Podcast
Questions and Answers
Which statement accurately describes the current understanding of pain?
Which statement accurately describes the current understanding of pain?
- Pain is purely a physical sensation and can be objectively measured by healthcare providers.
- If a patient does not appear to be in pain, they are not experiencing it.
- Pain is a sensory and emotional experience, influenced by psychological, social, and cultural factors. (correct)
- Pain is only significant if it results from actual tissue damage.
A patient who has been taking opioid medication consistently for a few weeks reports needing a higher dose to achieve the same level of pain relief. Which of the following phenomena best explains this situation?
A patient who has been taking opioid medication consistently for a few weeks reports needing a higher dose to achieve the same level of pain relief. Which of the following phenomena best explains this situation?
- Pseudoaddiction
- Physical dependence
- Addiction
- Tolerance (correct)
Which of the following is the priority nursing intervention when a patient is about to receive their first dose of an opioid analgesic?
Which of the following is the priority nursing intervention when a patient is about to receive their first dose of an opioid analgesic?
- Ensure the patient has access to a phone to call for help if needed.
- Assess the patient's respiratory rate and level of sedation closely. (correct)
- Administer the medication and leave the patient to rest.
- Educate the patient on the risk of addiction.
A patient with chronic pain has been prescribed an opioid analgesic on a regular basis. Which of the following is the MOST important factor to consider when evaluating the effectiveness of the pain management plan?
A patient with chronic pain has been prescribed an opioid analgesic on a regular basis. Which of the following is the MOST important factor to consider when evaluating the effectiveness of the pain management plan?
A nurse is caring for a client who is prescribed morphine for severe pain. Which of the following nursing interventions is most important to include in the plan of care?
A nurse is caring for a client who is prescribed morphine for severe pain. Which of the following nursing interventions is most important to include in the plan of care?
A client with a history of opioid abuse is admitted for a surgical procedure. The client reports experiencing severe pain. What is the most appropriate initial nursing action?
A client with a history of opioid abuse is admitted for a surgical procedure. The client reports experiencing severe pain. What is the most appropriate initial nursing action?
A nurse is educating a client about the difference between nociceptive and neuropathic pain. Which statement by the client indicates an understanding of the teaching?
A nurse is educating a client about the difference between nociceptive and neuropathic pain. Which statement by the client indicates an understanding of the teaching?
A client is concerned about becoming addicted to opioid medication prescribed for chronic back pain. What is the nurse's best response?
A client is concerned about becoming addicted to opioid medication prescribed for chronic back pain. What is the nurse's best response?
Which of the following is the primary goal of adjuvant medications in pain management?
Which of the following is the primary goal of adjuvant medications in pain management?
A nurse is caring for a patient receiving patient-controlled analgesia (PCA). Which of the following instructions is most important for the nurse to give the patient?
A nurse is caring for a patient receiving patient-controlled analgesia (PCA). Which of the following instructions is most important for the nurse to give the patient?
A nurse is teaching a patient about non-pharmacological pain management strategies. Which of the following is the most important concept to emphasize?
A nurse is teaching a patient about non-pharmacological pain management strategies. Which of the following is the most important concept to emphasize?
Which of the following pain descriptions is MOST indicative of neuropathic pain?
Which of the following pain descriptions is MOST indicative of neuropathic pain?
Which of the following best differentiates acute and chronic pain?
Which of the following best differentiates acute and chronic pain?
The nurse is assessing a client receiving opioid analgesics. Which assessment finding requires immediate intervention?
The nurse is assessing a client receiving opioid analgesics. Which assessment finding requires immediate intervention?
What is the rationale for using a combination of opioid and non-opioid analgesics for pain management?
What is the rationale for using a combination of opioid and non-opioid analgesics for pain management?
Which intervention is most appropriate for managing opioid-induced constipation?
Which intervention is most appropriate for managing opioid-induced constipation?
A nurse receives an order to administer a placebo to a patient who is reporting pain. What is the most appropriate action by the nurse?
A nurse receives an order to administer a placebo to a patient who is reporting pain. What is the most appropriate action by the nurse?
The healthcare provider prescribes methylphenidate hydrochloride (Ritalin) for a patient receiving opioids. What is the rationale for giving this medication?
The healthcare provider prescribes methylphenidate hydrochloride (Ritalin) for a patient receiving opioids. What is the rationale for giving this medication?
A patient is prescribed a fentanyl transdermal patch for chronic pain management. Which instruction is most important for the nurse to provide to the patient?
A patient is prescribed a fentanyl transdermal patch for chronic pain management. Which instruction is most important for the nurse to provide to the patient?
When assessing a client's pain, which question is MOST important for the nurse to ask to understand the impact of pain on function?
