Chapter 44

Question 1

Is pain subjective or objective?

Answer 1

subjective

Question 2

What are the 3 components to the nature of pain?

Answer 2

1. physical
2. emotional
3. cognitive

Question 3

What is nociception?

Answer 3

observable physiological response to painful stimuli

Question 4

What are the 4 physiological processes that occur in nociception? Describe each.

Answer 4

1. transduction: the stimuli itself
2. transmission: movement and communication about pain
3. perception: Interpretation of the communication of pain by the brain
4. modulation: Inhibition of the pain impulse

Question 5

What is the difference between acute, chronic, and idiopathic pain?

Answer 5

• acute/transient pain: short duration (3 - 6 months); tissue damage
• chronic/persistent pain: greater than 6 months
• idiopathic pain: unknown cause

Question 6

What is the most important rule in regards to patients and their reports of pain?

Answer 6

pain is subjective, so we must take patients at their word and accept their report of pain

Question 7

What are the 4 factors that influence pain?

Answer 7

1. physiological
2. social
3. psychological
4. cultural

Question 8

How does physiology influence pain? (4)

Answer 8

1. age
2. fatigue
   
   1. increased perception of pain, decreased coping ability
3. genes
   
   1. influence pain threshold/sensitivity
4. neurological function
   
   1. SCI (spinal cord injury)
   2. neuropathy – diabetics have nerve pain or decreased sensation in their feet sometimes

Question 9

What are the social factors that influence pain? (3)

Answer 9

1. previous experience of pain
   
   1. may understand how to deal with this particular type of pain
2. family and social network
   
   1. good sources of distraction
3. spiritual factors
   
   1. may provide relief from pain

Question 10

How does psychology influence pain? (3)

Answer 10

1. attention
   
   1. greater attention = greater perception of pain
2. anxiety/fear
   
   1. can increase pain
   2. pain can increase anxiety/fear
3. coping style
   
   1. sense of control
   2. asking questions
   3. being informed about pain

Question 11

How does culture influence pain? (2)

Answer 11

1. meaning of pain
2. ethnicity

Question 12

What are 4 factors that are influenced by pain?

Answer 12

1. QOL (quality of life)
2. self-care
3. work
4. social support

Question 13

What are the 3 characteristics of pain?

Answer 13

1. timing (onset, duration, pattern)
2. location
3. severity

Question 14

What are the 4 main pain scales? Who should they be used for?

Answer 14

1. numerical rating
   
   1. more cognitive pts
2. verbal descriptive scale – descriptive words to describe pain types
   
   1. more cognitive pts
3. visual analog scale – on a scale of 0 to 10, pts draw out their pain scale
   
   1. more cognitive pts
4. Wong-Baker Faces Pain Rating Scale
   
   1. pediatric pts

Question 15

What are concomitant symptoms? How do they affect pain?

Answer 15

• concomitant symptoms: symptoms that occur with pain
• usually increase pain severity