Posted: September 4th, 2023

Module Six: Pain

Module Six: Pain
Objectives:
1. Address components of a thorough pain assessment, including assessment of nonverbal or cognitively impaired individuals.
2. Compare and contrast acute and chronic pain, considering pathogenesis, manifestations, and treatment approaches.
3. Discuss pain threshold and pain tolerance.
4. Explore pathogenesis, clinical manifestation, and treatment approaches for neuropathic, somatic, and visceral pain.
5. Differentiate pain from suffering.
Required readings and resources:
Carvalho, A. S., Martins Pereira, S., Jácomo, A., Magalhães, S., Araújo, J., Hernández-Marrero, P., Costa Gomes, C., & Schatman, M. (2018). Ethical decision making in pain management: A conceptual framework. Journal of Pain Research, 11, 967–976. https://mnpals-
smsu.primo.exlibrisgroup.com/permalink/01MNPALS_SMSU/8db547/cdi_doaj_primary_oai_do aj_org_article_f8ac91b04b2846369a9ff6855a116e01

Ohyun Kwon. (2021). Pathophysiology of neuropathic pain. Journal of the Korean Medical Association / Taehan Uisa Hyophoe Chi, 64(7), 468–476.
https://doi-org.ssuproxy.mnpals.net/10.5124/jkma.2021.64.7.468

Rodriguez, L. (2015). Pathophysiology of Pain: Implications for Perioperative Nursing. AORN
Journal, 101(3), 338–344. https://doi-org.ssuproxy.mnpals.net/10.1016/j.aorn.2014.12.008

Siler, S., Borneman, T., & Ferrell, B. (2019). Pain and Suffering. Seminars in Oncology
Nursing, 35(3), 310-314. https://doi.org/10.1016/j.soncn.2019.04.013
Sorenson, M., Quinn, L., & Klein, D. (2019). Pathophysiology: Concepts of human disease. Pearson Education. Read chapter 32.
Stokes, L. (2019). ANA Position Statement: The Ethical Responsibility to Manage Pain and the
Suffering It Causes. Online Journal of Issues in Nursing, 24(1), 3. https://doiorg.ssuproxy.mnpals.net/10.3912/OJIN.Vol24No01PoSCol01

Optional resources:
Bueno-Gómez, N. (2017). Conceptualizing suffering and pain. Philosophy, Ethics & Humanities in Medicine, 12, 1–11. https://doi-org.ssuproxy.mnpals.net/10.1186/s13010-017-0049-5 Grant, A. (2018). Pain, suffering and the vulnerability of the empath. Journal of the Australian Traditional-Medicine Society, 24(3), 144–145. https://ssuproxy.mnpals.net/login?url=https://search.ebscohost.com/login.aspx?direct=true&d b=ccm&AN=131833900&scope=site

Sonneborn, O., & Williams, A. (2020). How does the 2020 revised definition of pain impact nursing practice? Journal of Perioperative Nursing, 33(4), e25–e28. https://doiorg.ssuproxy.mnpals.net/10.26550/2209-1092.1104

Resources linked into the module
Items due: Pain Exploration Worksheet
Please go to the Pain Exploration Assignment module under Content for guidance. An example, video, and downloadable template are included there.
Please see the course calendar for due dates. See the grading rubric in the syllabus appendices.
Appendix D: Pain Exploration Assignment Rubric
This exploration will be a worksheet / essay exercise that addresses a variety of types of pain, as well as contributing factors, manifestations, management, and consequences of unrelieved pain. Additional concepts related to pain will be explored.

For more guidance go to the Pain Exploration Assignment folder in the content area of this course shell
Criterion Excellent Developing Not Satisfactory
1. Acute pain All columns in table addressed. Summarizes essential information. Clear, accurate, focused, organized. Information appropriate for the practice of nursing. Supported by professional evidence. (4 points) Critical information is accurate. Does not include all essential information.
Organization is sporadic. Strength of professional evidence is questionable.
(2 points) Incomplete. Essential information lacking. Lacks structure. Not supported by professional evidence. (0 points)
2. Chronic pain All columns in table addressed. Summarizes essential information. Clear, accurate, focused, organized. Information appropriate for the practice of nursing. Supported by professional evidence. (4 points) Critical information is accurate. Does not include all essential information.
Organization is sporadic. Strength of professional evidence is questionable.
(2 points) Incomplete. Essential information lacking. Lacks structure. Not supported by professional evidence. (0 points)
3. Neuropathic pain All columns in table addressed. Summarizes Critical information is accurate. Does not Incomplete. Essential information lacking.

