NUR170 Exam 5 Questions and Answers
Latest Top Rated 2025
Pathophysiology of pain
Pain triggered by peripheral nervous system
Composed of sensory and motor neurons
Connections occur within spinal cord
Sensory neurons
Pain perception
Motor neurons
Pain response
Nociceptors
Specialized pain receptors
Where are nociceptors found?
in every tissue of the body except the brain
Skin and muscles have many
Internal organs have few
Nociceptive pain
results from external stimuli on uninjurie, fully functional nervous
system
Neuropathic Pain
Caused by nerve malfunction or injuries resulting from trauma,
disease, chemicals, infections, and tumors
- May be due to damage of peripheral or central nerves
Pain Theories
o Specificity Theory
o Peripheral Pattern Theory
o Gate Control Theory
Specifity Theory
Pain is a specific sensation that uses sensory neurons separate
from other sensations such as heat and touch.
- Pain is related to anatomical and physiological factors
Peripheral pattern theory
,All sensory nerve fiber endings are the same
- Pain felt when fibers are intensely stimulated
- Brain deciphers differences in signals
Gate control theory - Melzack and Wall, 1965
(most widely accepted theory)
Pain is a multifaceted perceptual experience that evolves from an
individual's psychological & physiological factors
- A gate in the spinal cord controls transmission of pain impulses
to the brain
Gate control stimulation explained
-Stimulation of small diameter (pain) fibers causes gates to open
-Stimulation of larger diameter (heat, cold, mechanical) fibers
causes gates to close
Amount of activity in small fibers vs large fibers controls
perception of pain
Factors that control gates
physical, emotional, behavioral
Overview of pain
> Highly personal
> Both physical and emotional
> Depends on magnitude of stimuli, individual ability to transmit
pain signals
> Depends on mental state
> Result of actual or potential tissue damage
Pain can be described in terms of
Location
Intensity
Quality
Duration
Location of pain - Where does it hurt?
Classification of pain based on where it is
- Radiation
- Referred
Radiation pain
,Spreads or extends to other areas
Referred pain
Appears to arise in different areas of the body other than the site
of origin
intensity of pain
refers to the strength of the amount of pain experienced rated
mild to severe
Standard 0-10
Pain scales
Wong-Baker faces pain scale
FLACC pain scale
Observation or behavioral pain scales
Abbey pain scale
CRIES pain scale
Standard 0-10 scale
- 1-4 = mild pain
- 5-6 = moderate pain
- 7-10 = severe pain
Wong-Baker Faces Pain Scale
Recommended for kids > 3 yo or older
Confused older adults
FLACC pain scale (Observation/behavioral)
combination of score
For children < 3 yo
Observational or behavioral pain scale
- Used to assess pain in patients who are unable to articulate their
needs
- Nurse observes & rates patient behavior according to
descriptions provided
Abbey pain scale
Used for dementia patients who are unable to verbalize their pain
-Should be used as a movement bases assessment
Quality of pain - What does the pain feel like? Can you
describe the pain?
, words such as sharp, dull, cramping, stabbing, shooting, pulling,
pinching, heavy, tender, cold, itchy
Duration of pain - How long have you had the pain and how
long does it usually last?
When did the pain start and what the patient believed caused the
pain
- Intermittent or continuous
- acute or chronic
Additional assessments for pain
o Vital signs
-Temperature
- Pulse
- Respiratory rate
- Blood pressure
o Inspection for injuries
o Palpation of specific location
o Associated symptoms
o Precipitating factors
o Alleviating factors
Associative symptoms
Nausea, vomiting
Visual assessment for pain
o Direct observation of patient
Facial expressions, Body movement, and Posture
Types of pain / duration of pain
acute and chronic
Acute pain
short-term (up to 6 months), sudden onset, related to injury,
illness, or surgery, resolves with healing, linked to a specific event
injury or illness
Sympathetic nervous system responses ( ^ pules, ^ rr, ^ BP,
Diaphoresis)
Chronic pain
Prolonged duration longer than 6 months), continues beyond
expected healing period
Latest Top Rated 2025
Pathophysiology of pain
Pain triggered by peripheral nervous system
Composed of sensory and motor neurons
Connections occur within spinal cord
Sensory neurons
Pain perception
Motor neurons
Pain response
Nociceptors
Specialized pain receptors
Where are nociceptors found?
