Lec9 Pain assessment

Select the INCORRECT answer regarding bone met pain

a) Pain control can be an issue

b) Consists of background continuous pain and incident pain

c) Continuous pain is localized in a particular area and may worsen with movements, positions, or under pressure

d) Bone met pain can increase in magnitude over the course of the disease

c) Continuous pain is localized in a particular area and may worsen with movements, positions, or under pressure

-incident pain is localized!

Who is the prime assessor of pain?

a) The RO - they know best

b) The radiation therapist - we see them everyday

c) The nurse - doctors often too busy

d) The patient - they are the ones in pain

d) The patient - they are the ones in pain

T/F

Health care professionals often overestimate the pain someone is experiencing

False

-they underestimate often

What does O,P,Q,R,S,T,U stand for in terms of pain assessment?

O: onset

P: provoking

Q: quality

R: Region/radiation

S: severity

T: treatment

U: understanding the impact

Which of the following is NOT a question relating to 'provoking' for pain assessment?

a) What makes it better?

b) What makes it worse?

c) What does it feel like?

d) What brings it on?

c) What does it feel like?

-this question relates to 'quality' of pain

-remember provoking refers to activities that makes it worse/better

List the 4 barriers to pain management

1. Patient related barriers

2. Physician related barriers

3. Healthcare system related barriers

4. Disease related barriers

Which of the following is a patient related barrier to pain management?

a) Inadequate knowledge and suboptimal use of available techniques

b) Cost of analgesics

c) Progressive disease, tissue damage and pain

d) Misconceptions about pain and available treatments

a) Inadequate knowledge and suboptimal use of available techniques - physican related

b) Cost of analgesics - healthcare system related

c) Progressive disease, tissue damage and pain - disease related

d) Misconceptions about pain and available treatments -patient related

Which of the following is a physician related barrier to pain management?

a) Poor availability, underutilization of advanced modalities for pain management

b) Injury, inflammation, nerve damage

c) Inadequate pain assessment

d) Fear of opioid addiction

a) Poor availability, underutilization of advanced modalities for pain management - healthcare system related

b) Injury, inflammation, nerve damage - disease related

c) Inadequate pain assessment - physician related

d) Fear of opioid addiction - patient related

Which of the following is a healthcare system related barrier to pain management?

a) Insufficiant pain education, training amongst professionals

b) Reluctance to report pain

c) Co-morbidities

d) Reluctance to prescribe opioids

a) Insufficiant pain education, training amongst professionals - healthcare system related

b) Reluctance to report pain - patient related

c) Co-morbidities - disease related

d) Reluctance to prescribe opioids - physician related

Which of the following describes neuropathic pain?

a) Responds well to analgesics

b) Pain arises from chemical or natural stimuli from damaged tissue

c) Burning, shooting, stinging in nature

d) Inflammatory

c) Burning, shooting, stinging in nature

= neuropathic pain

-all other options described nociceptive pain

What is the difference between spontaneous flare up pain and incident flare up pain?

Spontaneous: sudden and unexpected

Incident: associated with an action (movement, breathing) and can be anticipated

T/F

Flare up pain does not respond well to pain killers

True

When should baseline medications be taken?

a) As needed

b) 4 hrs apart

c) Once a day or twice a day (12 hrs apart)

d) Any of the above

c) Once a day or twice a day (12 hrs apart)

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When should breakthrough medication be taken?

a) As needed

b) Once a day or twice a day (12 hrs apart)

c) 1 hr before treatment and repeated every 4-6 hrs

d) 1 hr after waking up and repeated every 4-6 hrs

c) 1 hr before treatment and repeated every 4-6 hrs

Which of the following is a non-opioid?

a) Tramadol

b) Levorphanol

c) Methadone

d) Naproxen

d) Naproxen

Which of the following is NOT a weak opioid?

a) Codeine

b) Morphine

c) Hydrocodene

d) Tramadol

b) Morphine

-this is a strong opioid

Which of the following opioids is the strongest?

a) Hydromorphine

b) Methadone

c) Morphine

d) Levorphanol

a) Hydromorphine

Which of the following opioids is the weakest?

a) Oxycodone

b) Fentanyl

c) Morphine

d) Levorphanol

c) Morphine

T/F

Opiods are the mainstay treatment for cancer pain

True