essential information. Clear, accurate, focused, organized. Information appropriate for the practice of nursing. Supported by professional evidence. (4 points) include all essential information. Organization is sporadic. Strength of professional evidence is questionable.
(2 points) Lacks structure. Not supported by professional evidence. (0 points)
4. Assessment in unique situations Response is focused, accurate, clearly and concisely presented. Includes information essential for quality nursing care. Critical thought evident. Supported by professional evidence.
(4 points) Response is accurate. Some essential information lacking. Reasonably focused and clearly presented. Supported by professional evidence.
(2 points) Incomplete. Difficult to follow. Not supported by professional evidence.
(0 points)
5. Pain threshold and pain tolerance Response is focused, accurate, clearly and concisely presented. Includes information essential for quality nursing care. Supported by professional evidence.
(2 points) Response is accurate. Does not include all essential information. Reasonably focused and clearly presented. Supported by professional evidence.
(1 point) Incomplete. Difficult to follow. Not supported by professional evidence.
(0 points)
6. Compare and contrast pain and suffering. Response is focused, accurate, clearly and concisely presented. Includes information essential for quality nursing care. Supported by professional evidence. (4 points) Response is accurate. Does not include all essential information. Reasonably focused and clearly presented. Supported by professional evidence.
(2 points) Incomplete. Difficult to follow. Not supported by professional evidence.
(0 points)
7. Ethical implications Response is focused, accurate, clearly and concisely presented. Explores a minimum three principles of ethics (ex. beneficence,
nonmaleficence, justice, veracity, etc.). Supported by professional evidence.
(6 points) Response is accurate. Explores less than three principles or exploration is limited. (3 points) Incomplete. Difficult to follow. Not supported by professional evidence.
(0 points)
8. Writing quality /
APA style Accesses and integrates at least three professional evidence-based sources (see criteria p. 6 of syllabus) per
APA style. Sources developed for the lay person will not count as professional evidence. Minimal direct quotations. Fewer than five writing mechanics / APA style errors. (2 points) Multiple or lengthy direct quotations. References included, but do not meet criteria for professional evidence based sources. Five – ten writing mechanics / APA errors. (1 point) More than 10 writing mechanics /APA errors. Minimal professional evidence to support post.
(0 points)

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. Address components of a thorough pain assessment, including assessment of nonverbal or cognitively impaired individuals.
2. Compare and contrast acute and chronic pain, considering pathogenesis, manifestations, and treatment approaches.
3. Discuss pain threshold and pain tolerance.
4. Explore pathogenesis, clinical manifestation, and treatment approaches for neuropathic, somatic, and visceral pain.
5. Differentiate pain from suffering.
!
Address components of a thorough pain assessment, including assessment of nonverbal or cognitively impaired individuals.
A thorough pain assessment should involve a comprehensive evaluation of the individual’s pain experience, including the following components:

Location: Where is the pain located?
Intensity: How severe is the pain on a scale of 0 to 10?
Quality: What type of pain is it? (e.g., sharp, dull, burning, throbbing, etc.)
Onset and duration: When did the pain start, and how long has it been present?
Aggravating and relieving factors: What makes the pain worse or better?
Associated symptoms: Are there any other symptoms accompanying the pain?
Impact on daily activities: How does the pain affect the individual’s ability to carry out their usual activities?
Nonverbal cues: In the case of nonverbal or cognitively impaired individuals, it is essential to observe for any nonverbal cues that may indicate pain, such as facial expressions, body movements, changes in appetite or sleep patterns, etc.
Compare and contrast acute and chronic pain, considering pathogenesis, manifestations, and treatment approaches.
Acute pain is a sudden onset pain that typically lasts less than 3 to 6 months and is often associated with tissue damage or injury. In contrast, chronic pain is a persistent pain that lasts longer than 3 to 6 months and is often associated with underlying medical conditions.

Pathogenesis:
Acute pain typically results from tissue injury or inflammation, while chronic pain may result from nerve damage, inflammation, or altered pain processing in the nervous system.

Manifestations:
Acute pain is usually a sharp or throbbing pain, and its intensity typically decreases as the injury or damage heals. Chronic pain, on the other hand, is often described as a dull, aching pain that may be constant or intermittent and may be accompanied by other symptoms, such as fatigue, depression, or anxiety.

Treatment approaches:
Acute pain is usually treated with medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, or opioids, along with other interventions such as rest, ice, or physical therapy. Chronic pain, on the other hand, often requires a multidisciplinary approach, including medication management, physical therapy, psychological interventions, and complementary therapies.

Discuss pain threshold and pain tolerance.
Pain threshold refers to the point at

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