Pain Assessment Techniques

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Questions and Answers

What is a primary advantage of intraspinal drug therapy compared to systemic opiates?

It has a longer duration of effect.

It is administered intravenously.

It has a lesser sedative effect. (correct)

It has a faster onset of action.

Where do opiates act when delivered through intraspinal analgesics?

In the cerebrospinal fluid

On the dorsal horn of the spinal cord (correct)

In the epidural space

In the systemic circulation

What may be a side effect of intraspinal analgesics?

Increased appetite

Weight gain

Spinal headaches (correct)

Reduced nausea

Which route of analgesic delivery has the slowest absorption rate?

Topical and Transdermal Signup and view all the answers

What effect can naloxone have in the context of pain management?

It reverses the natural production of endorphins. Signup and view all the answers

What is the minimum time frame a medication should be reduced prior to surgery?

48 hours Signup and view all the answers

What is a potential effect of NSAIDs during surgery?

Inhibiting platelet aggregation Signup and view all the answers

What electrolyte imbalance may diuretics potentiate after surgery?

Potassium Signup and view all the answers

What is a misconception regarding allergies to shellfish?

They are allergic to seafood as well. Signup and view all the answers

How do anticonvulsants like Phenytoin affect anesthetic agents?

They alter metabolism of anesthetic agents. Signup and view all the answers

What does a score of 0 on the pain scale indicate?

The patient is not experiencing any pain. Signup and view all the answers

Which pain rating scale is considered the best for young patients?

Wong-Baker FACES pain rating scale Signup and view all the answers

What is a limitation of using the Verbal Descriptor Scale (VDS)?

Children may not understand the words used. Signup and view all the answers

Which pain assessment tool uses a 10cm line with word anchors?

Visual Analog Scale (VAS) Signup and view all the answers

Which of the following describes an aspect of the Wong-Baker FACES pain rating scale?

Includes a range from neutral to intense pain. Signup and view all the answers

How does the Faces Pain Scale - Revised (FPS-R) measure pain?

It presents images of faces representing pain levels. Signup and view all the answers

What type of information can the patient provide using the Quality of Pain aspect?

Descriptive terms for how pain feels. Signup and view all the answers

When evaluating pain, what factors might be considered regarding aggravating and relieving pain?

What activities minimize or increase the pain. Signup and view all the answers

What is the primary goal of the body's subsystems according to the Stimulus Based Model?

To achieve dynamic balance or steady state. Signup and view all the answers

Which of the following concepts is NOT one of the key components for understanding steady state?

Disruption Signup and view all the answers

What do life events or stressors result in, according to the Stimulus Based Model?

Physiological and psychological strains. Signup and view all the answers

How does the Social Readjustment Rating Scale (SRRS) relate to the concepts discussed?

It assesses life changes and stressors. Signup and view all the answers

What is the first phase of adaptation to a noxious stressor?

Alarm Phase Signup and view all the answers

Which of the following best defines Homeostasis?

A stable internal environment despite external changes. Signup and view all the answers

What happens during the Resistance Phase of adaptation according to the Stimulus Based Model?

The body withstands the stressor and adapts. Signup and view all the answers

Which statement regarding stress and adaptation is most accurate?

Positive stressors can also strain adaptation capacity. Signup and view all the answers

What complication may arise from prolonged surgery in older adults?

Pressure ulcers Signup and view all the answers

Why must eyeglasses be removed before administering a general anesthetic?

They can dry on the cornea Signup and view all the answers

Which method should be used if peripheral pulses are not palpable?

Employing a Doppler instrument Signup and view all the answers

What should be evaluated regarding the patient's physique before anesthesia administration?

Neck thickness and shape Signup and view all the answers

What is an essential consideration for patients with hearing impairment prior to surgery?

Using visual aids for communication Signup and view all the answers

What should be assessed regarding a patient's past anesthetic experiences?

Previous complications Signup and view all the answers

Which dental consideration should be explained to the patient prior to anesthetic administration?

Dental work may be damaged during airway insertion Signup and view all the answers

What is a common challenge faced during intubation for patients with a short stout neck?

Difficulty visualizing the airway Signup and view all the answers

Study Notes

Pain Assessment Tools

Pain scoring ranges from 0 (no pain) to 10 (worst pain).
Faces Pain Scale - Revised (FPS-R) developed for children; utilizes 6 facial expressions to represent pain intensity.
Wong-Baker FACES pain rating scale also includes 6 facial expressions linked to numerical values (0, 2, 4, 6, 8, 10).
Verbal Descriptor Scale (VDS) allows patients to describe pain quality using terms like "sharp," "shooting," or "burning."
Visual Analog Scale (VAS) consists of a 10cm line anchored by descriptive words representing the extremities of pain intensity.

Pain and Stress Models

The Stimulus Based Model suggests that life events or stressors can overwhelm individual adaptation capacities, leading to health issues.
Key concepts in this model include constancy, homeostasis, stress, and adaptation.
The Social Readjustment Rating Scale (SRRS) was developed to quantify stress induced by life changes.

Medication Administration Routes

Topical and Transdermal routes allow drug absorption through the skin with fewer sedative effects compared to systemic opioids.
Parenteral routes (IM, IV, SQ) enable rapid onset of relief; intrathecal space surrounds the spinal cord with cerebrospinal fluid.
Transmucosal routes include lozenges or nasal sprays, which absorb minimally into systemic circulation.
Intraspinal analgesics target opiate receptors in the dorsal horn of the spinal cord for persistent severe pain relief.

Non-Pharmacologic Interventions

The placebo effect can activate endogenous endorphins; this physiological response can be counteracted by naloxone.
Comprehensive preoperative assessments include evaluating the patient's medication history, allergies, and the potential risks associated with anesthesia.

Preoperative Considerations

Assess the impact of diuretics and NSAIDs on electrolyte balance and bleeding risk during and after surgery.
Pay attention to the risks posed by the patient's specific conditions (e.g., language barriers, hearing impairments) when planning anesthesia.
Address potential complications for older adults, such as shear injuries from positioning, and ensure the use of eyeglasses or contact lenses is managed appropriately pre-anesthesia.

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Description

This quiz explores methods for patients to evaluate their pain levels. It focuses on utilizing face scales for subjective pain rating, highlighting its effectiveness for those who can cognitively assess their pain. Understand the significance of both a zero and ten score in terms of pain perception.