Comfort + Pain Management

Question 1

Is pain always what the patient says?

Answer 1

Yes

Question 2

Pain is a personal experience based on what kinds of factors?

Answer 2

Psychological, biological, and social factors

Question 3

Pain can have an adverse effect with-

Answer 3

Function + Socialization

Question 4

Can pain occur in the absence of an obvious stimuli?

Answer 4

Yes

Question 5

The process of sensory receptors responding to potentially damaging stimuli by sending nerve signals to the spinal cord and brain =

Answer 5

Nociception

Question 6

Activated by thermal heat or cold =

Answer 6

Thermal Receptors

Question 7

Activated by excess pressure of mechanical deformation (For example, skin incisions)

Answer 7

Mechanical Nociceptors

Question 8

What’s detected by nociceptors and are transmitted into energy?

Answer 8

Noxious Stimuli

Question 9

Whenever noxious stimuli is detected by nociceptors and are transmitted into energy, what is this process creating?

Answer 9

An Action Potential

Question 10

What are pain signals transmitted from to the spinal cord and then the brain?

Answer 10

Nociceptors

Question 11

Visceral structures are sensitive to-

Answer 11

Stretch, ischemia, and inflammation

Question 12

What type of pain is diffuse, difficult to locate, and often referred to a distant, usually superficial, structure

Answer 12

Visceral Pain

Question 13

What type of pain may be accompanied with nausea and vomiting. May be described as sickening, deep, squeezing, and dull =

Answer 13

Visceral Pain

Question 14

What type of pain is initiated by stimulation of nociceptors in ligaments, bones, tendons, blood vessels, fascia, and muscles =

Answer 14

Deep Somatic Pain

Question 15

Does deep somatic pain include sprains and broken bones?

Answer 15

Yes

Question 16

What type of pain can be described as a dull, aching, poorly localized pain =

Answer 16

Deep Somatic Pain

Question 17

What type of pain is started by the activation of nociceptors in the skin or other superficial tissue + is sharp, well-defined, and clearly located =

Answer 17

Superficial Pain

Question 18

What types of injuries produce superficial pain?

Answer 18

Minor Wounds + Minor (1st degree) Burns

Question 19

IASP =

Answer 19

International Association for the Study of Pain

Question 20

What type of pain is defined by the IASP as caused by a lesion or a disease of the somatosensory nervous system?

Answer 20

Neuropathic Pain

Question 21

What kind of pain is typically described by PT’s as “burning” or “like pins and needles”?

Answer 21

Neuropathic Pain

Question 22

What disease processes can cause neuropathic pain?

Answer 22

Diabetes Mellitus, Strokes, and HIV

Question 23

Why is neuropathic pain generally undertreated?

Answer 23

Because it typically doesn’t respond to analgesics (painkillers)

Question 24

What meds are usually used to combat neuropathic pain?

Answer 24

Tricyclic Anti-depressant + Gabapentin

Question 25

If pain from retained gas in the colon causes pain to be perceived in the shoulder, does that mean that the pain is considered radiating?

Answer 25

Yes, because it is causing pain to be perceived at a location other than the site of the painful stimulus

Question 26

Nurses must consider what kinds of factors while assessing/providing holistic care for PT’s in pain?

Answer 26

Biological, Psychological, Social Factors

Question 27

What kind of pain has a limited duration and is associated with a specific cause?

Answer 27

Acute Pain

Question 28

What kind of pain usually causes a physiological response resulting in increased pulse, respirations, and BP?

Answer 28

Acute Pain

Question 29

Chronic pain is ongoing and persistent for longer than-

Answer 29

6 Months

Question 30

Chronic pain usually causes a change in vital signs or diaphoresis. True or false?

Answer 30

False, it usually doesn’t.

Question 31

What does chronic pain affect that can influence daily functioning?

Answer 31

Psychological, behavioral, and social functioning

Question 32

Osteoarthritis, spinal conditions, fibromyalgia, and peripheral neuropathy all cause what kind of pain?

Answer 32

These are all chronic conditions, so it causes chronic pain

Question 33

What kind of pain continue even after the original injury or illness has been healed/ resolved?

