Chapter 10

Question 1

List conditions that cause neuropathy.

Answer 1

Diabetes

Herpes zoster (shingles)

HIV/AIDS

Sciatica

Trigeminal neuralgia

Phantom limb pain

Chemotherapy

Question 2

What are the four sources of pain?

Answer 2

Visceral

• internal organs; kidneys, stomach, intestine, gallbladder, pancreas

Deep somatic

• blood vessels, joints, tendons, muscles, and bones

Cutaneous

• skin surface and subcutaneous tissue

Referred

• felt at a particular site, but originates from another location

Question 3

Common sites for reffered pain.

Answer 3

Question 4

What mnemonic could the nurse use when assessing pain?

Answer 4

P = Provocation/Palliation

• What were you doing when the pain started? What caused it? What makes it better or worse? What seems to trigger it? Stress? Position? Certain activities?
• What relieves it? Medications, massage, heat/cold, changing position, being active, resting?
• What aggravates it? Movement, bending, lying down, walking, standing?

Q = Quality/Quantity

• What does it feel like? Use words to describe the pain such as sharp, dull, stabbing, burning, crushing, throbbing, nauseating, shooting, twisting or stretching.

R = Region/Radiation

• Where is the pain located? Does the pain radiate? Where? Does it feel like it travels/moves around? Did it start elsewhere and is now localized to one spot?

S = Severity Scale

• How severe is the pain on a scale of 0 to 10, with zero being no pain and 10 being the worst pain ever? Does it interfere with activities? How bad is it at its worst? Does it force you to sit down, lie down, slow down? How long does an episode last?

T = Timing

• When/at what time did the pain start? How long did it last? How often does it occur: hourly? daily? weekly? monthly? Is it sudden or gradual? What were you doing when you first experienced it? When do you usually experience it: daytime? night? early morning? Are you ever awakened by it? Does it lead to anything else? Is it accompanied by other signs and symptoms? Does it ever occur before, during or after meals? Does it occur seasonally?

Question 5

What is the initial pain assessment?

Answer 5

The patient is asked 8 questions concerning location, duration, quality, intensity, and aggravating/relieving factors.

Question 6

What is the breif pain inventory?

Answer 6

The breif pain inventory rates pain within the past 24 hrs using graduated scales (0-10) with respect to its impact on areas such as mood, walking ability, and sleep (Fig.10-5).

Question 7

What is the Short-Form McGill Pain Questionnaire?

Answer 7

The Short-Form McGill Pain Questionnaire asks the patient to rank a list of descriptors in terms of their intensity and to give an overall intensity rating to his or her pain.

Question 8

Describe the faces pain scale?

Answer 8

The faces pain scale can be introduced at ages 4 to 5 years of age and has 6 drawing of faces that show pain intesity from no pain to very much pain.

Similarily, the oucher scale has six photographs of young boys faces with different expression of pain, ranked on a 0-5 scale. Can be used for girls and diverse ethnic groups.

Question 9

What are the acute pain behaviors?

Answer 9

• Guarding
• Grimacing
• Cocalizations such as moaning
• Aagitation
• Restlessness
• Stillness
• Diaphoresis
• Change in vital signs

Question 10

List the chronic pain behaviors?

Answer 10

• Bracing
• Rubbing
• Diminished activity
• Sighing
• Change in appetite
• Being with other people
• Movement
• Exercise
• Prayer
• Sleeping

Question 11

Physiological system acute pain responses

Answer 11