Ch. 11 (Pain Assessment)

Question 1

What is a highly complex and subjective experience that originates from the central or peripheral nervous system or both and is developed by nociceptive and neuropathic processing?

Answer 1

pain

Question 2

What specialized nerve ending are designed to detect painful sensations from the periphery and transmit them to the central nervous system (CNS) via A and C fibers?

Answer 2

nociceptors

Question 3

How can nociceptors be stimulated?

Answer 3

• directly by mechanical trauma
• directly by thermal trauma
• secondarily by chemical mediators (released from the site of tissue damage)

Question 4

What are two ways pain can develop?

Answer 4

• nociceptive processing
• neuropathic processing

Question 5

What type of pain develops when functioning and intact nerve fibers in the peripheral and central nervous systems are stimulated?

Answer 5

nociceptive pain

Question 6

Where does nociceptive pain start?

Answer 6

outside the nervous system from actual or potential tissue damage

Question 7

What are the four phases of nociception (nociceptive pain process)?

Answer 7

• transduction
• transmission (spinal cord -> brain)
• perception
• modulation

Question 8

What type of pain is typically predictable and time limited based on the extent of the injury?

Answer 8

nociceptive pain

Question 9

What type of pain does not adhere to typical and predictable phases and is due to a lesion or disease in the somatosensory system?

Answer 9

neuropathic pain

Question 10

Neuropathic pain implies what?

Answer 10

abnormal processing of the pain message (an injury of the nerve fiber)

Question 11

Fill in the blank:

Neuropathic pain is sustained on a ____ level.

Answer 11

neurochemical

Question 12

What type of pain is very difficult to assess and treat because it is perceived long after the site of injury heals and thus turns into a chronic condition?

Answer 12

neuropathic pain

Question 13

What kind of pain can change into another type of pain over time when pain has been poorly controlled?

Answer 13

1. nociceptive pain
2. neuropathic pain

Question 14

Why does nociceptive pain become neuropathic pain when left untreated?

Answer 14

constant irritation and inflammation caused by a pain stimulus, which alters nerve cells, making them more sensitive to any future stimulus

Question 15

What are different types of nociceptive pain?

Answer 15

• visceral pain
• somatic (deep & superficial) pain

Question 16

What type of pain originates from larger internal organs?

Answer 16

visceral pain

Question 17

Physical pain sources are based on their origin?

If a patient is experiencing pain in their stomach, what would their pain be classified as?

Answer 17

visceral pain

Question 18

Physical pain sources are based on their origin?

If a patient is experiencing acute appendicitis, what would their pain be classified as?

Answer 18

visceral pain

Question 19

Physical pain sources are based on their origin?

If a patient is experiencing ulcer pain, what would their pain be classified as?

Answer 19

visceral pain

Question 20

Physical pain sources are based on their origin?

If a patient is experiencing pain in their intestines, what would their pain be classified as?

Answer 20

visceral pain

Question 21

Physical pain sources are based on their origin?

If a patient is experiencing pain in their gallbladder, what would their pain be classified as?

Answer 21

visceral pain

Question 22

Physical pain sources are based on their origin?

If patient is experiencing pain in their pancreas, what would their pain be classified as?

Answer 22

visceral pain

Question 23

What type of pain originates from musculoskeletal tissues or the body surface?

Answer 23

somatic pain

Question 24

What are two ways somatic pain can be described as?

Answer 24

• superficial
• deep

Question 25

# Physical pain sources are based on their origin? If a patient is experiencing pain on their musculoskeleton, what would their pain be classified as?

Answer 25

somatic pain

Question 26

What type of pain originates from sources such as blood vessels, joints, tendons, muscles, and bone?

Answer 26

deep somatic pain

Question 27

# Physical pain sources are based on their origin? If a patient is experiencing pain in their blood vessels, what would their pain be classified as?

Answer 27

deep somatic pain

Question 28

# Physical pain sources are based on their origin? If a patient is experiencing pain in their joints, what would their pain be classified as?

Answer 28

deep somatic pain

Question 29

# Physical pain sources are based on their origin? If a patient is experiencing pain in their tendons, what would their pain be classified as?

Answer 29

deep somatic pain

Question 30

# Physical pain sources are based on their origin? If a patient is experiencing pain in their muscles, what would their pain be classified as?

Answer 30

deep somatic pain

Question 31

# Physical pain sources are based on their origin? If a patient is experiencing pain in their bones, what would their pain be classified as?

Answer 31

deep somatic pain

Question 32

# Physical pain sources are based on their origin? If a patient is experiencing arthritis pain, what would their pain be classified as?