When assessing a client's pain, which question is MOST important for the nurse to ask to understand the impact of pain on function?
A client reports pain as 7/10. They are grimacing and guarding the painful area. They refuse to participate in physical therapy. What should be the nurse's next action?
A client reports pain as 7/10. They are grimacing and guarding the painful area. They refuse to participate in physical therapy. What should be the nurse's next action?
A nurse is caring for a patient from a different culture who is experiencing pain. Which action by the nurse demonstrates cultural sensitivity?
A nurse is caring for a patient from a different culture who is experiencing pain. Which action by the nurse demonstrates cultural sensitivity?
A client receiving morphine via a PCA pump reports persistent pain despite frequent bolus doses. What action should the nurse take FIRST?
A client receiving morphine via a PCA pump reports persistent pain despite frequent bolus doses. What action should the nurse take FIRST?
Which statement accurately describes the 'ceiling effect' of non-opioid analgesics?
Which statement accurately describes the 'ceiling effect' of non-opioid analgesics?
Which of these statements explains the gate control theory of pain?
Which of these statements explains the gate control theory of pain?
A patient with chronic pain is being seen in clinic. Which statement is MOST important to assess the impact of chronic pain?
A patient with chronic pain is being seen in clinic. Which statement is MOST important to assess the impact of chronic pain?
A nurse is caring for an older adult patient who is hesitant to report pain due to the fear of being a burden. What is the MOST appropriate nursing intervention?
A nurse is caring for an older adult patient who is hesitant to report pain due to the fear of being a burden. What is the MOST appropriate nursing intervention?
A nurse is preparing to administer an opioid analgesic to a patient. Which of the following actions is ESSENTIAL to ensure patient safety?
A nurse is preparing to administer an opioid analgesic to a patient. Which of the following actions is ESSENTIAL to ensure patient safety?
A patient is prescribed both an opioid analgesic and a muscle relaxant for pain management. What is the primary reason for combining these medications?
A patient is prescribed both an opioid analgesic and a muscle relaxant for pain management. What is the primary reason for combining these medications?
Which non-pharmacological intervention is MOST appropriate for managing pain associated with muscle spasms?
Which non-pharmacological intervention is MOST appropriate for managing pain associated with muscle spasms?
A client with end-stage cancer is experiencing severe breakthrough pain. What type of medication order is MOST appropriate for this situation?
A client with end-stage cancer is experiencing severe breakthrough pain. What type of medication order is MOST appropriate for this situation?
A patient is being discharged home on opioid analgesics. Which of the following discharge instructions is MOST critical to prevent potential harm?
A patient is being discharged home on opioid analgesics. Which of the following discharge instructions is MOST critical to prevent potential harm?
A patient taking opioids for chronic pain reports new-onset itching. Which of the following actions is MOST appropriate?
A patient taking opioids for chronic pain reports new-onset itching. Which of the following actions is MOST appropriate?
A nurse is caring for a patient receiving epidural analgesia. Which assessment finding requires IMMEDIATE intervention due to the highest risk?
A nurse is caring for a patient receiving epidural analgesia. Which assessment finding requires IMMEDIATE intervention due to the highest risk?
A nurse is reviewing a patient's medication list and notices the patient is taking both an opioid analgesic and a benzodiazepine. What is the MOST important action for the nurse?
A nurse is reviewing a patient's medication list and notices the patient is taking both an opioid analgesic and a benzodiazepine. What is the MOST important action for the nurse?
Which statement best describes how pseudoaddiction differs from true addiction?
Which statement best describes how pseudoaddiction differs from true addiction?
A patient is being treated for pain using a multimodal approach. A multimodal approach encompasses which of the following principles?
A patient is being treated for pain using a multimodal approach. A multimodal approach encompasses which of the following principles?
According to the IASP's definition, which component is essential when describing pain?
According to the IASP's definition, which component is essential when describing pain?
Why might uncontrolled pain be detrimental to a patient's recovery?
Why might uncontrolled pain be detrimental to a patient's recovery?
What is a key consideration when providing pain management for patients from diverse cultures?
What is a key consideration when providing pain management for patients from diverse cultures?
What is the definition of the 'ceiling effect' concerning analgesics?
What is the definition of the 'ceiling effect' concerning analgesics?
Which statement accurately describes how NSAIDs provide analgesia?
Which statement accurately describes how NSAIDs provide analgesia?
A patient reports breakthrough pain despite taking controlled-release opioid medication. What would be an appropriate nursing intervention?
A patient reports breakthrough pain despite taking controlled-release opioid medication. What would be an appropriate nursing intervention?
Which factor is most important for a nurse to consider when administering opioid analgesics?
