Comfort: Pain Assessment and Management

How does the International Association for the Study of Pain define pain?

An unpleasant sensory and emotional experience related to actual or potential tissue damage.

What is Margo McCaffery’s clinical definition of pain?

Pain is whatever the person experiencing it says it is.

What is considered the gold standard and most reliable indicator of pain?

The patient’s self-report.

Where are nociceptors found in the human body?

In most tissues except the central nervous system.

What are the four phases of the pain process?

Transduction, Transmission, Perception, and Modulation.

What occurs during the transduction phase of the pain process?

Tissue damage releases chemical mediators that activate nociceptors, which triggers electrical signals in sensory nerves.

What occurs during the transmission phase of the pain process?

Pain signals travel through nerve fibers to the spinal cord and brain.

What occurs during the perception phase of the pain process?

The brain interprets pain signals in multiple regions, including the cortex and limbic system; it is influenced by past experiences, beliefs, and emotions.

What occurs during the modulation phase of the pain process?

The brain releases natural pain-relieving chemicals that reduce pain signal transmission.

What duration threshold distinguishes chronic pain from acute pain?

Chronic pain lasts longer than $3$ months and may persist for years, whereas acute pain begins suddenly, is linked to injury or illness, and improves with healing.

What causes nociceptive pain and what words commonly describe it?

It results from a normal response to tissue injury and is often described as aching, cramping, or throbbing.

What causes neuropathic pain and what words commonly describe it?

It results from damage to the nervous system and is often described as burning, shooting, or sharp.

What are two clinical examples of neuropathic pain?

Diabetic neuropathy and phantom limb pain.

How is cutaneous pain defined, and what is an example?

Superficial pain that usually involves the skin or subcutaneous tissue; an example is a paper cut.

How is somatic pain defined, and what is an example?

Diffuse pain that originates in tendons, ligaments, bones, blood vessels, or nerves; an example is deep bruising.

How is visceral pain defined, and what is an example?

Poorly localized pain that originates in organs; an example is tensing the abdomen in acute abdominal pain.

How is referred pain defined, and what is an example?

Pain that originates in one part of the body but is felt in an area distant from the origin; an example is myocardial infarction pain felt in the left arm or jaw.

At what age can children typically begin to accurately assign a number to their pain on a numeric scale?

Around $8$ years of age.

For what populations is the Wong–Baker FACES scale indicated?

Adults and children as young as $3$ years old.

What five categories comprise the FLACC pain assessment tool?

Face, Legs, Activity, Cry, and Consolability.

What is the clinical indication for the PAINAD (Pain Assessment in Advanced Dementia) scale?

Adults with advanced dementia who are not able to verbalize their needs.

What five criteria are evaluated on the PAINAD scale?

Breathing (independent of vocalization), Negative Vocalization, Facial Expression, Body Language, and Consolability.

For which patient population is the Critical Care Pain Observation Tool (CPOT) indicated?

Patients in critical-care units who cannot self-report pain, whether or not they are intubated.

What does each letter stand for in the COLDSPA pain assessment mnemonic?

Character, Onset, Location, Duration, Severity, Pattern, and Associated Factors/How it Affects Patient.