Nursing Pain Management Quiz
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Questions and Answers

Which pain scale is most appropriate for a nonverbal adult patient?

  • TPPPS
  • FLACC (correct)
  • POCIS
  • MOPS

    • A patient receiving morphine sulfate via PCA develops shallow, irregular respirations at 6 breaths/min. What is the nurse's priority action?

  • Increase the patient's primary intravenous (IV) flow rate.
  • Complete the FLACC scale.
  • Notify the health care provider and prepare to administer naloxone (Narcan). (correct)
  • Elevate the patient's head of bed to facilitate lung expansion.

    • Which of the following symptoms indicates salicylate toxicity?

  • Tinnitus (correct)
  • Increased bleeding times
  • Occasional nausea
  • Gastrointestinal (GI) bleeding

    • What is the main advantage of COX-2 inhibitor NSAIDs compared to other NSAIDs?

    <p>They have fewer GI adverse effects. (C)</p> Signup and view all the answers

    A patient is prescribed a nonsteroidal anti-inflammatory drug (NSAID) for pain relief. Which of the following would be a concern for the nurse regarding this medication?

    <p>Increased risk of bleeding (D)</p> Signup and view all the answers

    Which of the following is NOT a potential side effect of salicylates?

    <p>Increased blood clotting (A)</p> Signup and view all the answers

    A patient experiencing salicylate toxicity would likely present with which of the following symptoms?

    <p>Hyperventilation (A)</p> Signup and view all the answers

    Which of the following patient groups is MOST likely to experience GI side effects from NSAIDs?

    <p>Patients with a history of peptic ulcer disease (A)</p> Signup and view all the answers

    Which of these side effects of opiate agonists can be expected and should not warrant withholding the medication?

    <p>Constipation (B)</p> Signup and view all the answers

    Which statement accurately reflects the nurse's understanding of pain management?

    <p>Encourage patients to report pain before it becomes too severe. (D)</p> Signup and view all the answers

    A patient describes their pain as 'sharp and stabbing'. Which component of the pain history is this describing?

    <p>Quality (D)</p> Signup and view all the answers

    A patient on fentanyl (Duragesic) transdermal patch reports a pain level of 8 at 8 PM on Monday. The initial patch was applied at 8 AM on Monday. What should the nurse do?

    <p>Administer a PRN analgesic medication as ordered. (A)</p> Signup and view all the answers

    A patient experiencing chronic pain from metastatic cancer starts on a fentanyl patch. When should the nurse expect the initial patch to reach a steady blood level?

    <p>Within 12-24 hours. (D)</p> Signup and view all the answers

    Which of the following is NOT a common side effect of opiate agonists?

    <p>Increased appetite (D)</p> Signup and view all the answers

    Why is it important to encourage patients to report their pain before it escalates?

    <p>To prevent the need for stronger medications. (A)</p> Signup and view all the answers

    Why is it not necessary to contact the physician immediately when a patient on a fentanyl patch reports a pain level of 8, one hour after the patch was applied?

    <p>The patch needs time to reach a steady blood level. (E)</p> Signup and view all the answers

    What is the primary concern for the nurse regarding a patient taking meperidine (Demerol) with a respiratory rate of 10 breaths per minute?

    <p>Altered breathing pattern (C)</p> Signup and view all the answers

    What is the most appropriate nursing intervention to address the patient's current pain level of 2, based on the information provided?

    <p>Implement non-pharmacological pain management strategies (C)</p> Signup and view all the answers

    Which of these nursing interventions are considered ineffective for pain management in children?

    <p>Encouraging fluid intake (D)</p> Signup and view all the answers

    What is the primary rationale for encouraging parental participation in the care of a pediatric patient experiencing pain?

    <p>To reduce the child's anxiety (A)</p> Signup and view all the answers

    Which of the following is an adverse effect associated with opiate agonists?

    <p>Orthostatic hypotension (C)</p> Signup and view all the answers

    Besides pain management, what other condition(s) can salicylates effectively address? (Select all that apply)

    <p>Fever (A), Muscle aches (B), Migraine headaches (C), Swollen joints (D)</p> Signup and view all the answers

    A patient is prescribed salicylates for pain relief. Which of these statements is TRUE about the mechanism of action of salicylates?