Which factor is most important for a nurse to consider when administering opioid analgesics?
Why is it inadvisable to crush a controlled-release opioid tablet?
Why is it inadvisable to crush a controlled-release opioid tablet?
A patient receiving opioids reports constipation. Apart from medications, what non-pharmacological intervention should the nurse recommend?
A patient receiving opioids reports constipation. Apart from medications, what non-pharmacological intervention should the nurse recommend?
Under what circumstances is the use of placebos ethically acceptable in pain management?
Under what circumstances is the use of placebos ethically acceptable in pain management?
A patient is prescribed methylphenidate alongside their opioid analgesics. What is the purpose of adding methylphenidate to the pain management plan?
A patient is prescribed methylphenidate alongside their opioid analgesics. What is the purpose of adding methylphenidate to the pain management plan?
What is the primary advantage of ATC (around-the-clock) dosing for pain medication?
What is the primary advantage of ATC (around-the-clock) dosing for pain medication?
Which of the following statements describes Patient-Controlled Analgesia (PCA) and proper use for the patient?
Which of the following statements describes Patient-Controlled Analgesia (PCA) and proper use for the patient?
According to the WHO analgesic ladder, what is the first step in pain management?
According to the WHO analgesic ladder, what is the first step in pain management?
In the management of cancer pain, when would the use of corticosteroids as adjuvant medications be BEST indicated?
In the management of cancer pain, when would the use of corticosteroids as adjuvant medications be BEST indicated?
Which non-pharmacological intervention aims to use a patient's imagination to distance them from their pain?
Which non-pharmacological intervention aims to use a patient's imagination to distance them from their pain?
Which of the following factors could lead a nurse to suspect that a patient may be developing hyperalgesia?
Which of the following factors could lead a nurse to suspect that a patient may be developing hyperalgesia?
Why is meperidine use avoided in older adults and individuals with renal dysfunction?
Why is meperidine use avoided in older adults and individuals with renal dysfunction?
A patient reports persistent pain along a nerve pathway after recovering from shingles. Which type of pain is the patient most likely experiencing?
A patient reports persistent pain along a nerve pathway after recovering from shingles. Which type of pain is the patient most likely experiencing?
A nurse finds a patient prescribed transdermal fentanyl with a fever. What should the nurse anticipate regarding the medication's effects?
A nurse finds a patient prescribed transdermal fentanyl with a fever. What should the nurse anticipate regarding the medication's effects?
What teaching point should the nurse emphasize to the post-surgical patient regarding the importance of pain control aiding their recovery?
What teaching point should the nurse emphasize to the post-surgical patient regarding the importance of pain control aiding their recovery?
A nurse provides care for a patient using cutaneous stimulation. The nurse understands that pain relief using this method occurs by what mechanism?
A nurse provides care for a patient using cutaneous stimulation. The nurse understands that pain relief using this method occurs by what mechanism?
A patient has pain described as shooting and shock-like. With what type of pain is this patient MOST likely experiencing?
A patient has pain described as shooting and shock-like. With what type of pain is this patient MOST likely experiencing?
What type of pain is immediate and prompts an inflammatory response?
What type of pain is immediate and prompts an inflammatory response?
What is an important nursing action to prevent opioid-induced respiratory depression?
What is an important nursing action to prevent opioid-induced respiratory depression?
In the pain transmission process, which of the following describes the body's attempt to interrupt pain impulses by releasing endogenous opioids?
In the pain transmission process, which of the following describes the body's attempt to interrupt pain impulses by releasing endogenous opioids?
Name the neurotransmitters that are released from damaged tissue.
Name the neurotransmitters that are released from damaged tissue.
A terminally ill patient is experiencing continual and agonizing pain. What medication administration method would be MOST appropriate to providing them comfort?
A terminally ill patient is experiencing continual and agonizing pain. What medication administration method would be MOST appropriate to providing them comfort?
How does the pain experienced from a bowel obstruction BEST get described?
How does the pain experienced from a bowel obstruction BEST get described?
What is the first step in the nursing process for the patient experiencing pain?
What is the first step in the nursing process for the patient experiencing pain?
Which of the following is a type of nonpharmacological cognitive-behavioral method to address pain?
Which of the following is a type of nonpharmacological cognitive-behavioral method to address pain?
A new nurse is caring for a patient who reports acute pain. Which action, if performed by the new nurse, would require intervention by the experienced nurse?
A new nurse is caring for a patient who reports acute pain. Which action, if performed by the new nurse, would require intervention by the experienced nurse?
A patient has a history of opioid abuse and is hospitalized with multiple injuries from a motor vehicle accident. What approach should the nurse take in addressing the patient's pain?