Answer 32

deep somatic pain

Question 33

# Physical pain sources are based on their origin? If a patient is experiencing radiating pain from a bone fracture, what would their pain be classified as?

Answer 33

deep somatic pain

Question 34

# Physical pain sources are based on their origin? If a patient is experiencing radiating pain from a tendon tear, what would their pain be classified as?

Answer 34

deep somatic pain

Question 35

What type of pain occurs from the skin and subcutaneous tissues?

Answer 35

cutaneous/superficial somatic pain

Question 36

# Physical pain sources are based on their origin? If a patient is experiencing pain on their skin, what would their pain be classified as?

Answer 36

cutaneous/superifical somatic pain

Question 37

# Physical pain sources are based on their origin? If a patient is experiencing pain in their subcutaneous tissues, what would their pain be classified as?

Answer 37

cutaneous/superficial somatic pain

Question 38

# Physical pain sources are based on their origin? If a patient is experiencing pain on their skin from a sunburn, what would their pain be classified as?

Answer 38

cutaneous/superficial somatic pain

Question 39

# Physical pain sources are based on their origin? If a patient is experiencing pain on their skin from a paper cut, what would their pain be classified as?

Answer 39

cutaneous/superficial somatic pain

Question 40

What type of pain occurs when pain you feel in one part of your body is actually caused by pain or injury in another part of your body?

Answer 40

referred pain

Question 41

# Physical pain sources are based on their origin? If a patient is experiencing pain in their lower back but originates from their injured pancreas, what would their pain be classified as?

Answer 41

referred pain

Question 42

# Physical pain sources are based on their origin? If a patient is experiencing pain in their jaw but just had a heart attack, what would their pain be classified as?

Answer 42

referred pain

Question 43

# Physical pain sources are based on their origin? If a patient is experiencing pain in their upper thigh from a foot that has been amputated, what would their pain be classified as?

Answer 43

referred pain

Question 44

# Physical pain sources are based on their origin? If a patient is experiencing pain in their head after eating ice cream, what would their pain be classified as?

Answer 44

referred pain | the pain stimulus is happening in the patient's mouth/throat ## Footnote vagus nerve is stimulated and pain is felt in brain/head

Question 45

# Pain can also be classified by its duration. What type of pain is short-term and self-limiting, often following a predictable track and dissipating after the injury heals?

Answer 45

acute pain

Question 46

# Pain can also be classified by its duration. What type of pain continues for six months or longer and results from abnormal processing by pain fibers from peripheral or central sites and does not stop when the injury heals?

Answer 46

chronic (persistent) pain

Question 47

# Pain can also be classified by its duration. What type of pain is described as a transient spike in pain level in an otherwise controlled pain syndrome or as the result of incident or episodic pain?

Answer 47

breakthrough pain

Question 48

# True or false?: Preterm infants lack inhibitory neurotransmitters and are more sensitive to painful stimuli.

Answer 48

true

Question 49

# Pain is common in older adults. But, is pain normal during the process of aging?

Answer 49

no

Question 50

What are the two main symptoms of opioids?

Answer 50

* pain relief * euphoria

Question 51

What are the two most common side effects of opioids?

Answer 51

* respiratory depression * constipation

Question 52

What is the most reliable indicator of pain?

Answer 52

subjective report

Question 53

What may a patient do if they are experiencing chronic pain?

Answer 53

* subconsciously rub the affected area (as a means of achieving pain relief) * cranky/depression

Question 54

What may a patient do if they are experiencing acute pain?

Answer 54

* diaphoresis (excessive sweating due to sec. condition) * facial grimacing * tenseness/guarded * rigidity (resistance in range of motion)

Question 55

What position do patients with chronic pulmonary conditions tend to lean into to help aid in exhalation?

Answer 55

the tripod position | leans forward with arms braced on the arms of the chair

Question 56

What position do patients with congestive heart failure tend to lean into to help aid in respiration?

Answer 56

sits upright in a chair and will resist lying down | lying down may worsen the shortness of breath

Question 57

What type of fibers transmit rapidly to the CNS; localized, short term, sharp pain?

Answer 57

A fibers

Question 58

What type of fibers transmit pain more slowly to CNS; diffuse, aching, persistent?

Answer 58

C fibers

Question 59

Does neuropathic pain go through the same four phases nociceptive pain goes through?

Answer 59

no, does not even have four phases

Question 60

What type of pain describes a patient who has been on pain medicine but suddenly experiences pain again?

Answer 60

breakthrough pain