The Nature, Components, Types, and Physiology of Pain

Which patient statement demonstrates understanding of the effects of chronic pain? "Chronic pain will increase my immune response, so I should monitor for autoimmune disorders." "I need to closely watch for hypoglycemia because chronic pain can decrease blood glucose levels." "I will immediately report frequent urination and uncontrolled thirst or hunger to my health care provider." "Chronic pain will cause me to produce fewer cytokines, which could prolong my tissue damage."

"I will immediately report frequent urination and uncontrolled thirst or hunger to my health care provider." The release of cortisol from chronic pain increases glucose levels, so the patient should monitor for signs of hyperglycemia. These signs include frequent urination and uncontrolled thirst or hunger.

Match the hormone to the location it is secreted from. 1. Posterior pituitary 2. Adrenal cortex 3. Anterior pituitary a. Vasopressin b. Aldosterone c. Adrenocorticotropic hormone

1. a 2. b 3. c

Match the type of stimuli to the corresponding transduction category. 1. Thermal 2. Chemical 3. Mechanical a. Burn b. Toxic substances c. Surgical incision

1. a 2. b 3. c

Match the component of pain with its manifestation. 1. Distress, unpleasantness 2. Meaning of pain 3. Expressions that communicate pain 4. Nociception a. Sensory b. Emotional c. Cognitive d. Behavioral

1. a 2. b 3. c 4. d

Match the type of pain with the corresponding description. 1. Lasts more than 6 months 2. Affects the somatosensory system 3. Lasts less than 6 months 4. Involves superficial tissues a. Nociplastic b. Visceral c. Chronic d. Neuropathic

1. a 2. b 3. c 4. d

Which hormone is secreted during the midterm response to pain? Select all that apply. One, some, or all responses may be correct. Norepinephrine Corticotropin-releasing factor Aldosterone Cortisol Vasopressin

Aldosterone Aldosterone is released by the adrenal cortex during the midterm response to pain. Cortisol Cortisol is released by the adrenal cortex during the midterm response to pain. Vasopressin Vasopressin is released by the posterior pituitary during the midterm response to pain.

Injury to which organ would prompt a bradycardic response? Stomach Skin Bladder Lungs

Bladder Injury to the bladder or intestines causes a parasympathetic response, which decreases the heart rate.

The nurse is caring for a patient who has experienced 9 months of severe pain from fibromyalgia. In which way would the nurse classify this patient's pain? Select all that apply. One, some, or all responses may be correct. Chronic Visceral Acute Nociplastic Neuropathic

Chronic Chronic pain persists for more than 6 months; the patient's pain would be classified as chronic since it has lasted for 9 months. Nociplastic Nociplastic pain arises from an alteration of the nociceptive function, despite no clear evidence of tissue damage, disease, or lesion of the somatosensory system causing the pain. Fibromyalgia is a type of nociplastic pain disorder.

Which manifestation would the nurse expect to see when assessing the emotional component of pain? Distress Tachycardia Crying Rating of "10" on a 0-to-10 pain scale

Distress The emotional component includes negative emotions such as unpleasantness, distress, and anticipation.

Which part of the brain is responsible for the emotional response to pain? Thalamus Frontal cortex Hypothalamus Brainstem

Frontal cortex The frontal cortex and limbic system allow expression of the emotional component of pain.

Which nursing intervention would facilitate the descending pain modulation mechanism? Rubbing the injury site Administration of analgesics Guided imagery Providing an ice pack

Guided imagery Relaxation techniques, such as guided imagery, facilitate the release of endogenous opioids within the descending pain modulation mechanism.

Which physiologic response to somatic pain would the nurse expect to observe in a critical care patient? Select all that apply. One, some, or all responses may be correct. Hypervolemia Hypertension Bradycardia Tachypnea Perspiration

Hypervolemia The release of aldosterone causes decreased diuresis and increased intravascular volume, leading to hypervolemia. Hypertension The release of aldosterone increases intravascular volume, which increases the blood pressure. Tachypnea The release of catecholamines increases the respiratory rate (tachypnea). Perspiration The release of catecholamines causes perspiration and pupil dilation.

Which clinical manifestation would the nurse expect to find in a patient experiencing pain? Decreased central venous pressure Increased blood pressure Decreased pulmonary artery occlusion pressure Increased diuresis

Increased blood pressure The release of aldosterone by the adrenal cortex would lead to volume retention and an increased blood pressure.

Which nursing intervention would cause pain from mechanical transduction? Medication administration Radiation therapy Laparotomy Intravenous infiltration

Laparotomy A laparotomy is a surgical incision into the abdominal cavity. A surgical incision is an example of mechanical transduction.

The experience of pain is associated with which component? Select all that apply. One, some, or all responses may be correct. Sensory Emotional Cognitive Behavioral Social

Sensory Pain is associated with actual or potential tissue damage, which is an unpleasant sensory experience. Emotional Pain causes emotional distress and is an unpleasant emotional experience. Cognitive Pain is associated with cognitive damage and can alter cognitive responses. Behavioral Pain is associated with social/behavioral components. Social The experience of pain is associated with social/behavioral components. Yes, all of them.

Which organ is affected by visceral pain? Liver Stomach Lungs Kidneys

Stomach Some organs, such as the stomach, are abundantly innervated by sensory neurons that signal harmful events.

In which order does the process of nociception occur? Transduction Transmission Perception Modulation

Transduction Transmission Perception Modulation Nociception is a four-step process that follows a standardized pathway. The steps are transduction, transmission, perception, and modulation.

The nurse would expect to assess muscular rigidity during which stage of nociception? Transduction Transmission Perception Modulation

Transmission During transmission, the action potential is diffused along the neospinothalamic (NS) pathway. This process causes muscular rigidity.