Types of Pain
This type of pain is protective, with an identifiable cause, of short duration, resolves when the cause resolves, and causes short-term anxiety/fear.
What is acute pain?
The single most reliable indicator of pain.
What is a patient's self-report of pain?
These are the most common and effective method of pain relief.
What are analgesics?
Name 2 nonpharmacological interventions for pain.
What is acupuncture, massage, osteopathic and chiropractic manipulation, cognitive-behavioral interventions (distraction, prayer, mindfulness, relaxation, guided imagery, music, and biofeedback, meditative movement and mind-body interventions, and dietary and self-management approaches?
The nurse can expect to collaborate with many health care disciplines in pain management. Name 3.
What are advanced practice registered nurses, pharmacists, physical therapists, occupational therapists, physicians, social workers, psychologists, and clergy?
This pain arises from organs such as the gastrointestinal tract and pancreas and is usually described as deep, dull, aching, squeezing, or pressure-like.
What is visceral pain?
Grimacing, rigid body posture, limping, frowning, or crying are what responses to pain?
What are nonverbal responses to pain?
These are the 2 names/classes of nonopioid analgesics.
What are acetaminophen and NSAIDs (ibuprofen, naproxen, aspirin)?
Cold therapy is best for pain that is from:
Cold therapy treats the localized inflammatory response of an injured body part by reducing edema, hematoma formation, and pain. Specific examples could include an ankle fracture or post-op on the surgical site.
What psychological problems/symptoms will the nurse assess for in a patient with chronic pain? Name 3.
What are job loss, inability to perform simple daily activities, sexual dysfunction, social isolation, fatigue, insomnia, anorexia, weight loss, apathy, hopelessness, depression, and anger?
Name at least 1 area that somatic pain comes from and 1 way it's described by patients.
Somatic pain comes from bone, joint, muscle, skin, or connective tissue and is usually described as sharp, aching, dull, crushing, or throbbing in quality and well localized.
We can use numerical rating scales, verbal descriptor scales, and visual analogue scales. Describe how to use one of these.
What is a numerical rating scale? A numerical rating scale (NRS) requires patients to rate pain on an 11-point line of 0 to 10, with 0 representing no pain and 10 representing the worst pain the patient can imagine. This measures pain intensity before and after intervention.
or
What is a verbal descriptor scale? A verbal descriptor scale (VDS) consists of a line with two- to six-word descriptors equally spaced along the line. You ask a patient to look at the scale and choose the descriptor that best represents the severity of pain.
or
What is a visual analogue scale? A visual analogue scale (VAS) consists of a straight line without labeled subdivisions. The straight line shows a continuum of intensity and has labeled end points. A patient indicates pain by marking the appropriate point on the line.
These are medications originally developed to treat conditions other than pain, but that also have analgesic properties.
What are coanalgesics or adjuvants?
Heat therapy is best for pain that is from:
Moist heat applications are beneficial in increasing skeletal muscle and ligament relaxation and flexibility, promoting healing. Specific examples could include muscle spasms or stiffness.
The nurse knows to assess for these because they occur with pain and usually increase a patient’s pain severity.
What are concomitant symptoms?
A patient with gallbladder disease feels pain in the right shoulder. This is an example of:
What is referred pain?
Your patient is nonverbal due to a cognitive impairment. The pain scale used would then be:
What is the Oucher? or What is the Wong-Baker FACES pain scale?
Name 2 side effects of opioid analgesics.
What are nausea, vomiting, constipation, memory and thought changes, sedation, or respiratory depression?
When using heat or cold therapy, nurses need to use caution due to the risk of injury. Name 2 specific risk factors that put patients at highest risk, where heat or cold therapy may need to be avoided.
What are neuropathies (e.g., diabetic neuropathy, peripheral neuropathy), patients with spinal cord or other neurological disorders, older adults, and patients who are confused?
The current pharmacological approach to acute and chronic pain management is to provide:
What is multimodal analgesia?
2 specific types of pain that can result with cancer pain due to tissue injury and peripheral nerve injury.
What is nociceptive and neuropathic pain?
The mnemonic OLDCARTS or the mnemonic PQRRSTU stand for:
What is onset, location, duration, character, aggravating/relieving factors, timing, and severity?
What is palliative or provacative factors, quality, relief measures, region (location), severity, timing, and effect of the pain?
This was developed by The World Health Organization (WHO) in 1986 as a recommended approach for the slow introduction and upward titration of analgesics for managing pain.
What is the analgesic ladder?
There are nurse-initiated (independent), nonpharmacologic interventions for pain. Name 2.
What is distraction, prayer, mindfulness, relaxation, guided imagery, music, massage, or biofeedback?
The nurse is communicating with the physician on behalf of a patient whose current medication regimen is not controlling their pain. What specific nursing role is the nurse demonstrating?