Week 1: Pain Assessment

Question 1

why is understanding pain important? (3 points)

Answer 1

• it’s a universal symptom experienced by everyone
• can have a profound impact on client function, quality of life, relationships, etc
• nurses help patients understand pain

Question 2

how does the international association for the study of pain define pain?

Answer 2

“an unpleasant sensory and emotional experience associated with actual and potential tissue damage, or described in terms of such”

Question 3

what are the 6 steps that describe the physiology of pain?

Answer 3

-impulse is sensed from PNS
- PNS info travels to the spinal cord/CNS
-CNS determines whether pain may be blocked/allowed to continue
-if allowed, the info travels to the thalamus
- info then travels to the limbic system, where emotions to control pain are produced
-finally the info ends at the cerebral cortex, where pain will be recognized

Question 4

what are the 4 components of pain?

Answer 4

• sensory
  -emotional/affective
  -cognitive
  -social

Question 5

what are the 4 ways to classify pain?

Answer 5

• duration: acute vs chronic
• frequency: continuous vs intermittent
• form: nociceptive vs neuropathic
• associated with cancer

Question 6

what are the 7 types of pain?

Answer 6

• nociceptive
• neuropathic
• visceral
• somatic
• cutaneous
• referred
• parietal

Question 7

what is nociceptive pain?

Answer 7

inflicted pain (tissue damage)

Question 8

what is neuropathic pain?

Answer 8

nerve pain, the pain is real but there is no physical reason for it

Question 9

what is visceral pain?

Answer 9

due to injury of an organ

Question 10

what is somatic pain?

Answer 10

“felt” pain- sensory pain

Question 11

what is cutaneous pain?

Answer 11

superficial/skin pain

Question 12

what is referred pain?

Answer 12

pain felt in one part of the body, but origin is in a different location

Question 13

what is parietal pain?

Answer 13

pain in the lining inside of the abdomen

Question 14

what are red flags of an acute pain assessment?

Answer 14

• sudden onset (explosive headache, painful breathing, chest pain, abdominal pain, severe pain unrelieved by appropriate medication)
  -new onset, undiscernible cause

Question 15

what to do when presented with red flags during an acute pain assessment?

Answer 15

• focused/emergent history
• involve others, family/witnesses
• observation of the patient and their behaviours

Question 16

what are the factors influencing pain in the patient’s experience?

Answer 16

• age
• gender
• culture
  -spiritual
• family and social support
• the personal meaning of pain
• level of anxiety
• coping style
• fatigue
• previous experiences of pain

Question 17

what is the role of the nurse dealing with a patient experiencing pain?

Answer 17

• to observe and notice/monitor changes
• reassessment of pain
• documentation of pain
• make recommendations based on assessments
• advocate for patients
• explore treatment options with client

Question 18

what are the effects of poorly managed pain?

Answer 18

• reduced cognitive/mental function
• sleeplessness, anxiety, fear
• high blood sugar (hyperglycemia)
• increased HR, increased CO
• decreased depth of respiration, decreased cough, sputum retention
• decreased immune system response
• muscle spasm, immobility
• decreased gastric and bowel mobility
• decreased urinary output
• increased suffering for the client and loved ones
• potential for development of chronic pain

Question 19

what are the 8 ways to assess pain?

Answer 19

• OLDCARTSS
• QPQRTSU
• numeric pain severity scale
• pain/distress severity scale
• visual analogue scale-FACES
• FLACC
• brief pain inventory
• universal pain assessment tool