Ms. Chan is suffering from.
Acute, Nociceptive somatic pain
Acute – pain has been present since surgery only. Less than 24 hours
Nociceptive – surgery to the tissues has resulted in the pain
Somatic – connective tissue has been damaged through surgery.
Using the OPQRSTUV approach, what is O, P and Q for Ms. Chan’s pain assessment:
O Post-surgery yesterday
P Keeping it still and having it elevated
Slightest movement
Q Painful throbbing ache
Using the OPQRSTUV approach, what is R, S and T for Ms. Chan’s pain assessment:
R Her lower left leg
Pain does not radiate anywhere
S 6/10 now, was 9/10 earlier
Cold, miserable, nauseated, unable to concentrate
T Morphine works for a little while but not for long.
Elevation of leg, immobilisation.
Using the OPQRSTUV approach, what is U and V for Ms. Chan’s pain assessment:
U Mobility affected.
Worried about cancer diagnosis and the effect on her life.
Her quality of life may decrease as it affects almost all activities, such as driving, walking,
going to the toilet easily
Affects life with her family. primary income is affected as she is unable to work, they have
just bought a new house and there is now the possibility that she may be off work for quite
some time
Need to have ongoing treatment
V Pain to go away so she can think and plan for the future.
Long term to be able to return to work
Relieve her negative feelings associated with the surgery
Identify the type of pain Mr. M’Budzi is suffering from.
Acute, Nociceptive somatic AND Neuropathic
* Acute as the injury has just happened.
* Nociceptive as it is damage to tissue.
* Somatic as it is damage to connective tissues.
* Neuropathic – due to explanation of quality of pain – spasms with pins and needles
in his finger.
Using the OPQRSTUV approach, what is O, P and Q for Mr. M’Budzi’s pain assessment:
O This morning when he fell off the roof, slicing open his forearm on a piece of tin as he fell.
P Nothing mentioned
Possibly movement and when he thinks about it
As this is a recent injury (less than 24 hours) and he has not yet had any treatment, there is no
information regarding this.
Bandage over wound may improve pain and stop him from seeing his wound – decrease psychological
impact
Q Right lower arm - Constant aching with spasms
Middle finger – pins and needles
Right shoulder – constant and sharp
Using the OPQRSTUV approach, what is R, S and T for Mr. M’Budzi’s pain assessment:
R Right lower arm into fingers
Right shoulder pain could be radiation, but consider mechanism of injury in relation to possibly trying to stop the fall and damaging the tissues in his shoulder as well.
S 8/10
Associated symptoms include – anxious, hot, sweaty with a racing heart – remember that the sympathetic nervous system (fight/fright/flight) will be working resulting in tachycardia,
hypertension, tachypnoea etc.
T We don’t know if anything works yet as nothing has been tried. His arm is bandaged so this may decrease some of the psychological factors that might impact his pain experience.
Due to undergo microsurgery and is awaiting pain relief with morphine.
Using the OPQRSTUV approach, what is U and V for Mr. M’Budzi’s pain assessment:
U Understands that the injury is serious as he requires microsurgery. Worried that this may impact his
ability to work and other areas of his life.
Worried about performing daily activities and taking care of his family.
V I want the pain to go, but I need my arm to be fixed so I can work again and provide for my family.
Needs to be normal.
Identify the type of pain Mr McLure is suffering from.
Persistent/Chronic – pain has been present for longer than 3 months.
Nociceptive – pain is due to inflammation to tissue
Somatic – pain associated with inflammation of connective tissue
Using the OPQRSTUV approach, what is O, P and Q for Mr. McLure’s pain assessment:
O 4/12 ago, constant
P Heat but not much else – shower in the morning and electric blanket at night.
Walking, using his hands, first thing in the morning
Q Throbbing and aching pains especially in his knees and ankles
Using the OPQRSTUV approach, what is R, S and T for Mr. McLure’s pain assessment:
R Wrists, ankles and knees
No radiation
S 4-9/10. Usually 5-6/10.
Has swelling of his joints, fatigued, hot, weakness in hands
Grumpy, short tempered, lethargic – lack of sleep (pain keeps him awake at night)
Distressing – feels like crying
T Heat – showers and electric blanket
Nurofen with no help
Using the OPQRSTUV approach, what is U and V for Mr. McLure’s pain assessment:
U Pain from RA, which affects his joints
Decreased mobility and interfering with ADL, feeling relationship strain
Decreased sleep due to baby and pain
He understands there is likelihood for prolonged pain
V Alleviate as much pain as possible to a level that is tolerable for Mark by starting stronger
pain medications.
Alleviate the pain so that he is able to rest at night, which will improve the family dynamic
with his wife and child. Be able to help his wife more with the baby.
Improved sleep
