NURS 2910 > Pain Assessment > Flashcards

Pain Assessment Flashcards

(53 cards)

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1
Q

Pain is the most common reason to seek medical care in the U.S. T or F

A

TRUE

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2
Q

What is pain?

A
  • unpleasant sensory/ emotional experience
  • can have destructive effects
    -can warn of potential injury
  • multidimensional experience
  • pain can effect life/ job/ intimacy
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3
Q

Pain is NOT unique to each person T or F

A

FALSE

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4
Q

Origins of pain

A
  • cutaneous/ superficial
  • deep somatic
  • viseral
  • radiating/ referred
  • phantom
  • Psychogenic
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5
Q

Cutaneous/ superficial pain

A
  • short term pain
  • papercut, touch hot item
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6
Q

Deep Somatic pain

A
  • pain originating in ligaments, tendons, nerves, bones(fracture/ sprain)
  • more localized and achy feeling
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7
Q

Visceral pain

A
  • Deep internal pain receptors
  • tight/ pressure/ crampy
  • menstrual cramps
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8
Q

Radiating Pain

A
  • pain starts at origin and extends to other locations
  • sore throat> pain in ear, GERD
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9
Q

Phantom pain

A
  • Pain in the area that has been removed
  • amputations
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10
Q

Psychogenic pain

A
  • pain arise from mind
  • no physical cause
  • mental pain
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11
Q

Referred pain

A
  • Pain is distent from origin
  • heart attack> arm pain
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12
Q

Classifications of pain

A
  • By cause
  • By duration/ onset
  • Description
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13
Q

BY CAUSE: classification

A
  • Nociceptive
  • Neuropathic
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14
Q

BY DURATION/ONSET: classification

A
  • Acute> short term, less than 6mo
  • Chronic> long term, more than 6mo
  • Intractable> intense pain won’t go away
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15
Q

BY DESCRIPTION: classification

A
  • Quality> dull/stabbing
  • Periodically> episode come and go?
  • Intensity> mild/ moderate/ long lasting
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16
Q

Nociceptive Cause

A
  • Respond to stimuli that is potentially damaging
  • trauma, surgery, aching
  • Somatic> sin, muscles, bone, connective tissue pain
  • Viserable> organ pain
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17
Q

Neuropathic Cause

A
  • complex pain, often chronic
  • nerve injury> stroke/ tumor, diabetes
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18
Q

Physiology of pain terms

A
  • Transduction
  • Transmission
  • Pain perception
  • Pain modulation
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19
Q

Transduction

A
  • Activation of nociceptors by stimuli
  • Mechanical stimuli> external forces, friction on body
  • Thermal stimuli> heat/ cold
  • Chemical stimuli> external reason, lemon juice
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20
Q

Transmission

A
  • Conduction og pain message to spinal cord
  • A-delta fibers(fast)> sharp pain, last short time
  • C fibers(slow)> dull pain, last long time
  • connected to the spinal cord
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21
Q

Pain Perception

A
  • Recognizing and defining pain in cortex
  • perception of pain
  • different for everyone
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22
Q

Pain Modulation

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A
  • Changing pain perception
  • facilitate or inhibit pain
  • endogenous analgesia or gate control theory
23
Q

Factors that influence pain

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A
  • emotions
  • past experiences with pain
  • developmental stage
  • sociocultural status
  • communication skills
  • cognitive impairments
24
Q

