1. Describe the process of nociception using the four phases of: Transduction: occurs when a noxious stimulus in the form of traumatic or chemical injury, burn, incision, or tumor takes place in the skin, as well as somatic and visceral structures. Transmission: second phase the impulse moves from the level of the spinal cord to the brain. Perception: indicates the conscious awareness of a painful sensation. Modulation the pain message is inhibited.

2. What is the difference between nociceptive and neuropathic pain. What words will people describe nociceptive and neuropathic pain? Nociceptive pain results from direct activation of pain nerve fibers, either due to chemical, inflammatory or mechanical mediators. Neuropathic pain refers to pain that is generated or sustained by the nervous system. Nociceptive pain is pain that can be sharp, well define and located. Neuropathic pain is hard to locate it is burning, electrical, stabbing, numbness, dull ache and tingling.

3. List Various source of pain: deep somatic pain, cutaneous pain, psychogenic pain, referred pain, acute pain, chronic pain.

4. Explain how acute and chronic pain differs in term of nonverbal behavior. With acute pain there are physiologic signs of acute pain patient guards or rub the area, heart rate increase, increase in blood pressure and repertory rate and in chronic pain there is no change in pt’s bp, respiratory or hate rate.

5. Identify the most reliable indictor of a person’s pain. Subjective report is the most reliable indicator for pain.

6. Recall question for initial pain assessment.

Where is the Location of the pain,
Duration: is the pain consent, does it keep you awake,
quality: what does the pain feel like is the pain dull, burning, aching? Intensity of the pain: how strong is the pain on a scale of 0-10 zero being no pain and 10 being extreme pain. What makes the pain worst?

What makes the pain better?
7. Select pain assessment tools that are appropriate for adults, infant and children. Assessing pain in adults you can use McGill pain questionnaire, numeric rating scale, descriptor scale and PAINAD for dementia patient.

Infant CRIES

Assessing a child use the face pain scale wong-Baker.
8. Describe physical examination finding that may indicate pain. Swelling, inflammation, deformity crepitation , bruising, lesion, atrophy, tachycardia, elevated BP, vomiting.

9. Recall how poorly controlled acute and chronic pain adversely affects physiologic, social and cognitive functioning. increase heart rate , insomnia, blood pressure, and peripheral vascular resistance ,t chronic stress, suicidal thought, and depression this can interfere with work, domestic activities and personal care.

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