A patient has a history of opioid abuse and is hospitalized with multiple injuries from a motor vehicle accident. What approach should the nurse take in addressing the patient's pain?
A nurse is teaching a patient and their family about pain management. Which statement best illustrates the interdisciplinary nature of pain management?
A nurse is teaching a patient and their family about pain management. Which statement best illustrates the interdisciplinary nature of pain management?
A nurse is helping a patient schedule interventions who is struggling with chronic pain to meet her goals. What is the MOST important thing to consider?
A nurse is helping a patient schedule interventions who is struggling with chronic pain to meet her goals. What is the MOST important thing to consider?
What should be the INITIAL assessment of a patient coming in for pain?
What should be the INITIAL assessment of a patient coming in for pain?
Which of the following is NOT TRUE in differentiating acute pain from chronic pain?
Which of the following is NOT TRUE in differentiating acute pain from chronic pain?
A client grimaces and states that they are in pain, but their vital signs are within normal limits. Which action is most appropriate?
A client grimaces and states that they are in pain, but their vital signs are within normal limits. Which action is most appropriate?
Which statement best describes the difference between tolerance and physical dependence in the context of opioid use?
Which statement best describes the difference between tolerance and physical dependence in the context of opioid use?
A client reports a burning, shooting pain that radiates along their lower back down to the leg. How should the nurse best characterize this type of pain?
A client reports a burning, shooting pain that radiates along their lower back down to the leg. How should the nurse best characterize this type of pain?
Which of the following is the MOST appropriate intervention for a client experiencing breakthrough pain while on a long-acting opioid for chronic pain?
Which of the following is the MOST appropriate intervention for a client experiencing breakthrough pain while on a long-acting opioid for chronic pain?
The nurse is caring for four clients. Which client would the nurse expect to have the MOST difficulty managing their pain?
The nurse is caring for four clients. Which client would the nurse expect to have the MOST difficulty managing their pain?
According to Margo McCaffery, what is the most important factor in defining a patient's pain?
According to Margo McCaffery, what is the most important factor in defining a patient's pain?
What is the primary purpose of pain?
What is the primary purpose of pain?
What can uncontrolled pain lead to?
What can uncontrolled pain lead to?
In pain management, providing accurate information and relevant choices helps patients to:
In pain management, providing accurate information and relevant choices helps patients to:
Which of the following is a common misconception (myth) about pain?
Which of the following is a common misconception (myth) about pain?
What does the term tolerance mean in the context of pain management?
What does the term tolerance mean in the context of pain management?
If an opioid is abruptly discontinued after a few weeks of continuous use, what is a likely result?
If an opioid is abruptly discontinued after a few weeks of continuous use, what is a likely result?
What is the primary difference between addiction and pseudoaddiction?
What is the primary difference between addiction and pseudoaddiction?
During pain transmission, what is the role of endorphins?
During pain transmission, what is the role of endorphins?
What is the key difference between somatic and visceral pain?
What is the key difference between somatic and visceral pain?
Which of the following is characteristic of neuropathic pain?
Which of the following is characteristic of neuropathic pain?
What is the main distinction between acute and chronic pain?
What is the main distinction between acute and chronic pain?
What is the meaning of the 'ceiling effect' of analgesics?
What is the meaning of the 'ceiling effect' of analgesics?
What is the primary action of nonopioid analgesics?
What is the primary action of nonopioid analgesics?
Why is it essential to avoid crushing a controlled-release opioid tablet?
Why is it essential to avoid crushing a controlled-release opioid tablet?
In the WHO analgesic ladder, at what level are strong opioids introduced?
In the WHO analgesic ladder, at what level are strong opioids introduced?
What is the primary goal of balanced analgesia?
What is the primary goal of balanced analgesia?
What is the most important consideration when using Patient-Controlled Analgesia (PCA)?
What is the most important consideration when using Patient-Controlled Analgesia (PCA)?
Which of the following is an example of a cognitive-behavioral intervention?
Which of the following is an example of a cognitive-behavioral intervention?
Which of the following is an example of a physical agent used for pain relief?
Which of the following is an example of a physical agent used for pain relief?
When applying heat for pain relief, what precaution should the nurse take?
When applying heat for pain relief, what precaution should the nurse take?
When assessing pain, what should the nurse prioritize?
When assessing pain, what should the nurse prioritize?
When should pain be assessed?
When should pain be assessed?
What is the significance of understanding family dynamics in pain management?
What is the significance of understanding family dynamics in pain management?
Which action is contraindicated when taking care of someone in pain?
Which action is contraindicated when taking care of someone in pain?
A patient reports lower back and flank pain. The nurse would expect what potential problem?
