Nurs 230- exam 2 UPDATED ACTUAL Questions and CORRECT
Answers
Pain Subjective experience: "pain is what the patient says it is"
• "Unpleasant sensory and emotional experience associated with, or resembling
that associated
with actual or potential tissue damage" (International Association for the Study of
Pain, 2020)
• 5th Vital Sign
• Most common reason people seek health care
• ANA: "Nurses have an ethical responsibility to relieve pain and the suffering it
causes" (Yoost &
Crawford, 2020, p. 851)
Types of Pain: Duration - acute= protective pain, temporary as tissue heals
- chronic= not protective, ongoing/recurring with long-term physical and
emotional impacts
Types of Pain: Idiopathic Chronic pain without identifiable physical or psychological cause
Types of Pain: Intractable - difficult pain
- resistant to therapy
- persist despite multiple interventions
Types of Pain: Referred - tissue damage originates in one area, but the pain is in another area
ex) right shoulder pain with gallbladder problems
Types of Pain: Radiating - stems from one source to an adjacent area of the body
ex) chest pain (heart attack) that goes down the arm
,Responses to pain • Sympathetic response: acute pain - increase in BP, HR, RR, pupil dilation
• Parasympathetic response: if pain is unrelieved - N/V, decreased BP & HR, pupil
constriction (chronic pain)
• Behavioral: posture, activities, facial features, verbalizations, withdrawal
• Psychological: anxiety, depression, anger, exhaustion, hopelessness
Origin of pain- nociceptive (tissue) o Cutaneous - skin, SQ tissues
o Visceral - internal organs (abdominal)
o Somatic - bones, joints, muscles, connective tissue
"throbbing" "aching"
Origin of pain- neuropathic - damaged pain nerves
o Phantom limb pain (amputation, but still feels pain)
o Neuropathy
"burning" "tingling" "stabbing"
- chronic
Consequences of unrelieved pain: • Decline in function
• Complications of immobility
• Depression
• Increased agitation and confusion (can be a reason for change in mental status)
Pain assessment: • Joint Commission standard: pain must be regularly assessed
• COLDSPA
• Health history related to patient's c/o pain (background to treat underlying)
• Cognitive impairment:
o Treat known pain-causing diagnoses (ex: surgery)
o Consider pain as cause of agitation (underlying factors)
• Pain assessment tools
, Nursing diagnosis: - Impaired comfort
- Acute pain
- Chronic pain
Pain outcomes: plan • Prevent, reduce, or eliminate pain
• Individualized & measurable - what level of pain is acceptable in what period of
time (diff. for each patient)
Pain interventions: • Choose diff. intervention based on pain severity:
o Mild (1-3)
o Moderate (4-7)
o Severe (8-10)
• Reassess - check effectiveness of intervention 30-60 minutes after implementing
(when meds kick-in, iv meds are fastest)
• Analgesics - medications to relieve pain (don't want pain to get ahead of us)
• Nonpharmacological measures (can use in addiction)
Analgesics: Nonopioids • Appropriate for mild-moderate pain
• Nonaddictive
• Safer than opioids
• Examples: acetaminophen (Tylenol- liver), NSAIDs (Advil, aspirin- bleeding and
stomach ulcers), local anesthetic agents (lidocaine- numb)
Opioids - all controlled substances • Routes: oral (pills), parenteral (injections), transdermal (patch)
• Examples: oxycodone, hydrocodone, morphine, hydromorphone, fentanyl
(works well with moderate to severe)
• Risks:
o Tolerance- body becomes use, so need a higher dosage
o Physical dependence- body becomes use to dosage so will have withdrawal if
suddenly gets off
o Addiction- use for needs other than pain control
Answers
Pain Subjective experience: "pain is what the patient says it is"
• "Unpleasant sensory and emotional experience associated with, or resembling
that associated
with actual or potential tissue damage" (International Association for the Study of
Pain, 2020)
• 5th Vital Sign
• Most common reason people seek health care
• ANA: "Nurses have an ethical responsibility to relieve pain and the suffering it
causes" (Yoost &
Crawford, 2020, p. 851)
Types of Pain: Duration - acute= protective pain, temporary as tissue heals
- chronic= not protective, ongoing/recurring with long-term physical and
emotional impacts
Types of Pain: Idiopathic Chronic pain without identifiable physical or psychological cause
Types of Pain: Intractable - difficult pain
- resistant to therapy
- persist despite multiple interventions
Types of Pain: Referred - tissue damage originates in one area, but the pain is in another area
ex) right shoulder pain with gallbladder problems
Types of Pain: Radiating - stems from one source to an adjacent area of the body
ex) chest pain (heart attack) that goes down the arm
,Responses to pain • Sympathetic response: acute pain - increase in BP, HR, RR, pupil dilation
• Parasympathetic response: if pain is unrelieved - N/V, decreased BP & HR, pupil
constriction (chronic pain)
• Behavioral: posture, activities, facial features, verbalizations, withdrawal
• Psychological: anxiety, depression, anger, exhaustion, hopelessness
Origin of pain- nociceptive (tissue) o Cutaneous - skin, SQ tissues
o Visceral - internal organs (abdominal)
o Somatic - bones, joints, muscles, connective tissue
"throbbing" "aching"
Origin of pain- neuropathic - damaged pain nerves
o Phantom limb pain (amputation, but still feels pain)
o Neuropathy
"burning" "tingling" "stabbing"
- chronic
Consequences of unrelieved pain: • Decline in function
• Complications of immobility
• Depression
• Increased agitation and confusion (can be a reason for change in mental status)
Pain assessment: • Joint Commission standard: pain must be regularly assessed
• COLDSPA
• Health history related to patient's c/o pain (background to treat underlying)
• Cognitive impairment:
o Treat known pain-causing diagnoses (ex: surgery)
o Consider pain as cause of agitation (underlying factors)
• Pain assessment tools
, Nursing diagnosis: - Impaired comfort
- Acute pain
- Chronic pain
Pain outcomes: plan • Prevent, reduce, or eliminate pain
• Individualized & measurable - what level of pain is acceptable in what period of
time (diff. for each patient)
Pain interventions: • Choose diff. intervention based on pain severity:
o Mild (1-3)
o Moderate (4-7)
o Severe (8-10)
• Reassess - check effectiveness of intervention 30-60 minutes after implementing
(when meds kick-in, iv meds are fastest)
• Analgesics - medications to relieve pain (don't want pain to get ahead of us)
• Nonpharmacological measures (can use in addiction)
Analgesics: Nonopioids • Appropriate for mild-moderate pain
• Nonaddictive
• Safer than opioids
• Examples: acetaminophen (Tylenol- liver), NSAIDs (Advil, aspirin- bleeding and
stomach ulcers), local anesthetic agents (lidocaine- numb)
Opioids - all controlled substances • Routes: oral (pills), parenteral (injections), transdermal (patch)
• Examples: oxycodone, hydrocodone, morphine, hydromorphone, fentanyl
(works well with moderate to severe)
• Risks:
o Tolerance- body becomes use, so need a higher dosage
o Physical dependence- body becomes use to dosage so will have withdrawal if
suddenly gets off
o Addiction- use for needs other than pain control