in every tissue of the body except the brain
Skin and muscles have many
Internal organs have few
Nociceptive pain
results from external stimuli on uninjurie, fully functional nervous
system
Neuropathic Pain
Caused by nerve malfunction or injuries resulting from trauma,
disease, chemicals, infections, and tumors
- May be due to damage of peripheral or central nerves
Pain Theories
o Specificity Theory
o Peripheral Pattern Theory
o Gate Control Theory
Specifity Theory
Pain is a specific sensation that uses sensory neurons separate
from other sensations such as heat and touch.
- Pain is related to anatomical and physiological factors
Peripheral pattern theory
,All sensory nerve fiber endings are the same
- Pain felt when fibers are intensely stimulated
- Brain deciphers differences in signals
Gate control theory - Melzack and Wall, 1965
(most widely accepted theory)
Pain is a multifaceted perceptual experience that evolves from an
individual's psychological & physiological factors
- A gate in the spinal cord controls transmission of pain impulses
to the brain
Gate control stimulation explained
-Stimulation of small diameter (pain) fibers causes gates to open
-Stimulation of larger diameter (heat, cold, mechanical) fibers
causes gates to close
Amount of activity in small fibers vs large fibers controls
perception of pain
Factors that control gates
physical, emotional, behavioral
Overview of pain
> Highly personal
> Both physical and emotional
> Depends on magnitude of stimuli, individual ability to transmit
pain signals
> Depends on mental state
> Result of actual or potential tissue damage
Pain can be described in terms of
Location
Intensity
Quality
Duration
Location of pain - Where does it hurt?
Classification of pain based on where it is
- Radiation
- Referred
Radiation pain
,Spreads or extends to other areas
Referred pain
Appears to arise in different areas of the body other than the site
of origin
intensity of pain
refers to the strength of the amount of pain experienced rated
mild to severe
Standard 0-10
Pain scales
Wong-Baker faces pain scale
FLACC pain scale
Observation or behavioral pain scales
Abbey pain scale
CRIES pain scale
Standard 0-10 scale
- 1-4 = mild pain
- 5-6 = moderate pain
- 7-10 = severe pain
Wong-Baker Faces Pain Scale
Recommended for kids > 3 yo or older
Confused older adults
FLACC pain scale (Observation/behavioral)
combination of score
For children < 3 yo
Observational or behavioral pain scale
- Used to assess pain in patients who are unable to articulate their
needs
- Nurse observes & rates patient behavior according to
descriptions provided
Abbey pain scale
Used for dementia patients who are unable to verbalize their pain
-Should be used as a movement bases assessment
Quality of pain - What does the pain feel like? Can you
describe the pain?
, words such as sharp, dull, cramping, stabbing, shooting, pulling,
pinching, heavy, tender, cold, itchy
Duration of pain - How long have you had the pain and how
long does it usually last?
When did the pain start and what the patient believed caused the
pain
- Intermittent or continuous
- acute or chronic
Additional assessments for pain
o Vital signs
-Temperature
- Pulse
- Respiratory rate
- Blood pressure
o Inspection for injuries
o Palpation of specific location
o Associated symptoms
o Precipitating factors
o Alleviating factors
Associative symptoms
Nausea, vomiting
Visual assessment for pain
o Direct observation of patient
Facial expressions, Body movement, and Posture
Types of pain / duration of pain
acute and chronic
Acute pain
short-term (up to 6 months), sudden onset, related to injury,
illness, or surgery, resolves with healing, linked to a specific event
injury or illness
Sympathetic nervous system responses ( ^ pules, ^ rr, ^ BP,
Diaphoresis)
Chronic pain
Prolonged duration longer than 6 months), continues beyond
expected healing period