A patient reports lower back and flank pain. The nurse would expect what potential problem?
For a patient diagnosed with shingles, what type of pain would the nurse anticipate?
For a patient diagnosed with shingles, what type of pain would the nurse anticipate?
A nurse notices an order for IM promethazine for a patient reporting pain. The nurse knows to...
A nurse notices an order for IM promethazine for a patient reporting pain. The nurse knows to...
Which of the following medication options would be suitable for acute and chronic pain?
Which of the following medication options would be suitable for acute and chronic pain?
Why might a nurse initiate stool softeners and laxatives for a patient in pain?
Why might a nurse initiate stool softeners and laxatives for a patient in pain?
A patient reports that they are experiencing continued breakthrough pain. What would the nurse say?
A patient reports that they are experiencing continued breakthrough pain. What would the nurse say?
What is a critical point to remember when using transdermal patches?
What is a critical point to remember when using transdermal patches?
What are examples of medication that can be given rectally?
What are examples of medication that can be given rectally?
The nurse is helping a patient practice meditation. Which type of intervention is this?
The nurse is helping a patient practice meditation. Which type of intervention is this?
A patient is prescribed an anticonvulsant medication for pain. The nurse knows that this type of adjuvant classification will...
A patient is prescribed an anticonvulsant medication for pain. The nurse knows that this type of adjuvant classification will...
If an unresponsive patient has a prescription for pain and cannot communicate their level, the nurse is able to observe the patient, document findings and...
If an unresponsive patient has a prescription for pain and cannot communicate their level, the nurse is able to observe the patient, document findings and...
Pain can keep the patient from sleeping well, becoming exhausted. Which intervention would be inappropriate for the nurse to initiate?
Pain can keep the patient from sleeping well, becoming exhausted. Which intervention would be inappropriate for the nurse to initiate?
What action violates professional scope?
What action violates professional scope?
According to the International Association for the Study of Pain (IASP), which of the following is the MOST accurate description of pain?
According to the International Association for the Study of Pain (IASP), which of the following is the MOST accurate description of pain?
A patient reports feeling continuous distress because of their pain. Which term BEST describes this feeling?
A patient reports feeling continuous distress because of their pain. Which term BEST describes this feeling?
What physiological responses are related to uncontrolled pain?
What physiological responses are related to uncontrolled pain?
Which of the following is the MOST important to assess for a patient regarding their cultural pain responses?
Which of the following is the MOST important to assess for a patient regarding their cultural pain responses?
When providing options for pain management, it is important to maintain patient autonomy by:
When providing options for pain management, it is important to maintain patient autonomy by:
Which statement accurately describes a similarity between pain and addiction?
Which statement accurately describes a similarity between pain and addiction?
Which of the following BEST describes the nurse's role in caring for a patient experiencing pain?
Which of the following BEST describes the nurse's role in caring for a patient experiencing pain?
Which of the following is a common physiological occurrence in patients who have physical dependency to an opioid such as Morphine?
Which of the following is a common physiological occurrence in patients who have physical dependency to an opioid such as Morphine?
If a patient is seeking more pain medication than is prescribed, it is important to remember that patients are...
If a patient is seeking more pain medication than is prescribed, it is important to remember that patients are...
A patient newly prescribed an opioid medication reports constipation and they are very concerned. What is the best course of action?
A patient newly prescribed an opioid medication reports constipation and they are very concerned. What is the best course of action?
If a patient is watching the clock in anticipation of the next analgesic dose, the nurse should FIRST consider that the patient is:
If a patient is watching the clock in anticipation of the next analgesic dose, the nurse should FIRST consider that the patient is:
A patient with a history of opioid abuse is reporting pain after surgery. The nurse recognizes that this patient:
A patient with a history of opioid abuse is reporting pain after surgery. The nurse recognizes that this patient:
A patient is receiving opioid doses that are too low or spaced too far apart to relieve their pain. This is best described as:
A patient is receiving opioid doses that are too low or spaced too far apart to relieve their pain. This is best described as:
A patient expresses concern that she will become addicted to opioid medication prescribed for chronic back pain. Which is the BEST response?
A patient expresses concern that she will become addicted to opioid medication prescribed for chronic back pain. Which is the BEST response?
Compared to Intramuscular (IM) injections, what can be expected of other pain treatment options?
Compared to Intramuscular (IM) injections, what can be expected of other pain treatment options?
A nurse is educating an older adult patient about pain management. Which of the following is accurate?
A nurse is educating an older adult patient about pain management. Which of the following is accurate?
Nonopioids work mainly peripherally, at the site of injury, rather than in the central nervous system, as opioids do. What is the exception to this rule?
