Pain & Comfort

What is the definition of pain?

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

What distinguishes acute pain from chronic pain?

Acute pain has a sudden onset and lasts less than 6 months, while chronic pain lasts more than 6 months.

What is referred pain?

Pain felt distant from its source, such as left arm pain during a myocardial infarction.

What are the four stages of the pain pathway physiology?

Transduction, Transmission, Perception, and Modulation.

What does the Gate-Control Theory suggest about pain perception?

Pain impulses can be blocked by stimulating larger A-fiber input.

What are some common physiologic responses to pain?

Increased heart rate, blood pressure, respiratory rate, and gastrointestinal discomfort.

What subjective factors are important in pain assessment?

Client’s description, pain scale, location, duration, quality, intensity, and factors that aggravate or relieve the pain.

What is PCA in pain management?

Patient-Controlled Analgesia allows the client to activate the IV pump for pain relief.

What is the maximum daily dose of Acetaminophen?

3,000 to 4,000 mg per day.

What should be monitored when administering opioid analgesics?

Respiratory rate, sedation, and bowel function.

What is a key nursing priority regarding pain management?

To believe the client’s report of pain.

What role does age play in pain sensitivity?

Older adults generally have increased sensitivity to pain.

What assessment tool is recommended for infants and nonverbal clients?

The FLACC scale.

What are non-pharmacologic methods for managing pain?

Relaxation, deep breathing, massage, TENS, distraction, ice/heat, repositioning

How should pain relief be evaluated after administering analgesics?

Reassess 30-60 minutes later and document pain score and response. *15 mins for opioid*

What is Radiating Pain?

Radiating — Extends from origin to adjacent area. Low-back → leg

What is Phantom Pain?

Phantom — Pain in missing limb. Post-amputation

What is Neuropathic Pain?

Neuropathic — Burning, shooting, nerve injury. Diabetic neuropathy

What is the first pain pathway?

Transduction: Pain stimulus → electrical impulse.

What is the second step in the pain pathway?

Transmission: Impulse travels via A-delta & C fibers → spinal cord → brain.

What is the third step in the pain pathway?

Perception: Conscious awareness of pain in cerebral cortex.

What is the fourth step in the pain pathway?

Modulation: Brain sends inhibitory signals (endorphins, serotonin) to reduce pain

What is the Neuromatrix Pain Theory?

Pain perception influenced by genetics, emotions, memory, & stress.

What pain scale would you use for a patient with dementia?

PAINAD

What pain scale would you use for a child 3 years or younger?

Wong-Baker FACES – children > 3 yrs

What pain scale would you use for an infant?

FLACC

List 2 pain assessment tools that can be used for assessing pain

OLD CARTS & PQRST

What is OLD CARTS?

Onset, Location, Duration, Characteristic, Aggravating Factors, Radiation, Treatment, Severity

What is PQRST?

Provocation, Quality, Radiation, Severity, Timing

What is an epidural?

Opioid or local infusion in epidural space — Monitor RR, BP, motor function, catheter site.

Non opioid analgesics & most important side effect

Acetaminophen — hepatotoxicity. & NSAIDs — GI bleed & renal impairment.

List common opioid analgesics & priority nursing assessments.

Morphine, hydromorphone, oxytocin — Monitor RR, sedation, constipation; use stool softeners

What are adjuvant medications? How do they relate to pain management?

Antidepressants, anticonvulsants, local anesthetics — Treat neuropathic pain and enhance analgesia

What is chronic pain?

Pain lasting longer than 6 months, may be chronic or intermittent.