Differentiate between acute pain and chronic pain. 

1. Define Pain: The term pain is used to describe a sensory-emotional experience of unpleasant nature that occurs when tissue is damaged or is at risk for being damaged.
2. Difference between chronic and acute pain. Chronic pain may last for long periods of time or be caused by a chronic medical condition.
3. Why does everyone respond differently to pain? Individual responses to pain are due to differences between people in their pain perception and past pain experiences, as well as cultural and social factors.

a. It is important to outline the steps that are involved when investigating pain.

• Taking a thorough history to determine the duration, location, intensity, quality, and aggravating/relieving factors of the pain.
• Physical examination is necessary to determine any potential pain causes or abnormalities.
• You can order diagnostic tests, such as imaging studies or nerve conduction testing, to help identify the cause of your pain.
• Evaluating the patient’s response to previous treatments and medications.
• If necessary, refer the patient to an expert in pain.

b. Include the following cultural considerations in a health history or physical examination of pain.

• The need for an interpreter service to help with language barriers
• Different cultural views on pain and differences in perception of pain.
• Religious or spiritual beliefs that may impact the patient’s perception of pain and pain management.
• The attitudes towards alternative and medication therapies.

What personal and social factors are relevant to a pain patient? The following personal and social history should be considered in the case of a pain patient:

• History of past illness and surgery.
• Pain medications, as well as over-the-counter medicines.
• Families with chronic pain and pain-related disorders.
• The social history includes employment, living conditions, and the support system.
• History of substance abuse or use.

How should a patient’s pain be evaluated? If a patient reports pain, the following should be done:

• Determine the intensity and location of pain.
• You should assess any factors which may aggravate your pain.
• Using a pain scale to quantify the patient’s pain.
• Assessing the patient’s emotional and psychological response to pain.
• Physical examination is performed to determine any potential or abnormal causes for the pain.

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? The fifth and most important vital sign is pain.

Why is it so difficult to gauge pain in older people? The difficulty in assessing pain in older people is due to the changes in their pain perception and communication problems, as well as comorbidities which may exacerbate or mask pain.

Mr. Hannigan, a 48 year old man, presents himself to the Emergency Department with a headache complaint that is not relieved after 3 days. Now he complains about visual disturbances and inability to focus.

1. What are the main indications for taking your blood pressure?

• Hypertension and hypotension should be monitored.
• Risk factors for cardiovascular diseases are assessed.
• Effectiveness of medications is evaluated.

2. 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.
3. You would expect the patient’s symptoms to include signs other than an elevated blood-pressure. What signs and symptoms would you expect the patient to exhibit beside elevated blood pressure?