Pediatric considerations with pain

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A
  • Newborns have same sensitivity to pain as older infants
  • infants and small children respond to pain by crying
  • neonates> pain response may be subtle
  • chronic pain affect 15-20%
  • fetuses may feel pain as early as 20 weeks
  • children and infants> pain is assessed thru self- report, behavioral observations, or physiological measures
  • Wong-Baker FACES pain scale
  • Oral Sucrose
25
Older Adult considerations with pain
- 1 in 3 adults report having pain that interferes with normal functioning - cognitive impairment can prevent some older adults from reporting pain - importance of nonverbal cues - persistent pain is common - greater risk for undertreatment - risk of overtreament - poor pain management risk
26
Collecting objective data: DURING EXAM
- make sure you are using correct assessment tool - explain to client why we are rating their pain - ensure privacy - report clients behavior - understand different cultures response to pain
27
Collecting objective data: PHYSICAL EXAM
- General impressions> any sign of pain? - Vital signs
28
Collecting objective data: GENERAL IMPRESSION
- observe posture - facial expressions - face, legs, activity, cry, concolability - inspect joints and muscles - observe skin for scars, lesions, rashes, changes and discoloration
29
Collecting objective data: VITAL SIGNS
- Measure HR, RR, BP - Vital usually go up when in pain
30
Bodies reaction to pain
- Sympathetic> fight or flight(1st) - Parasympathetic> rest and digest(2nd)
31
Impact of unrelieved pain on body systems
- Cardiovascular> clotting, increase vitals - Musculoskeletal> impared muscle function - Respiratory> shallow breathing/ splinting, reduced air flow - Genitourinary - Endocrine - Gastrointestinal> Intestinal secretions - impacts the whole body, not just a focused system
32
COLDSPAA
- Character - Onset - Location - Duration - Severity - Pattern - Associated factors/ how it affects the patient
33
Symptom analysis Mnemonic
COLDSPAA
34
Assessing pain
- obtain a complete pain history - location/ quality - intensity - aggravation/ alleviating factors - timing and duration - impact on ADLs and mobility - psychological and social factors - Pain> 5th vital sign
35
Joint Commission Standards for pain management
- Actively engage medical staff and hospital leadership in improving pain assessment and management, including strategies to decrease opioid use and minimize risk associated with opioid use - Provide at least one non-pharmacological pain modality when clincans determine need for pain treatment - include patients in plan and teach - assessing pain becomes second nature
36
Pain Scales
- Visual analogue scale(VAS) - Numeric rating scale(NRS) - Simple descriptor scale - Wong-Baker faces pain rating scale - FLACC pain scale
37
Visual analogue scale(VAS)
- patient point to level of pain on the scale - simple/ quick - best for adults with no cognitive imparements
38
Numeric Rating Scale(NRS)
- Most common to see - patient rate pain on scale 1 to 10 - make sure patient can read/ count
39
Simple descriptor scale
- List of adjectives that describe pain/ intensity - Dementia patients/ cognitively impaired patients - Can modify to make simpler
40
Wong-Baker faces pain rating scale
- Best for cognitively impared adults and children - choose face that best describes feeling - explain each face/ emotion - for children 3+
41
FLACC pain scale
- Behavioral pain assessment scale - observe nonverbals in patients - pain observed by 5 categories - Face, Legs, Activity, Cry, Consolability
42
Which pain assessment scale is most appropriate for a verbal, alert adult with no cognitive impairments
0-10 Numeric Pain Intensity Scale
43
Which pain assessment scale is most appropriate for a 13-month-old patient
FLACC
44
Nonverbal signs of pain
- Facial expression, posture, body position - vital signs change - behavioral manifestations - pain as an expression of weakness - Assess for depression
45
Nonpharmacological Measures: CUTANEOUS STIMULATION
- Massage - Acupuncture - Acupressure - use of heat or cold - Spinal Cord Stimulator> chronic nuero pain - TENS/ PENS> short- term acute or chronic
46
Nonpharmacological Measures: COGNITIVE-BEHAVIORAL INTERVENTION
- Distractions - Guided imagery - Hypnosis - Therapeutic touch - Humor -Expressive writing - Animal Therapy - Diaphragmatic breathing
47
Nonpharmacological Measures: IMMOBILIZATION
- Splint - Cast
48
Pharmacological Measures
- Nonopioid> NSAIDS/ Acetaminophen - opioid analgesics> IV, transdermal, and epidural form
49
Affinity Bias
Warm up to people to be perceived to be liked
50
Halo Effect
Think everyone is a good person just because you like those people
51
Perception Bias
Tendency to form stereotypes and assumptions
52
Confirmation Bias
tendency to seek info that confirms existing beliefs
53
Group thinking
bias occurs when someone tries to hard to fit in, bias occurs
NURS 2910
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