Nonopioids work mainly peripherally, at the site of injury, rather than in the central nervous system, as opioids do. What is the exception to this rule?
A patient receiving Vicodin (acetaminophen and hydrocodone) continues to experience pain. What is the appropriate next step?
A patient receiving Vicodin (acetaminophen and hydrocodone) continues to experience pain. What is the appropriate next step?
Which class of medications has a ceiling effect, which means that there is a dose beyond which there is no improvement in the analgesic effect, but there may be an increase in adverse effects?
Which class of medications has a ceiling effect, which means that there is a dose beyond which there is no improvement in the analgesic effect, but there may be an increase in adverse effects?
What information should the nurse provide to other nurses about Fentanyl?
What information should the nurse provide to other nurses about Fentanyl?
Why should older patients being prescribed Meperidine (Demerol) be avoided?
Why should older patients being prescribed Meperidine (Demerol) be avoided?
The MOST important thing to note when prescribing the potent analgesic, Methadone (Dolophine) is:
The MOST important thing to note when prescribing the potent analgesic, Methadone (Dolophine) is:
For a patient in the hospital requiring relief from Osteoporosis, what medication interventions can be applied to provide aid in pain relief?
For a patient in the hospital requiring relief from Osteoporosis, what medication interventions can be applied to provide aid in pain relief?
What BEST describes adjuvants for patients and pain medication?
What BEST describes adjuvants for patients and pain medication?
A patient asks why she is receiving methylphenidate hydrochloride (Ritalin) along with her opioid pain medication. What is your best response?
A patient asks why she is receiving methylphenidate hydrochloride (Ritalin) along with her opioid pain medication. What is your best response?
What would be the course of action when setting up an opioid on an IV controller?
What would be the course of action when setting up an opioid on an IV controller?
The BEST time to provide analgesics is...
The BEST time to provide analgesics is...
If using the WHO ladder and if the patient is having severe pain, which Level is the starting point BEST be from?
If using the WHO ladder and if the patient is having severe pain, which Level is the starting point BEST be from?
What is a potential negative interaction between an IV and controlled-release tablet when providing medication?
What is a potential negative interaction between an IV and controlled-release tablet when providing medication?
How has education been shown to decrease patients' pain?
How has education been shown to decrease patients' pain?
How do applications of heat help pain?
How do applications of heat help pain?
All of the following are cognitive-behavioral interventions to MINIMIZE pain EXCEPT?
All of the following are cognitive-behavioral interventions to MINIMIZE pain EXCEPT?
What is the FIRST appropriate step in doing to collect data using nonpharmacological methods when assessing your patient?
What is the FIRST appropriate step in doing to collect data using nonpharmacological methods when assessing your patient?
Why is it important for patients to keep a pain diary?
Why is it important for patients to keep a pain diary?
Why do patients become exhausted with continuous pain?
Why do patients become exhausted with continuous pain?
What is an example of something to add to a room the may help the patient sleep?
What is an example of something to add to a room the may help the patient sleep?
Which of the pain rating scales has the faces designed for adults?
Which of the pain rating scales has the faces designed for adults?
If a patient has dementia, which type of pain rating scales would be selected?
If a patient has dementia, which type of pain rating scales would be selected?
When assessing pain, what BEST reflects Margo McCaffery's widely accepted definition?
When assessing pain, what BEST reflects Margo McCaffery's widely accepted definition?
A client describes their rheumatoid arthritis pain as a consistent throbbing ache. How can this pain BEST get typified?
A client describes their rheumatoid arthritis pain as a consistent throbbing ache. How can this pain BEST get typified?
What is the physiological rationale for encouraging activity and mobilization for surgical patients in pain?
What is the physiological rationale for encouraging activity and mobilization for surgical patients in pain?
An older adult with chronic pain is concerned about addiction to opioid medication. What response aligns with current guidelines?
An older adult with chronic pain is concerned about addiction to opioid medication. What response aligns with current guidelines?
A patient receiving morphine via PCA reports continued high pain levels, an unlikely circumstance based on averages from similar adults and procedures. As such, the nurse concludes 'obvious drug-seeking behavior.' What is the MOST appropriate IMMEDIATE next action?
A patient receiving morphine via PCA reports continued high pain levels, an unlikely circumstance based on averages from similar adults and procedures. As such, the nurse concludes 'obvious drug-seeking behavior.' What is the MOST appropriate IMMEDIATE next action?
Flashcards
Pain Definition
Pain Definition
A sensory and emotional experience associated with actual or potential tissue damage.
Pain Management
Pain Management
The most common reason patients seek medical advice.
Patient's Report
Patient's Report
Pain is whatever the experiencing person says it is, whenever they say it exists.
