Assessing Pain and Vital Signs

Question 1

• is an unpleasant sensory and emotional experience
  associated with actual or potential tissue damage, or
  described in terms of such damage.

Answer 1

PAIN

Question 2

the 5th Vital Sign

Answer 2

PAIN

Question 3

▪ Pain is subjective and highly individualized
▪ Its stimulus is physical and/or mental in nature
▪ Only the patient knows whether pain is present and how the experience feels
▪ May not be directly proportional to amount of tissue damage

Answer 3

Nature of Pain

Question 4

Types of Pain

Answer 4

• Based on duration
• Based on location
• Based on intensity
• Based on etiology

Question 5

Types of Pain

Based on duration :

Answer 5

Acute
Chronic
- Chronic non-cancer pain
- Chronic episodic pain
- Chronic cancer pain

Question 6

Classification of pain based on duration :

Answer 6

ACUTE PAIN
CHRONIC PAIN

Question 7

▪ Lasting from seconds to 6
months
▪ It usually resolves, with or
without treatment, after an
injured area heals
▪ Unrelieved acute pain can
progress to chronic pain

Answer 7

ACUTE PAIN

Question 8

▪ Last longer than 6 months
▪ Can be:
-Chronic non cancer pain
-Chronic cancer pain
-Chronic Episodic pain:
pain episodes last for
hours, days, weeks.
(e.g. migraine headaches)

Answer 8

CHRONIC PAIN

Question 9

Classification of pain-based on intensity

Answer 9

▪ Mild Pain: Pain scale reading from 1 -3
▪ Moderate Pain: Pain scale reading from 4 to 6
▪ Severe Pain: Pain scale reading from 7 to 10

Question 10

Classification of pain based on etiology.

Answer 10

Nociceptive pain
Neuropathic pain

Question 11

experienced when an intact, properly functioning nervous system sends signals that tissues are damaged, requiring attention and proper care.

✓ Somatic pain: pain that is originating from the skin, muscles, bone,
or connective tissue
✓ Visceral pain: pain that results from the activation of nociceptors of
the thoracic, pelvic or abdominal viscera (organs)

Answer 11

Nociceptive pain

Question 12

associated with damaged or
malfunctioning nerves due to illness, injury, or undetermined
reasons.

✓ Peripheral neuropathic pain: due to damage to peripheral nervous
system
✓ Central neuropathic pain: results from malfunctioning nerves in the
central nervous system

Answer 12

Neuropathic pain

Question 13

These are various tools that are designed to assess the
level of pain.

Answer 13

Pain Assessment Tool

Question 14

The most commonly used Pain Assessment Tools are.

Answer 14

1. Verbal Rating Scale
2. Numeric Rating Scale
3. Wong Baker’s Faces Pain Scale

Question 15

A drug delivery system called patient-controlled analgesia
(PCA) is a safe method for pain management that many patient prefer.

Answer 15

Patient-Controlled Analgesia

Question 16

It is a drug delivery system that allows patients to self-administer opioids with minimal risk overdose.

Answer 16

Patient-Controlled Analgesia

Question 17

▪ vital signs reflect the body’s physiologic status and provide
information critical to evaluating homeostatic balance.

▪Includes: Temperature, Pulse Rate, Respiratory Rate, and
Blood Pressure

Answer 17

Vital Signs

Question 18

▪ It is the hotness or coldness of the body. It is the balance between heat production and heat loss of the body.

Answer 18

Temperature

Question 19

2 Kinds of Body Temperature

Answer 19

1. Core Temperature: temperature of internal organs.
2. Surface temperature: temperature of the skin,
   subcutaneous tissue, and fat cells.

Question 20

For healthy adult the normal resting pulse range from

Answer 20

60 – 100 beats per minute

Question 21

is characterized a fast heart rate which is more than 100 beats per minute.

Answer 21

Tachycardia

Question 22

is characterized as an abnormally low heart rate which is fewer than 60 beats per minute.

Answer 22

Bradycardia

Question 23

Each respiration is divided into two phases:

Answer 23

• Inhalation, which is breathing in
• Exhalation, which is breathing out

Question 24

normal respiration (12 – 20 respirations/minute)

Answer 24

Eupnea

Question 25

Respirations above 20 respirations/minute

Answer 25

Tachypnea

Question 26

Respirations less than 12 respirations/minute

Answer 26

Bradypnea

Question 27

Is a measurement of the pressure or force exerted by the
blood on the wall of the arteries in the heart.

Answer 27

Blood Pressure

Question 28

Formal, legal document that provides evidence of a client’s
care. There are different systems and forms of documentation,
but all client records have similar information.

Answer 28

Chart/ Client Record

Question 29

▪ AKA charting/documenting
▪ process of making an entry on a client record

Answer 29

Recording

Question 30

Purposes of Records

Answer 30

▪ Communication
▪ Planning client care
▪ Auditing health agencies
▪ Research
▪ Legal Documentation
▪Reimbursement

Question 31

Types of Charting

Answer 31

Narrative Charting
Focus Charting (FDAR)
Progress Notes (SOAPIE)

Question 32

– a traditional part of source-oriented records.
- It consists of written notes that include routine care,
normal findings, and client problems

Answer 32

Narrative Charting

Question 33

Focus, Data, Action, Response
- Intended to make the client and client concerns the focus of care.

• Provides a holistic perspective of the client and the client’s needs.

Answer 33

Focus Charting (FDAR)

Question 34

Subjective Data, Objective
Data, Assessment, Plan, Intervention, Evaluation

Answer 34

Progress Notes (SOAPIE)