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Flashcards in Pain (Comfort) Deck (25)
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What are the three types of responses to pain? Give an example of each.

1) Behavioral (Voluntary) - Moving away from painful stimuli, grimacing, moaning and crying.
2) Physiologic (Involuntary) - Increased BP, HR & pulse, nausea and vomitting.
3) Affective (Psychological) - Withdrawal, anxiety, depression, fear, anger, fatigue, anorexia, powerlessness and hopelessness.


Describe cutaneous pain vs.
somatic pain vs.
visceral pain

1) Cutaneous Pain - Superficial pain in the skin or subcutaneous tissue.
2) Somatic Pain - Pain originating from bones, tendons, ligaments, blood vessels and nerves.
3) Visceral Pain - Pain originating from body organs in the thorax, cranium and abdomen.


Define neuropathic pain.

Pain resulting from an injury to a nerve. It is often described as stabbing or burning.


Define intractable pain.

Pain that is resistant to therapy and persists despite a variety of interventions.


Define psychogenic pain.

Pain for which no physical cause can be identified.


Women who have had a hysterectomy can have a dropped bladder which could cause referred pain where?

Down the thighs


What is the single most reliable indicator of the existence and intensity of acute pain and resultant affective discomfort or distress?

The patient's self report


What specific areas of the body does not have much referred pain?

The extremities, if you get a paper cut or a knee scrape, there usually isnt any referred pain.


What is PAINAD?

The Pain Assessment in Advanced Dementia scale - developed to assess pain in cognitively impaired individuals. It relies on the observation of 5 things: breathing, vocalization, facial expression, body language, and consolability.


What is the best scale to use to assess patients with dementia and other cognitively impaired patients?

Wong-Baker Faces scale


Define Pain Tolerance.

The point beyond which a person is no longer willing to endure pain.


(T/F) Fatigue tends to increase pain, therefore, promoting rest is helpful in treating pain?



Name the 10 Non-Pharmacologic methods mentioned in Taylor, used to relieve pain?

1) Using Distraction 2) Employing Humor
3) Listening to Music 4) Using Imagery
5) Employing Relaxation 6) Using Cutaneous Stimulation
7) Using Acupuncture 8) Using Hypnosis
9) Employing Biofeedback 10) Providing Therapeutic Touch


Name four forms of Cutaneous Stimulation used as a nonpharmacologic means of relieving pain?

1) Massage
2) Application of heat or cold
3) Acupressure
4) Transcutaneous Electrical Nerve Stimulation (TENS) - Requires a physician's order.


Describe what each number in the numeric sedation scale signifies?

1 = Awake and alert; no action necessary
2 = Occasionally drowsy but easy to arouse; requires no action
3 = Frequently drowsy and drifts off to sleep during conversation; decrease the opioid dose.
4 = Somnolent with minimal or no response to stimuli; discontinue the opioid and consider use of naloxone.


What is the difference between physical dependence and addiction?

1) Physical dependence - When the body becomes physiologically accustomed to the opioid and suffers withdrawal symptoms if the opioid is suddenly removed or or the dose is rapidly decreased.
2) Addiction - A pattern of compulsive opioid use for means other pain control.


What are the four characteristics that define addiction?

1) Craving for the substance
2) Compulsive use
3) Lack of control over the drug
4) Continued use despite harm


Name three reasons why adjuvant meds may be used in conjunction with opioids?

1) Used to enhance the effect of opioids by providing additional pain relief.
2) Used to reduce side effects.
3) Used to lessen anxiety about the pain experience.


What kind of patients are indicated for the use of a PCA? What kind of patients are not recommended for this type of pain relief?

1) Indicated for PTs who are alert and capable of controlling the unit.
2) Not recommended for confused elderly PTs, children, cognitively impaired PTs, and PTs who are sedated.


Name 6 nursing strategies a nurse can implement that will most likely assist the patient to achieve pain relief outcomes?

1) Establish a trusting nurse-patient relationship
2) Manipulate factors affecting the pain experience
3) Use nonpharmacologic methods
4) Use Pharmacologic methods
5) Teach patient and family about pain
6) Ensure ethical and legal responsibility to relieve pain


Name 2 physical pain relief techniques?

1) Positioning and hygiene
2) Cutaneous stimulation


Name 4 cognitive pain relief techniques

1) Anticipatory guidance
2) Distraction
3) guided imagery
4) Hypnosis


Name 3 behavioral pain relief techniques

1) relaxation
2) meditation
3) biofeedback


Opioid-induced respiratory depression is usually preceded by what?



Describe the steps of the 3-step ladder for cancer pain relief and palliative care.

1) Step 1 - nonopioid +/- adjuvant
2) Step 2 - opioid for mild to moderate pain relief + nonopioid +/-
3) Step 3 - opioid for moderate to severe pain relief + nonopioid +/-