Chapter 10 - Pain Assessment

Question 1

How are white individuals different regarding cultural/racial differences in the treatment of pain?

Answer 1

White individuals receive more analgesic therapy than black or Hispanic individuals with similar symptoms

Question 2

Neuropathic pain implies an abnormal…

Answer 2

processing of the pain message

Question 3

An older adult patient with dementia has a pain rating of 5 on the Pain Assessment in Advanced Dementia (PAINAD) Scale. The nurse should

Answer 3

administer the prescribed pain medication

Question 4

two main processes for pain assessment:

Answer 4

nociceptive and/or neuropathic processing

Question 5

nociceptive processing (nociceptor)

Answer 5

designed to detect painful sensations from the periphery and transmit them to the CNS.

Nociceptors are located within the skin, connective tissue, muscle, and the thoracic, abdominal, and pelvic viscera.

can be stimulated directly by trauma or injury or secondarily by chemical mediators that are released from the site of tissue damage

Question 6

analgesic

Answer 6

pain killer

Question 7

Pain

Answer 7

is a highly complex and subjective experience that originates from the central nervous system (CNS) or peripheral nervous system (PNS), or both

Question 8

Nociceptors carry the pain signal to the central nervous system by

Answer 8

two primary sensory (or afferent) fibers: Aδ and C fibers

Question 9

Aδ fibers

Answer 9

myelinated and larger in diameter, so they transmit the pain signal rapidly to the CNS. The sensation is very localized, short-term, and sharp in nature because of the Aδ fiber stimulation

Question 10

C fibers

Answer 10

are unmyelinated and smaller and they transmit the signal more slowly. The “secondary” sensations are diffuse and aching, and they last longer after the initial injury

Question 11

substantia gelatinosa.

Answer 11

interneurons located within a specified area of the cord called the

Question 12

anterolateral spinothalamic tract

Answer 12

structure and pathway that transmits pain signals to the brain

Question 13

Nociceptive pain

Answer 13

develops when nerve fibers in the periphery and in the central nervous system are functioning and intact.

described as aching pain

starts outside of the nervous system from actual or potential tissue damage.

can be divided into four phases:

(1) transduction
(2) transmission
(3) perception
(4) modulation

Question 14

transduction

Answer 14

occurs when a noxious stimulus in the form of traumatic or chemical injury, burn, incision, or tumor takes place in the periphery

Question 15

transmission

Answer 15

the pain impulse moves from the level of the spinal cord to the brain

Question 16

perception

Answer 16

indicates the conscious awareness of a painful sensation

Question 17

modulation

Answer 17

pain message is inhibited

Question 18

Neuropathic pain

Answer 18

implies an abnormal processing of the pain message from an injury to the nerve fibers.

described as burning, shooting, and tingling

most difficult to assess and treat.

Pain is often perceived long after the site of injury heals and can start 2 to 3 years after an initial injury.

Question 19

Visceral pain

Answer 19

originates from the larger interior organs

Question 20

Deep somatic pain

Answer 20

comes from sources such as the blood vessels, joints, tendons, muscles, and bone

Question 21

referred pain

Answer 21

Pain that is felt at a particular site but originates from another location

Question 22

Acute pain

Answer 22

short-term and self-limiting, often follows a predictable trajectory, and dissipates after an injury heals

Question 23

persistent (or chronic) pain

Answer 23

diagnosed when the pain continues for 6 months or longer.

can be further divided into malignant (cancer-related) and nonmalignant

Question 24

breakthrough pain

Answer 24

pain that starts again or escalates before the next scheduled analgesic dose

Question 25

Pain is ALWAYS…

Answer 25

subjective

Question 26

In the Initial Pain Assessment, the clinician asks the patient to answer eight questions concerning …

Answer 26

location, duration, quality, intensity, and aggravating/relieving factors

Question 27

The Brief Pain Inventory, asks the patient…

Answer 27

to rate the pain within the past 24 hours using graduated scales (0-10) with respect to its impact on areas such as mood, walking ability, and sleep

Question 28

The short-form McGill Pain Questionnaire, asks the patient to

Answer 28

rank a list of descriptors in terms of their intensity and to give an overall intensity rating to his or her pain.

Question 29

Crepitation

Answer 29

an audible and palpable crunching that accompanies movement

Question 30

allodynia

Answer 30

pain sensation is evoked with a stimulus that does not normally induce pain

Question 31

Diaphoresis

Answer 31

the state of perspiring profusely

Question 32

PAINAD

Answer 32

“Pain Assessment In Advanced Dementia” Scale

-a score of 4 or greater should be reported for pain mngmt purposes

Question 33

Reflexive Sympathetic Dystrophy (RSD) or Complex Regional Pain Syndrome (CRPS)

Answer 33

RSD/CRPS is a chronic progressive nerve condition, characterized by burning pain, swelling, stiffness, and discoloration of the affected extremity. It affects both men and women, usually around 40 to 60 years old, and occurs weeks to months after a nerve injury (e.g., carpal tunnel syndrome, broken leg, cerebral lesions)

Question 34

Intractable Pain

Answer 34

pain not relieved with typical measures

Question 35

Cholecystitis causes which type of pain?

Answer 35

Inflammation in the gallbladder