Pain management in the Kenntnisprüfung

What is the gold standard of pain assessment?

• The patient’s self-report — pain is what the patient says it is
• The vital signs, as pulse and blood pressure rise reliably and objectively with pain
• The assessment of the most experienced nurse, as patients often exaggerate pain
• The use of as-needed medication in the last 24 hours as an objective measure

Explanation: According to McCaffery: pain is whatever the patient says it is — and it exists whenever they say it does. Self-assessment always takes priority over external assessment; vital signs or outward appearance do not disprove a report of pain.

When is pain considered chronic, and what has been lost?

• After 2 weeks; treatability
• After 4 weeks; localisability
• After 3–6 months; the warning function
• After 12 months; pain conduction

Explanation: Chronic means: longer than 3–6 months or beyond the expected healing time. The warning function of acute pain is lost — the pain has become a disease in its own right, with consequences such as sleep disturbance, depression and withdrawal.