Pain Types and Viscerogenic Pain Patterns Flashcards Preview

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Flashcards in Pain Types and Viscerogenic Pain Patterns Deck (93)
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1

What are the characteristics of VASCULAR pain?

Throbbing
Pounding
Pulsing
Beating

2

What are the characteristics of NEUROGENIC pain?

Sharp
Crushing
Pinching
Burning
Hot
Searing
Itchy
Stinging
Pulling
Jumping
Shooting
Electrical
Gnawing
Pricking

3

What are the characteristics of MUSCULOSKELETAL pain?

Aching
Sore
Heavy
Hurting
Deep
Cramping
Dull

4

What are the characteristics of EMOTIONAL pain?

Tiring
Miserable
Vicious
Agonizing
Nauseating
Frightful
Piercing
Dreadful
Punishing
Exhausting
Killing
Unbearable
Annoying
Cruel
Sickening
Torturing

5

What are the contents of the Verbal Descriptor Scale (VDS)?

0 = No pain
1 = Slight pain
2 = Mild pain
3 = Moderate pain
4 = Severe pain
5 = Extreme pain
6 = Pain as bad as it can be

6

What are symptoms of pain characterized as in patients with cognitive impairments?

Verbal comments such as "ouch" or "stop"

Nonverbal vocalizations (moans, sighs, gasps)

Facial grimacing or frowning

Audible breathing independent of vaocalization (labored, short or long periods of hyperventilation)

Agitation or increased confusion

Unable to be consoled or distracted

Bracing or holding onto furniture

Decreased mobility

Lying very still, refusing to move

Clutching painful area

Resisting care provided by others, striking out, pushing others away

Sleep disturbance

Weight loss

Depression

7

What is the Nursing Assessment of Pain (PQRST)?

PROVOCATION and PALLIATION. What causes the pain and what makes it better or worse?

QUALITY of pain. What type of pain is present (aching, burning, sharp)?

REGION and RADIATION. Where is the pain located ? Does it radiate to other parts of the body?

SEVERITY on a scale of 1-10. Does the pain interfere with daily activities, mood, function?

TIMING. Did pain come on suddenly or gradually? Intermittent? How often? How long? Does it come at the same time?

8

What are the characteristics of SYSTEMIC pain pertaining to ONSET?

Recent, sudden

Does not present as observed for years without progression of symptoms

9

What are the characteristics of SYSTEMIC pain pertaining to DESCRIPTION?

Knife-like (stabbing from the inside out), boring, deep ache

Cutting, gnawing

Throbbing

Bone pain

Unilateral or bilateral

10

What are the characteristics of SYSTEMIC pain pertaining to INTENSITY?

Related to the degree of noxious stimuli; usually unrelated to presence of anxiety

Mild to severe

Dull to severe

11

What are the characteristics of SYSTEMIC pain pertaining to DURATION?

Constant, no change, awakens person at night

12

What are the characteristics of SYSTEMIC pain pertaining to PATTERN?

Although constant, may come in waves

Gradually progressive, cyclical

Night pain
- Location: Chest and shoulder
- Accompanied by shortness of breath, wheezing
- Eating alters symptoms
- Sitting up relieves symptoms (decreases venous return to the heart: possible pulmonary or cardiovascular etiology)

Symptoms unrelieved by rest or change in position

Migration arthralgias (pain/symptoms last for 1 week in 1 joint, then resolve and appear in another joint)

13

What are the characteristics of SYSTEMIC pain pertaining to AGGRAVATING FACTORS?

Cannot alter, provoke, alleviate, eliminate, or aggravate the symptoms

Organ dependent (examples):
- Esophagus--eating or swallowing affects symptoms
- Heart--cold, exertion, stress, heavy feeling affects symptoms
- GI--peristalsis affects symptoms

14

What are the characteristics of SYSTEMIC pain pertaining to RELIEVING FACTORS?

Organ dependent examples:
- Gallbladder--leaning forward may reduce symptoms
- Kidney--leaning to the affected side may reduce symptoms
- Pancreas--sitting upright or leaning forward may reduce symptoms

15

What are the characteristics of SYSTEMIC pain pertaining to ASSOCIATED S&S?

