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What is a common clinical manifestation of chronic pain in osteoarthritis?
Which of the following is NOT a consequence of chronic pain in osteoarthritis?
What diagnostic test is MOST effective for visualizing degenerative disk disease?
What lifestyle change is encouraged in patients with chronic pain in osteoarthritis?
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Which of the following is a common pharmacological treatment for neuropathic pain in degenerative disk disease?
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Which of the following describes a symptom of radiculopathy associated with degenerative disk disease?
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What type of injection is typically used for treating inflammation in osteoarthritis?
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What clinical manifestation is characterized by a crunching sound during joint movement in osteoarthritis?
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Which of the following treatment options is most suitable for long-term management of neuropathic pain?
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What is a recommended nursing intervention for patients experiencing chronic pain?
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Which of the following is an antecedent necessary for a patient to experience Comfort?
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What is one of the clinical manifestations that indicates a patient may be experiencing impaired Comfort?
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Which of the following describes the Nursing interventions aimed at maintaining attributes of Comfort?
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What are the primary contexts of Comfort as described in the theory?
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Which population is typically at risk for undertreatment of pain?
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How can a nurse best assess a patient's comfort level?
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Which of the following is NOT a consequence of impaired Comfort?
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What is an appropriate nursing intervention for managing procedural pain during dressing changes?
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Which medication class is commonly used for managing acute pain in a post-operative patient?
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What is a significant barrier to effective pain management often observed among nurses?
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What should a nurse monitor after administering pain medication to ensure its effectiveness?
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Which pain scale would be appropriate for assessing pain in nonverbal patients?
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What is one primary goal of using the WHO analgesic ladder in pain management?
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What is a potential adverse effect of opioid medications that nurses must monitor?
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Study Notes
Chronic Pain in Osteoarthritis
- Affects weight-bearing joints, where cartilage cushions wear down leading to bone friction.
- Inflammation is a consequence of the cartilage degradation.
Clinical Manifestations
- Pain exceeds 3 months and occurs during and after joint use, relieved by rest.
- Patients experience stiffness, decreased range of motion, crepitus, swelling, and joint effusion.
- Symptoms typically have a gradual and insidious onset.
Laboratory & Diagnostic Tests
- X-rays, CT scans, and MRIs are used for diagnostic purposes.
Complications and Negative Consequences
- Stress, anxiety, and depression are common due to limited mobility and loss of independence.
Nursing Interventions
- Nonpharmacological strategies include alternating heat and cold treatment, joint protection devices, and acupuncture.
- Encourage moderate physical activities like swimming and walking to maintain joint health.
- Promoting a healthy weight is vital.
Medical/Surgical Management
- Pharmacological options include PRN medications prior to activities, long-acting drugs, topical treatments, and antidepressants.
- Anti-inflammatory steroid injections may offer relief.
- Severe cartilage loss may necessitate joint replacement surgery.
Neuropathic Pain in Degenerative Disk Disease
- Caused by radiculopathy from pinched nerves, leading to conditions like sciatica or phantom limb syndrome.
- Degenerative disk disease occurs with age or due to sports/injuries, resulting in bone friction.
Clinical Manifestations of Neuropathic Pain
- Symptoms include paresthesia, burning, tingling, numbness, and pressure sensitivity in affected areas.
- Long-term nerve damage may alter deep tendon reflexes, with MRI being the best imaging tool.
Negative Complications of Neuropathic Pain
- Leads to limited mobility, sleep disturbances, and increased stress and depression.
Medical/Surgical Management for Neuropathic Pain
- Anticonvulsant and antidepressant medications are common treatments.
- NSAIDs may alleviate some neuropathic pain, with narcotics used for severe cases.
- Surgical options may include diskectomy or spinal fusion if pain remains uncontrollable.
Drug Therapy for Neuropathic Pain
- Gabapentin and Pregabalin are key anticonvulsant medications.
- Understanding side effects and adverse effects is crucial for patient education.
Comfort Concept in Nursing Care
- Comfort encompasses physical, psycho-spiritual, sociocultural, and environmental aspects.
- Impaired comfort can arise from inadequate physiological functioning and noxious stimuli.
Patient Assessment for Comfort
- Assess the patient’s comfort level using pain scales and indicators like facial expressions and vital signs.
- Document patients’ understanding and set pain goals for effective pain management.
Positive and Negative Consequences of Pain
- Positive outcomes include improved social interactions and the ability to perform ADLs.
- Negative effects manifest as tissue damage, shock, increased heart rate, and developmental issues.
Developmental Considerations
- Populations at risk for under-treatment of pain include infants, children, older adults, and individuals with a substance abuse history.
- Pain scales need to be adapted for nonverbal patients (e.g., Wong-Baker Faces Pain Rating Scale).
Acute Pain in Post-Operative Patients
- Pain response includes transduction, transmission, threshold, tolerance, perception, and modulation.
- Vital sign changes, nonverbal pain indicators like grimacing, and other discomforts are noted post-surgery.
Nursing Interventions for Acute Pain
- Scheduled assessments of surgical sites, position changes, minimizing irritants, and monitoring for infection are vital for effective pain management.
- Education on pain management and medication timing is essential for optimal recovery.
Drug Therapy for Post-Operative Pain
- Morphine is an opioid used for pain relief; it requires monitoring for side effects like constipation and sedation.
- Naloxone serves as an opioid antagonist for overdose situations.
Procedural Pain Management
- Anticipate pain during physical therapy or dressing changes and manage it with PRN medication before procedures.
- Document patient's pain and provide education on managing pain after discharge.
Drug Therapy for Procedural Pain
- Examples include acetaminophen and NSAIDs like ibuprofen, with specific mechanisms of action and patient education requirements emphasized.
- Combination drugs like Hydrocodone-Acetaminophen are used for moderate to severe pain, necessitating knowledge of side effects and importance of dosing limits.
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Description
This quiz explores the impact of chronic pain in osteoarthritis, focusing on its clinical manifestations, diagnostic tests, complications, and nursing interventions. Understand how cartilage degradation affects mobility and the recommended nonpharmacological strategies for management.
