Last Updated on March 10, 2023 by Admin

In your professional opinion what is the difference between chronic and acute pain? How is the assessment for each type of pain different? What must you keep in mind when assessing acute pain?

Discussion Question:

In your professional opinion what is the difference between chronic and acute pain? How is the assessment for each type of pain different? What must you keep in mind when assessing acute pain? What must you keep in mind when assessing chronic pain? Reflect upon a time when you assessed a patient in pain. What did you do well? What points could you have improved upon? How did the pain impact the patient? What specific treatments could have lessened the impact of the pain on the patient?

Expert Answer and Explanation

The International Association for the Study of Pain (2020) has revised the definition of pain to encompass the complexity and nuances of this subjective experience. Initially, pain was defined as “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage.”

Today, the revised definition includes six key points. Pain is a personal experience impacted by biological, psychological, and social factors. As such, the concept of pain is learned through personal life experiences and should be respected. Adverse effects of pain impact function, social, and psychological well-being. It is important to recognize that pain and nociception are different wherein pain cannot be a result of sensory neuron activity.

Lastly, a verbal description is only one approach to expressing pain and may be described through various behavioural changes. Acute pain occurs suddenly and is typically intense lasting from a few minutes to less than six months. It is often an indication of illness or injury and subsides once the underlying cause is treated (International Association for the Study of Pain, 2021a).

Meanwhile, chronic pain is defined as pain that persists or recurs longer than three months. It is often the predominant condition impacted by multiple factors such as biological, psychological, and/or social (International Association for the Study of Pain, 2021b).

When assessing pain, whether acute or chronic, it is important to complete a comprehensive assessment of the patient’s pain experience. This will include assessing the location, quality, severity, timing, triggering and alleviating factors, and any associated symptoms related to the pain experience (Bickley, 2021).

However, assessment considerations for acute and chronic pain should be noted. Acute pain occurs abruptly typically triggered by an acute illness or trauma. As such, it is important to incorporate an assessment of potential comorbidities. Effective management and treatment of the underlying condition will often remedy the pain experience. Moreover, when assessing chronic pain, activities of daily living, mood, sleep, work, and sexual activity should be included given that chronic pain persist more than three to six months and has a profound impact on disability (Bickley, 2021).

One of my past experiences in assessing pain was when I was a staff nurse on a cardiac surgery inpatient unit. Performing a pain assessment was routinely incorporated in our conversations with our patients as a majority of the patients had a sternotomy. Areas of strength in my pain assessment was that I was able to complete them efficiently and provide my patients with the necessary pain medication in a timely manner.

Areas of improvement in my pain assessment could have been in expanding broader questioning and allowing my patient to elaborate in greater detail their full pain experience. Due to the patient nurse ratio especially if there was a sick call, it was challenging to complete some of these more comprehensive pain assessments. Because a majority of the patients had a sternotomy, it was assumed that the patient was experiencing post operative pain at the surgical site, the chest area.

As such, I didn’t probe further into location and type as it was similar across the unit’s patient population type and perhaps many assumptions were made now that I look back at my previous pain assessment. Specific treatments lessened the impact of pain for this particular patient population. For instance, this unit has a pre-order set of post cardiac bypass and valvular surgeries that allows access to narcotics every four hours as needed. These were often administered for patients that were post operative day one to four.

Non-pharmacological treatment included deep breathing exercises supported by a chest pillow that was provided to every patient who underwent cardiac surgery. Patients were able to use the chest pillow to support the surgical site while encouraging deep breathing and coughing exercises to minimize pleural effusions or pneumonia.

References

Bickley, L. S. (2021). Bate’s guide to physical examination and history taking (13th ed.). Wolters Kluwer/Lippincott Williams & Wilkins.

International Association for the Study of Pain. (2020). IASP announces revised definition of pain. https://www.iasp-pain.org/publications/iasp-news/iasp-announces-revised-definition-of-pain/

International Association for the Study of Pain. (2021a). Acute pain. https://www.iasp-pain.org/resources/topics/acute-pain/

International Association for the Study of Pain. (2021b). Definitions of chronic pain syndromes. https://www.iasp-pain.org/advocacy/definitions-of-chronic-pain-syndromes/

Alternative Answer and Explanation

Chronic pain is spontaneous, lasts for longer periods, and can be considered a disease on its own (Pozek et al., 2016). If chronic pain is associated with a disease, it tends to last longer and does not have a biological purpose. On the other hand, Acute pain is the most common form of pain as it responds to sudden stimuli such as injuries, bruises, or even surgery (Orhurhu et al., 2020).

Acute pain lasts a short time and can fade away as the wound heals or after treatment has been performed on the affected area. In this regard, acute pain can be a biological reaction that a person feels when the body is in discomfort or affected and needs attention or treatment. Human beings experience pain due to different reasons within the body.

Pain is associated with something wrong in the body and requires intervention to alleviate the pain or know the locations that need to be treated. A nurse needs to distinguish between acute and chronic pain as it can be significant harm to the body (Bickley, 2021).

Assessment of acute pain is more straightforward, and it is a result of an injury or existing condition, making it easy to identify. For chronic pain, the nurse needs to perform screening for contributing conditions and more tests like CT scans and other lab tests (Orhurhu, 2020). In assessing both acute and chronic pain, the key aspect to keep in mind includes the duration of pain, rating, and location of the pain.

I recently assessed the pain of a patient that had fallen during a skating competition. The assessment was easier as she had minor bruises on the leg, making it easy to identify the cause of the pain. The areas of improvement can include the need to include the patient in the assessment. The pain led the patient to limp, and the main treatment was the use of pain medication and dressing of the affected wound.

References

Bickley, L. S. (2021). Bate’s guide to physical examination and history taking (13th ed.). Wolters Kluwer/Lippincott Williams & Wilkins. ISBN: 9781496354709.

Orhurhu, V., Roberts, J., Ly, N. & Cohen, S. P. (2020). Ketamine in acute and chronic pain management. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK539824/

Pozek, J. P. J., Beausang, D., Baratta, J. L., & Viscusi, E. R. (2016). The Acute To Chronic Pain Transition: Can Chronic Pain Be Prevented?. Medical Clinics, 100(1), 17-30.

Module 2 Assignment 1

Assignment Description:

Complete the ShadowHealth© HEENT assignment

After you have achieved at least 80% on the assignment(s) download, save and upload your LabPass document to the dropbox.

Module 2 Assignment 2

Assignment Description:

Write a 500-word APA reflection essay of your experience with the Shadow Health virtual assignment(s). At least two scholarly sources in addition to your textbook should be utilized. Answers to the following questions may be included in your reflective essay:

• What went well in your assessment?
• What did not go so well? What will you change for your next assessment?
• What findings did you uncover?
• What questions yielded the most information? Why do you think these were effective?
• What diagnostic tests would you order based on your findings?
• What differential diagnoses are you currently considering?
• What patient teaching were you able to complete? What additional patient teaching is needed?
• Would you prescribe any medications at this point? Why or why not? If so, what?
• How did your assessment demonstrate sound critical thinking and clinical decision making?