Differentiate between acute pain and chronic pain. 

  1. Definition: What is pain? Pain can be described as a complicated sensory and emotional experience.
  2. There are two types of acute pain. One is sudden and it is most often caused by an injury or illness. The other is chronic, which lasts longer and can be caused by a chronic medical condition.
  3. Why are people able to have different responses to pain? Different pain perceptions, social and cultural factors, past pain experiences, genetic factors and other factors can lead to individuals having individualized pain responses.

a. These are the steps to investigate pain as an actual problem.

  • Taking a thorough history to determine the duration, location, intensity, quality, and aggravating/relieving factors of the pain.
  • Perform a thorough physical exam to determine if there are any potential causes.
  • To help identify the root cause of pain, you may order diagnostic tests like bloodwork, imaging studies or nerve conduction test.
  • Evaluating the patient’s response to previous treatments and medications.
  • Referring to a pain specialist when necessary.

b. List cultural considerations for pain examinations and histories: Here are some examples of cultural considerations:

  • The need for interpreter service and language barriers
  • Cultural beliefs and pain perceptions may differ.
  • Religious or spiritual beliefs that may impact the patient’s perception of pain and pain management.
  • Attitudes toward alternative and medication therapies.

How should a pain patient’s personal and social history be analyzed? The following personal and/or social history factors should be examined by a pain patient:

  • Past illnesses, surgeries and medical histories.
  • All medications, both prescription and over-the counter.
  • Ancestry of chronic pain in the family or other pain-related issues.
  • The social history of a person, including their employment and living situations, as well as the support system.
  • Use of substances or history of abuse.

What should be done if a patient is complaining of pain? How should a patient’s pain be evaluated?

  • Finding the source, location, intensity and duration of pain.
  • Examining factors that may aggravate or alleviate the pain.
  • Using a pain scale to quantify the patient’s pain.
  • Assessing the patient’s emotional and psychological response to pain.
  • Perform a thorough physical exam to determine if there are any potential causes.

Describe how to determine cuff size in an adult patient: To determine cuff size in an adult patient, measure the circumference of the patient’s upper arm and select a cuff size that is appropriate for their arm circumference.

Which vital sign is pain? This is the fifth vital sign.

It is difficult for older adults to evaluate pain. Because of changes in pain perception, communication difficulties and other comorbidities which may mask or exacerbate pain, it can be difficult to diagnose pain in seniors.

The 48-year-old Mr. Hannigan presented to the emergency department complaining of a headache. He has been suffering from it for 3 days. Now, he complains about visual disturbances and inability to focus.

  1. Define the main indications for blood pressure measurement: These are the most important indications to take blood pressure measurements:
  • Monitor for hypertension/hypotension.
  • Evaluation for risk factors related to cardiovascular disease.
  • Evaluation of the medication’s effectiveness.
  1. Describe the correct cuff size for a patient: The correct cuff size for a patient should be selected based on the patient’s upper arm circumference to ensure an accurate reading.
  2. You would expect patients to show signs and symptoms other than elevated blood pressure. Other than elevated blood pressure, what other symptoms would you expect?

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