Answer 33

Chronic Pain

Question 34

Is it possible to suffer chronic pain even if there hasn’t been any previous injury or illness?

Answer 34

Yes

Question 35

Muscle tension, immobility, low energy, changes in appetite, and emotional pain are all effects of what kind of pain on the body?

Answer 35

Chronic Pain

Question 36

Depression, anger, and fear of re-injury are all considered to be what kind of pain?

Answer 36

Emotional Pain

Question 37

Are older adults at an increased risk for under-treatment of pain?

Answer 37

Yup

Question 38

It’s estimated that up to what percentage of older adults in the community have pain due to chronic conditions?

Answer 38

70%

Question 39

It’s estimated that up to what percentage of older adults living in long-term care centers have pain due to chronic conditions?

Answer 39

Up to 85%

Question 40

Why is pain often under-assessed in older adults?

Answer 40

Because they are less likely to report it + it can present atypically with confusion and agitation

Question 41

Is pain described as the 5th vital sign?

Answer 41

Yup

Question 42

Pain assessment and pain management began to undergo significant changes when?

Answer 42

1990s

Question 43

What trends led to liberal prescribing of opioid pain meds for acute + chronic pain?

Answer 43

Healthcare providers began focusing on pain scores

Question 44

What encouraged + incentivized the aggressive treatment of pain in the 1990s?

Answer 44

Pain Scores

Question 45

What resulted from the push to effectively manage pain?

Answer 45

An Opioid Crisis

Question 46

Do pain management and the opioid crisis continue to influence each other as they evolve?

Answer 46

Yup

Question 47

Pain treatment plans must -

Answer 47

Balance pain control, optimize functioning, and enhance quality of life all while minimizing the risk of opioid misuse

Question 48

Reduced response to pain meds when the same dose has been given repeatedly, requiring a high dose of the drug to achieve the same level of response =

Answer 48

Tolerance

Question 49

A patient is receiving morphine for palliative care, why would the dosage of the morphine need to increase over time?

Answer 49

Tolerance

Question 50

Withdrawal symptoms that occur when a chronic pain med is suddenly reduced/stopped because of physiological changes that occur to chronic exposure to a medication =

Answer 50

Physical Dependence

Question 51

What are some symptoms of withdrawal?

Answer 51

Diaphoresis (sweating), goose bumps, vomiting, anxiety, insomnia, and muscle pain

Question 52

A PT take’s someone else’s pain medication but it’s to reduce pain. Is this still considered misuse?

Answer 52

Yup

Question 53

Significant impairment/ distress from a pattern of substance use (includes alcohol, drugs, or prescription meds) =

Answer 53

Substance Abuse Disorder

Question 54

Inability to abstain, impaired behavior control, cravings, diminished recognition of problems, dysfunctional emotional response =

Answer 54

Addiction

Question 55

Substance Abuse Disorder can be characterized by using more substance than planned or using for more time than planned. True or false?

Answer 55

True

Question 56

Substance Abuse Disorder can be characterized by an inability to cut down. True or false?

Answer 56

True

Question 57

Substance Abuse Disorder can be characterized by cravings/ intense urges. True or false?

Answer 57

True

Question 58

Substance Abuse Disorder can be characterized by spending a substantial amount of the day obtaining, using, or recovering. True or false?

Answer 58

True

Question 59

Substance Abuse Disorder can be characterized by spending a large amount of money. True or false?

Answer 59

True

Question 60

Substance Abuse Disorder can be characterized by an inability to meet important professional or social obligations. True or false?

Answer 60

True

Question 61

How many characterizations of substance abuse disorder do you have to experience in order to have a substance abuse disorder?

Answer 61

2 or more characterizations

Question 62

Substance Abuse Disorder can be characterized by persistent usage despite knowing its causing problems. True or false?

Answer 62

True

Question 63

Substance Abuse Disorder can be characterized by engaging in risky behaviors, like driving under the influence. True or false?

Answer 63

True

Question 64

Pain assessment and management standards were recently revised and published when and by who?

Answer 64

2018, The Joint Commission (TJC)

Question 65

The revised standards by The Joint Commission requires hospitals to identify what as an organizational priority?

Answer 65

Pain Assessment + Pain Management (Including Safe Opioid Prescribing)