Suffering Definition
Suffering Definition
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Risks of Uncontrolled Pain
Risks of Uncontrolled Pain
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Tolerance
Tolerance
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Physical Dependence
Physical Dependence
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Opioid Addiction
Opioid Addiction
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Pseudoaddiction
Pseudoaddiction
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Opioid Analgesics
Opioid Analgesics
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Transduction
Transduction
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Transmission
Transmission
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Perception
Perception
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Modulation
Modulation
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Nociception
Nociception
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Somatic Pain
Somatic Pain
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Visceral Pain
Visceral Pain
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Neuropathic Pain
Neuropathic Pain
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Acute Pain
Acute Pain
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Chronic Pain
Chronic Pain
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Analgesics
Analgesics
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Adjuvant Medications
Adjuvant Medications
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Ceiling Effect
Ceiling Effect
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Benzodiazepines (Pain)
Benzodiazepines (Pain)
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Tricyclic Antidepressants (Pain)
Tricyclic Antidepressants (Pain)
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Anticonvulsants
Anticonvulsants
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Balanced Analgesia
Balanced Analgesia
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Around-the-Clock Dosing
Around-the-Clock Dosing
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Patient-Controlled Analgesia (PCA)
Patient-Controlled Analgesia (PCA)
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Patient-Controlled Analgesia (how it works)
Patient-Controlled Analgesia (how it works)
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Nursing Care Tip (Treating Pain)
Nursing Care Tip (Treating Pain)
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World Health Organization (WHO) Analgesic Ladder
World Health Organization (WHO) Analgesic Ladder
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Alternative Pain Relief Interventions
Alternative Pain Relief Interventions
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What do the nurses need to monitor if administering Opioids and / or muscle relaxants?
What do the nurses need to monitor if administering Opioids and / or muscle relaxants?
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Persistent Acute Pain
Persistent Acute Pain
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Somatic Nociceptive Pain
Somatic Nociceptive Pain
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Visceral Nociceptive Pain
Visceral Nociceptive Pain
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Analgesics definition
Analgesics definition
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Opioid Analgesics definition
Opioid Analgesics definition
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Full vs. Partial Agonists and Mixed Agonists/Antagonists
Full vs. Partial Agonists and Mixed Agonists/Antagonists
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Scheduled pain medicine
Scheduled pain medicine
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Cognitive-Behavioral Interventions for pain
Cognitive-Behavioral Interventions for pain
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Physical Agents for pain
Physical Agents for pain
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Prevent Opioid Induced Respiratory Depression
Prevent Opioid Induced Respiratory Depression
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Referred Pain
Referred Pain
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Study Notes
Definitions of pain
- Pain is both a sensory and emotional experience, which impacts one's being and relationship with their environment
- Pain prompts the most medical consultations
- Pain often goes unaddressed or undertreated despite the extensive focus and expenditure on its care
- Nurses are major contributors to pain management
- According to Margo McCaffery, pain is subjective and defined by the person experiencing it
- Pain is described by the International Association for the Study of Pain (IASP) as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage"
- Pain serves as a protective mechanism and warning signal
Suffering
- Suffering refers to feelings of continuous distress associated with pain
- Suffering, characterized by physical, psychological, social, and spiritual distress, is closely linked to, but not synonymous with pain
- Persistent pain without meaning can diminish a patient's quality of life
- Approaching care with assessment and cultural congruence are key to relieving ones suffering
Risks of uncontrolled pain
- Untreated or undertreated pain leads to complications
- The body responds to pain by releasing harmful substances that cause tissue breakdown, increased metabolic rate, impaired immune function, and negative emotions
- Poorly managed pain hinders activities like walking, deep breathing, and coughing, leading to complications
- Well-managed pain reduces above complications and helps patients recover and return home
Pain and Culture
- Cultural background influences patient responses to pain, so varied ways of expression exist
- Knowledge of different ethnic and cultural groups can assist with acceptable care responses
- Individualized patient assessment and ethical principles should be the focus, not assumptions based on culture or ethnicity
Pain Management
- The patient is the focal point of the healthcare team
- Provision of accurate information regarding options helps the patient maintain their autonomy
- The entire health team has the responsibility of pain management
- Management includes cost-effective practices, that minimize side effects, prevent complications, and reduce hospital stays.
- Regulatory bodies recognize the importance of pain management.
- Standards support approrpiate and effective safe pharmacological management as well as patient and family teaching.
Myths and Barriers to Effective Pain Management
- Many factors, like previous experiences, influence pain treatment
- Common misconceptions can impede objectivity, creating barriers to effective treatment
- Laughing and or talking does not mean a person is not in pain, it can be a distraction
- Respiratory depression with opioid medications is uncommon, it is preventable if closely monitored.