Fever, chills

Sweats

Unusual vital signs

Warning signs of cancer

GI symptoms (nausea, vomiting, anorexia, unexplained weight loss, diarrhea, constipation)

Early satiety (feeling full after eating)

Bilateral symptoms (paresthesias, weakness, edema, nail bed changes, skin rash)

Painless weakness of muscles (more often proximal, but may occur distally)

Dyspnea (breathlessness at rest or after mild exertion)

Diaphoresis (excessive perspiration)

Headaches, dizziness, fainting

Visual disturbances

Skin lesions, rashes, or itching that the client may not associate with the musculoskeletal symptoms

Bowel/bladder symptoms
- Hematuria (blood in the urine)
- Nocturia
- Urgency (sudden need to urinate)
- Frequency
- Melena (blood in the feces)
- Fecal or urinary incontinence
- Bowel smears

16

What are the characteristics of MUSCULOSKELETAL pain pertaining to ONSET?

May be sudden or gradual, depending on history
- SUDDEN--usually associated with acute overload stress, traumatic event, repetitive motion; can occur as a side effect of some meds (statins)
- GRADUAL--secondary to chronic overload of the affected part; may be present off and on for years

17

What are the characteristics of MUSCULOSKELETAL pain pertaining to DESCRIPTION?

Usually unilateral

May be stiff after prolonged rest, but pain level decreases

Achy, cramping pain

Local tenderness to pressure is present

18

What are the characteristics of MUSCULOSKELETAL pain pertaining to INTENSITY?

May be mild to severe

May depend on the person's anxiety level--the level of pain may increase in a client fearful of a "serious" condition

19

What are the characteristics of MUSCULOSKELETAL pain pertaining to DURATION?

Can be modified by rest or change in position

May be constant but is more likely to be intermittent, depending on the activity or the position

20

What are the characteristics of MUSCULOSKELETAL pain pertaining to PATTERN?

Restriction of active/passive/accessory movements observed

One or more particular movements "catch" the patient and aggravate pain

21

What are the characteristics of MUSCULOSKELETAL pain pertaining to AGGRAVATING FACTORS?

Altered by movement; pain may become worse with movement or some myalgia decreases with movement

22

What are the characteristics of MUSCULOSKELETAL pain pertaining to RELIEVING FACTORS?

Symptoms reduced or relieved by rest or change in position

Muscle pain is relieved by short periods of rest without resulting stiffness, except in the case of fibromyalgia; stiffness may be present in older adults

Stretching

Heat, cold

23

What are the characteristics of MUSCULOSKELETAL pain pertaining to ASSOCIATED S&S?

Usually none, although stimulation of trigger points (TrPs) may cause sweating, nausea, blanching

24

What are all the possible SOURCES of pain?

Cutaneous
Deep somatic
Visceral
Neuropathic
Referred

25

What are all the possible TYPES of pain?

Tension

Inflammatory

Ischemic

Myofascial pain
- Muscle tension
- Muscle spasm
- Trigger points (TrPs)
- Muscle deficiency (weakness and stiffness)
- Muscle trauma

Joint pain
- Drug induced
- Chemical exposure
- Inflammatory bowel disease
- Septic arthritis
- Reactive arthritis

Radicular pain

Arterial, pleural, tracheal

Gastrointestinal pain

Pain at rest

Night pain

Pain with activity

Chronic pain

26

What are all the possible CHARACTERISTICS/PATTERNS of pain?

Client describes:
- Location/onset
- Description
- Frequency
- Duration
- Intensity

Therapist recognizes the pattern:
- Vascular
- Neurogenic
- Musculoskeletal/spondylotic
- Visceral
- Emotional

27

What conditions cause CENTRAL neuropathic pain?

Multiple sclerosis (MS)

Headache (migraine)

Stroke

Traumatic brain injury (TBI)

Parkinson's disease

Spinal cord injury (incomplete)

28

What conditions cause PERIPHERAL neuropathic pain?

Trigeminal neuralgia (Tic douloureux)

Poorly controlled diabetes mellitus (metabolic-induced)

Vincristine (drug-induced, used in cancer treatment)

Isoniazid (drug-induced, used to treat tuberculosis)

Amputation (trauma)

Crush injury/brachial avulsion (trauma)

Herpes zoster (shingles, postherpetic neuralgia)

Complex regional pain syndrome (causalgia)

Nerve compression syndromes (carpal tunnel syndrome, thoracic outlet syndrome)

Paraneoplastic neuropathy (cancer-induced)

Cancer (tumor infiltration/compression of nerve)

Liver or biliary impairment (liver cancer, cirrhosis, primary biliary cirrhosis)

Leprosy

Congenital neuropathy (porphyria)

Guillain-Barre syndrome

29

What are the risk factors for rhabdomyolysis as far as trauma?

Crush injury

Electrical shock

Severe burns

Extended mobility

30

What are the risk factors for Rhabdomyolysis?

Trauma

Extreme muscular activity

Toxic effects

Metabolic abnormalities

Medication-induced