Pain Management (ch 13)

Question 0

Acute pain

Answer 0

• usually of recent onset and commonly associated with a specific injury.
• indicates that damage or injury has occurred.
• last from seconds to 6 months

Question 1

3 basic categories of pain

Answer 1

Acute, chronic (nonmalignant), and cancer-related pain

Question 2

Chronic pain

Answer 2

• constant or intermittent pain that persists beyond the expected healing time
• seldom attributed to a specific cause or injury
• may have poorly designed onset
• often difficult to treat because cause or origin may be unclear.
• usually becomes a problem in its own right
• serves no useful purpose

Question 3

Pain

Answer 3

An unpleasant sensory and emotional experience associated with actual or potential tissue damage.

Question 4

Cancer-related pain

Answer 4

-pain associated with cancer may be acute or chronic
-can be directly associated with the cancer, a result of cancer treatment, or not associated with the cancer
(Most pain associated with cancer is direct result of tumor involvement)

Question 5

Effects of Acute Pain

Answer 5

• unrelieved acute pain can affect the pulmonary, cardiovascular, gastrointestinal, endocrine, and immune systems.
• “stress response”:
  - increased metabolic rate and cardiac output
  - impaired insulin response
  - increased production of cortisol
  - increased retention of fluids

Question 6

Effects of Chronic Pain

Answer 6

• suppression if the immune function associated with chronic pain may promote tumor growth.
• depression
• disability
• failure to administer adequate pain relief may be unsafe because of the consequences of unrelieved pain.

Question 7

Factors Influencing Pain Response

Answer 7

-past experiences with pain: the more experience a person has had with pain, the more frightened he/she is likely to be about subsequent painful events.
-anxiety: (relevant or related to pain) may increase the patient’s perception of pain; unrelated to pain) may distract the patient and may actually decrease the perception of pain; most effective way to relieve pain is by directing the treatment at the pain rather than the anxiety.
-culture: beliefs about pain and how to respond to it differ from one culture to the next (people from diff cultures who experience the same intensity of pain may not report it or respond to it in the same ways)
-age: because elderly have a slower metabolism and greater ratio of body fat to muscle mass compared to younger people, small doses of analgesics may be sufficient to relieve pain-may be effective longer
-decrease in myelinated fibers partly responsible for decrease in expression of major myelin proteins–causes a gradual
reduction in endoneural blood flow with increasing age, which may contribute to reduced peripheral nerve
function and diminished pain perception.
-gender: study results have been inconsistent, but some show women consistently report higher pain intensity, pain unpleasantness, frustration, and fear, compared to men.
-genetics
-expectations about pain relief