- Oral medication is a better option first, the IV option is better in order to treat post-operative pain
- Teenagers are not more likely to get addicted to older patients
- Pain is NOT a normal part of aging
- Effective pain treatment helps elderly mobility and helps improve overall health
Opioid Addiction vs. Normal Opioid Use
- Nurses may worry about patient who ask for large amount of pain medication or know when the next dose is
- It is important to know the difference between addiction, tolerance, and physical dependence
- Exposure to drug induces changes that result in a decrease of one or more of the drug's effects over time, called tolerance
- Physical dependence is a normal physiological phenomenon that most people experience after a few weeks of opiod use
- Withdrawal symptoms includes sweating, tearing, runny nose, restlessness, irritability, tremors, dilated pupils, sleeplessness, nausea, vomiting, and diarrhea. Prevent this by slowly Weaning and not stopping suddenly.
- Addiction or psychological dependence comes from a disease of the brain, that causes a compulsive substance
- Patients can stop addiction when pain is relieved. Monitor those with medication tolerance.
- Pseudoaddiction is described in patients who are not getting adequate dosages of medication.
Mechanisms of Pain Transmission
- Pain transmission involves Nociception
- Specificity theory, describes a trauma sends a message directly to the brain.
- gate control theory, describes a dorsal horn on the spinal cord allows impulse to go through.
- However, pain is transmitted through transduction, transmission, perception, and modulation
Types of pain
- Includes nociceptive and neuropathic
- Nociception refers to the body's normal reaction to noxius stimuli
- Nociceptive pain can be somatic (muscles or bone) or visceral(organ pain)
- Neuropathic pain is associated with injury to either nervous system. The pain can be numbness, tingling, sharp, shooting or shocklike.
Acute vs. Chronic Pain
- Acute pain is immediate, follows injury and subsides with healing, and prompts inflammatory response
- Physical signs of acute pain include increased heart rate and elevated blood pressure, must continue guard against labeling patient malingering or drug seeker simply because vital signs are no longer altered
- Examples of acute pain include childbirth, surgery, burns or other trauma
- Chronic Pain lasts 3 months or longer
- Examples include arthiritis, phantom limb
- Chronic pain may have both nociceptive and neuropathic components that will require combination of medications and nonpharmogical treatments
Options for Treatment of Pain
- Medications that relieve pain is called analgesics.
- Analgesics has three main classes that include, opioids, nonopioids, and adjuvents
- Opioids, bind to opioid receptors to inhibit perception of pain
- nonopioids inclu NSAIDS and Acetaminophen.
- adjuvents provide categories for medications to relieve other than pain.
Analgesic Medication classes
- A good understanding of these pharmacological treatment options
- nonapioid, are first class the drug to use
- nonapioids help acute/cronic pain. Drug is limited because there's a ceiling. Care is ensured that the nonapioid dose does not excedd maximum safe dose for 24 hour periods
- non apioids do not product tolerance
- opioids are drugs that similar to morphine
- opioids are classified by Affect receptor, full partial, mixed
Opioid Adverse Effects/Contraindications
- Opioids alone have no ceiling effect to analgesia.
- Hyperalgesia, or increased sensitivity to pain
- Inappropriate prescribing.
- Vigilance for side effects such as constipation, confusion, and fatigue is important.
- Respiratory depression is not a common side effect, but life threatening
- Opioid-naive patients may be more sensitive to side effects.
Balanced Approach to Analgesia
- Combine analgesics and adjuvants from different classes
- Minimizes the adverse effects of opioids
- Maximizes pain relief
- Opioid and nonopioid given together can provide better pain relief with an overall lower dose
- Able to reduce the use of other sedating medications such as antiemetics and antihistamines if possible
Routes for Medication Administration
- Oral is desired in most cases, some can be given rectally
- Transdermal patches allow easy application
- IV helps give continuous infusion, to keep the patient
- Subcutaneous is used has an alternative to IV
- Epidural, delivers closer to site of pain, helps have fewer side effects
Nonpharmacological Therapies
- Includes both Cognitive-behavioral interventions or Physical Agents
- Cognitive-behavioral helps patients take active part in pain assessment & control
- The Physical Agents can give comfort, correct correction and alter physiological responses.
- Both are used in conjunction with drug therapies are not expected to relieve in there own
Nursing Process for the Patient Experiencing Pain
- Accurate assessment is essential
- Inquire about pain history
- Use appropriate assessment tools
- Complete physical assessment
- Set goals with patients and family, remember, pain is exhausting and a team approach is the most effective approach
- give patient education.
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