Module 1: Pain

Question 1

definition of pain

Answer 1

• unpleasant sensory and emotional experience associated with actual or potential tissue damage
• whatever the person says it is (subjective)
• not synonymous with suffering

Question 2

consequences of pain

Answer 2

• unnecessary suffering
• physical and psychosocial dysfunction
• impaired recovery from acute illness and surgery
• immunosuppression
• sleep disturbances

Question 3

definition of suffering

Answer 3

a state of distress associated with events that threaten the intactness of a person

Question 4

why is pain undertreated

Answer 4

• inadequate skills to assess and treat pain
• misconceptions about pain
• inaccurate information about addiction and other side effects of opioids
• fear of hastening death
• patients underreporting pain

Question 5

why is pain underreported

Answer 5

• fear of addiction, tolerance, side effects
• belief that pain is inevitable
• expectation that drugs will not relieve pain
• desire to be a “good” patient and not complain

Question 6

dimensions of pain

Answer 6

• physiological
• sensory → discriminative
• motivational → affective
• cognitive → evaluative

Question 7

perception of pain

Answer 7

occurs when pain is recognized, defined, and responded to

Question 8

modulation of pain

Answer 8

activation of descending pathways that exert inhibitory or facilitatory effects on the transmission of pain

Question 9

dimensions of pain: sensory - discriminative

Answer 9

• the recognition of the sensation as painful
• sensory-pain elements include pattern, area, intensity, and nature

Question 10

dimensions of pain: motivational - affective

Answer 10

• emotional response to pain experience:
  
  • anger
  • fear
  • depression
  • anxiety

Question 11

dimensions of pain: behavioural

Answer 11

• observable actions used to express or control the pain
  
  • facial expressions
  • posturing
  • adjusting social and physical activities

Question 12

dimensions of pain: cognitive - evaluative

Answer 12

beliefs, attitudes, memories, and meaning attributed to pain

Question 13

dimensions of pain: sociocultural

Answer 13

demographics, support systems, social roles, past pain experiences, and culture

Question 14

nociceptive pain

Answer 14

damage to the somatic or visceral tissue

Question 15

somatic tissue pain

Answer 15

• aching or throbbing
• localized
• arises from bone, joint, muscle, skin, or connective tissue

Question 16

visceral tissue

Answer 16

• tumor involvement or obstruction
• arises from internal organs

Question 17

neuropathic pain

Answer 17

• damage to the peripheral nerve or central nervous system
  
  • burning, shooting, stabbing, or electrical in nature
  • sudden, intense, short-lived, or lingering

Question 18

neuropathic pain: peripherally generated

Answer 18

• painful peripheral neuropathies
  
  • felt along many nerves
• painful peripheral monopathies
  
  • one nerve

Question 19

acute pain

Answer 19

temporarily related to injury, resolves after appropriate healing time

Question 20

persistent (chronic) pain

Answer 20

outlasts “usual” healing process

Question 21

incidental pain definition

Answer 21

pain that is caused by a healthcare worker in the clinical setting

Question 22

incidental pain examples

Answer 22

• transfers, ambulation
• bathing
• changing clothes
• dressing changes

Question 23

goals for pain assessment

Answer 23

to describe the patient’s sensory, affective, behavioural, cognitive, and sociocultural pain experience (in that order

Question 24

OPQRSTUV

Answer 24

• onset
• provoking
• quality
• region/radiation
• severity
• timing/treatment
• understanding/impact on you
• values

Question 25

PAIN acronym

Answer 25

* pattern: onset, duration, breakthrough pain * area: locations assists in identifying the cause and treatment * intensity: reliably measure to determine treatment * nature: quality or characteristics of the pain

Question 26

breakthrough pain

Answer 26

a sudden severe pain that erupts while a patient is medicated, usually happens quickly

Question 27

neuropathic qualities of pain

Answer 27

* burning, cold, shooting, stabbing, or itcy

Question 28

nociceptive pain qualities

Answer 28

sharp, aching, throbbing, and cramping

Question 29

scheduling analgesics

Answer 29

used for patients with chronic pain that require constant pain meds rather than PRNs

Question 30

considerations for putting patients on opioids

Answer 30

do not give to patients that are experiencing nausea/vomiting, sedation, and constipation

Question 31

tolerance

Answer 31

when the pts body gets used to the medications being administered, and overtime different opioids or higher dosages are required for the drugs to take effecg

Question 32

psychological dependence

Answer 32

the idea from a patient that they are required to take medications in order to function properly

Question 33

physical dependence

Answer 33

when the patient experiences unpleasant physical symptoms of withdrawal when taken off the medication

Question 34

opioid filtration

Answer 34

essential that doses be titrated up to effect and down as cause of pain diminishes

Question 35

opioids rotation

Answer 35

opioids switched if adverse reactions or not effective

Question 36

opioid toxicity

Answer 36

* caused by the neuro-excitatory activity of opioids or their metabolites * symptoms include: * confusion * myoclonus (a quick and involuntary muscle jerk) * paradoxical pain (abnormal pain) * hyperalgesia (extreme sensitivity to pain) * allodynia (extreme sensitivity to tough)

Question 37

a

Answer 37

a