PrepU: Ch.9 Pain

Acute pain can be differentiated from chronic pain because

* acute pain is associated with a recent onset of illness or injury with a duration of less than 6 months, whereas chronic pain persists longer than 6 months.*

The nurse is working in the post anesthesia care unit and assessing pain in a 6 month old infant. Which method should the nurse use to assess the infant's pain?

*FLACC scale*

The U.S. government has created guidelines for health care providers caring for clients in pain. Which of the following reflect these guidelines?

*Joint Commission Standards for Pain Management.* Joint Commission Standards for Pain Management were revised and published in 2000-2001. The standards require health care providers and organizations to improve pain assessment and management for all patients. (less)

A patient recovering from a stroke complains of pain. The nurse suspects this patient is most likely experiencing which type of pain?

*Neuropathic* NOT Nociceptive!! Exp:Neuropathic pain can occur from central nervous system brain injury caused by a stroke. Nociceptive pain is caused by tissue damage. Somatic pain is another term used for nociceptive pain. Idiopathic pain does not have an identified cause.

A cyclist reports to the nurse that he is experiencing pain in the tendons and ligaments of his left leg, and the pain is worse with ambulation. The nurse will document this type of pain as which of the following?

*Phantom pain*

Mark is a 20-year-old college student who has been experiencing increasingly sharp pain in the right, lower quadrant of his abdomen over the last 12 hours. A visit to the emergency department and subsequent diagnostic testing have resulted in a diagnosis of appendicitis. What category of pain is Mark most likely experiencing?

*Visceral pain*

A client with spinal nerve compression says the pain is uncomfortable. When the nurse provides the following scale, where would the nurse expect the client to identify the pain level to be?

*anywhere btwn 4-6*

A client who suffers from arthritis complains of sharp pain in her knees and elbows. The nurse recognizes this is what type of pain?

*somatic*

What are the steps for pain transmission in the gate control theory? (Mark all that apply.)

-*The pain stimulus crosses the dorsal horn of the spine to the limbic system* -*The pain stimulus passes down the afferent pathway* -Unrelieved painful stimulus on a peripheral neuron causes the "gate" to open -The brain stem recognizes the stimulus as pain -The gate opens through repolarization of the nerve fiber

Identify the steps in nociception. (Number 1 is the first step and number 4 is the last step.)

1. Transduction 2. Transmission 3. Perception 4. Modulation

An adolescent client who suffered a crushing leg injury due to an all terrain vehicle (ATV) rollover, complains of painful tingling in the affected leg and inability to bend the knee. The client's leg is swollen. What is the nurse's priority action?

Correct:*Notify the healthcare provider immediately.* Wrong: elevate leg & apply ice If acute pain is undertreated or completely untreated, patients are at risk for harder-to-treat neuropathic pain syndromes, such as complex regional pain syndrome (CRPS). Continued painful assault on the peripheral nerves results in neuronal plasticity and transfer of the pain stimulus to the central nervous system. These syndromes are very diffi cult to treat. Patients who have had surgery or a crush-type injury are at high risk for developing CRPS. You should be aware that when a patient with such an injury continues to complain of high levels of pain and begins to experience a subsequent loss of function, temperature sensitivity, swelling, or other skin changes (e.g., hair loss in the affected area), the patient may be developing CRPS. You should also be alert for the common terms that patients use to report neuropathic pain, such as burning, painful tingling, pins and needles, and painful numbness. The client may be developing CRPS or suffering other complications from the crush injury. The healthcare provider should be notified immediately. Elevating the leg, head of bed, or administering an NSAID are all interventions that will not help this client.

The Joint Commission supports the patient's right to pain management and published standards for assessment and management of pain in hospitals, ambulatory care settings, and home care settings (Joint Commission, 2008b). Which of the following are recommended guidelines for pain management? Select all that apply.

• *Teach all clients to use a pain rating scale.* • *Determine a pain-rating goal with each client.* • *Manipulate factors that affect the pain experience.*