Pain I

Question 1

What is nociception?

Answer 1

the method of feeling pain

Question 2

What is a neuromodulator?

Answer 2

a substance that alters nerve impulse transmission.

Question 3

What is pain threshold?

Answer 3

the point beyond which a stimulus causes pain

Question 4

what is an adjunct or adjuvant?

Answer 4

something that is added as a supplementary rather than an essential part

Question 5

How long must you experience pain for it to be classified as chronic?

Answer 5

> 3 months

Question 6

Describe what deep somatic pain or visceral pain is.

Answer 6

It is pain that is initiated in the ligaments, tendons, bones, blood vessels, and muscles.

described as dull, aching, poorly localized pain. Ex broken bone or sprain

Question 7

What is neuropathic pain?

Answer 7

chronic pain resulting from injury to the nervous system.

Can be to the CNS or PNS

Question 8

What are endogenous chemicals?

Answer 8

chemicals that originate within the body

Question 9

What is pain tolerance?

Answer 9

it is the maximum level of pain that a person is able to tolerate

Question 10

explain the difference between pain threshold and pain tolerance.

Answer 10

Pain threshold is the point where pain can be detected

pain tolerance is the maximum pain that one can endure

Question 11

What is cutaneous/superficial pain?

Answer 11

pain that is detected just below the skin.

This area has a high amount of nociceptors resulting in a well defined, localized pain of short duration

Question 12

What is referred pain?

Answer 12

It is pain that is felt in a part of the body other than its actual source.

Question 13

Define pain.

Answer 13

Pain is whatever the experiencing person says it is, existing wherever the person says it is.

PAIN IS WHAT THE PATIENT SAYS IT IS

Question 14

Who introduced the gate control theory and in what year?

Answer 14

Melzack and Wall in 1965

Question 15

Explain the gate control theory. What does it emphasize?

Answer 15

Pain = physiological process + psychological variables

emphasized the holistic nature of pain.

Question 16

What did the gate control theory develop into?

Answer 16

the neuromatrix theory that includes a genetic component

Question 17

What are the five dimensions of pain? explain each.

Answer 17

1) PHYSIOLOGICAL and SENSORY: the physical sensation/experience
2) AFFECTIVE: emotional aspect
3) BEHAVIOURAL: wincing, crying, irritable, not wanting to move
4) COGNITIVE: perception and coping strategies
5) SOCIOCULTURAL: influence how pain is expressed

Question 18

What are the four phases of nociception?

Answer 18

TRANSDUCTION
TRANSMISSION
PERCEPTION
MODULATION

Question 19

Describe the phase of transduction

Answer 19

1) noxious stimuli cause tissue damage
2) sensitizing chemicals released by damaged cells (ex bradykinins and prostaglandins)
3) chemicals stimulate nociceptors
4) AP generated and travels from periphery to spinal cord

Question 20

What do NSAIDs target to relieve pain?

Answer 20

NSAIDs target the sensitizing substances released by damaged cells such as bradykinins and prostaglandins

Question 21

Describe the transmission phase of nociception.

Answer 21

Has three parts
1) injury site to spinal cord

2) spinal cord to dorsal horn for processing
3) to thalamus (basic pain sensation) and cortex (interprets pain)

Question 22

Describe what perception of pain is

Answer 22

the conscious experience of pain

recognition and definition of pain

Question 23

Describe what perception of pain is

Answer 23

the conscious experience of pain

when pain is recognized, defined and responded to by the individual

Question 24

List 3 substances that are involved in the modulation of pain.

Answer 24

1) endogenous opioids such as enkephalins and endorphins
2) serotonin
3) norepinephrine

Question 25

List 3 substances that are involved in the modulation of pain.

Answer 25

1) endogenous opioids such as enkephalins and endorphins 2) serotonin 3) norepinephrine

Question 26

List the 8 types of pain

Answer 26

ACUTE CHRONIC CUTANEOUS / SUPERFICIAL DEEP SOMATIC VISCERAL REFERRED NEUROPATHIC PHANTOM

Question 27

Describe acute pain

Answer 27

Sudden onset with limited duration has purpose expect elevated HR and BP, will be able to observe signs

Question 28

Describe chronic pain.

Answer 28

more gradual pain becomes chronic after 3-6 months can show no signs Want to limit opioids within 90 days

Question 29

Describe cutaneous / superficial pain

Answer 29

pain on your skin

Question 30

Describe deep somatic pain

Answer 30

muscles, tendons and organs

Question 31

Describe visceral pain

Answer 31

inside the body ex gallstones, chest pain

Question 32

Describe neuropathic pain.

Answer 32

due to damage to the nervous system tingling, electrical ex slipped disk, shingles, diabetic neuropathy

Question 33

What is phantom pain?

Answer 33

feeling in a limb that is no longer there

Question 34

What are some predisposing factors that contribute to acute pain progressing to chronic pain?

Answer 34

Hx of anxiety, depression type A personality Pre-existing chronic pain hx of childhood abuse hx of substance abuse

Question 35

List some factors affecting response to pain.

Answer 35

Pain tolerance Pain threshold Fear and fatigue Developmental factors Sociocultural influences Physchological and physiological factors Nurse's interpretations or biases

Question 36

What are some developmental factors that might influence pain?

Answer 36

older adults do not want to admit pain children can't explain or verbalize pain

Question 37

Describe the three ways that sleep disturbances are associated with pain.

Answer 37

Sleep deprivation inc pain perception and neg affects mood 90 percent of patients with chronic pain also experience sleep disturbances Medications: NSAIDs dec melatonin production OPIOIDS dec REM cycles

Question 38

What should you be sure you are assessing when someone has pain?

Answer 38

sleep disturbances

Question 39

What are the principles to remember when assessing pain?

Answer 39

1) Sensation of pain is completely subjective 2) Pain can't be proven or disproved 3) Pain is whatever the experiencing person says it is 4) The gold standard for assessing existence of pain is the pt's self report of pain 5) People's responses to pain will vary

Question 40

What are some appropriate assessment tools for pain?

Answer 40

OPQRSTA (med-surg) Descriptive scale (mild, mod, severe) Numerical scale (initial assessment tool age relevant factors such as faces

Question 41

List things that can be affected by pain.

Answer 41

Sleep Activity level Concentration Appetite Social activities

Question 42

List things that can be affected by pain.

Answer 42

Sleep Activity level Concentration Appetite Social activities

Question 43

What is the mnemonic OPQRSTA stand for and what is it used for?

Answer 43

it outlines the questions to be asked when assessing pain. ``` Origin Provocation or palliation Quality Region and radiation Severity Time Associated symptoms ```