    <p>They reduce inflammation by inhibiting the production of prostaglandins. (D)</p> Signup and view all the answers

    A patient on warfarin therapy is prescribed an NSAID for pain management. Which of the following is a priority nursing action?

    <p>Monitor the patient closely for signs and symptoms of bleeding. (C)</p> Signup and view all the answers

    What type of medication is meperidine (Demerol) and what is its primary action?

    <p>Opiate agonist, reduces pain (D)</p> Signup and view all the answers

    Which of these medications is a potential drug interaction with NSAIDs, requiring close monitoring by the nurse?

    <p>Lithium (B)</p> Signup and view all the answers

    Prior to administering an NSAID medication, the nurse performs a baseline neurologic assessment. Which of these findings is considered a component of this assessment?

    <p>Assessment of orientation to date, time, and place (A)</p> Signup and view all the answers

    A patient presents with a migraine headache. Which of the following medications is NOT typically recommended as a first-line treatment for migraine headaches?

    <p>Salicylates (B)</p> Signup and view all the answers

    A patient is recovering from a surgery and is experiencing a dull, aching pain in their abdomen. What type of pain is this most likely to be?

    <p>Visceral pain (C)</p> Signup and view all the answers

    A patient is being discharged after being hospitalized for GI bleeding caused by salicylate therapy. The patient expresses confusion about why Tylenol does not provide the same relief as aspirin. Which statement accurately explains the difference between the two medications?

    <p>Tylenol does not possess any anti-inflammatory properties, unlike aspirin. (A)</p> Signup and view all the answers

    What is the term used to define an individual's ability to tolerate pain?

    <p>Tolerance (C)</p> Signup and view all the answers

    A nurse administers a parenteral pain medication to a patient. How frequently should the nurse reassess the patient's pain level to evaluate the medication's effectiveness?

    <p>Every 30 minutes (C)</p> Signup and view all the answers

    Which of the following is a characteristic of neuropathic pain?

    <p>It arises from nerve injury. (A)</p> Signup and view all the answers

    A patient reports experiencing severe pain in the area of a recent surgical incision. Which of the following actions should the nurse prioritize?

    <p>Administer pain medication as prescribed. (C)</p> Signup and view all the answers

    What is the point at which a person first interprets a sensation as painful?

    <p>Pain threshold (C)</p> Signup and view all the answers

    Which of the following is NOT an adverse effect of medications?

    <p>Improved pain management (C)</p> Signup and view all the answers

    Which of the following is not a symptom of opiate withdrawal?

    <p>Bradycardia (A)</p> Signup and view all the answers

    Which medication is contraindicated for a patient taking warfarin (Coumadin)?

    <p>Aspirin (C)</p> Signup and view all the answers

    What is the most reliable way to assess the effectiveness of an opiate agonist?

    <p>Verbal report of pain on a 1 to 10 scale (B)</p> Signup and view all the answers

    Which medication would be most appropriate for a patient reporting pain at an 8 on a 0 to 10 scale?

    <p>Morphine (Roxanol) (C)</p> Signup and view all the answers

    When would a nurse be justified in withholding an opiate agonist?

    <p>Respiratory rate of 10 breaths/min (A)</p> Signup and view all the answers

    Why are time frames of 10 minutes, 1 hour, and 2 hours considered inaccurate for evaluating the effectiveness of parenteral medications?

    <p>Parenteral medications take much longer to reach peak effect. (D)</p> Signup and view all the answers

    Which of the following symptoms would be considered a sign of opioid withdrawal?

    <p>Muscle spasms (A)</p> Signup and view all the answers

    Which statement accurately reflects the relationship between warfarin and salicylates?

    <p>Salicylates enhance the anticoagulant effect of warfarin. (B)</p> Signup and view all the answers

    Flashcards

    FLACC Scale

    A tool to assess pain in nonverbal patients, focusing on face, legs, activity, cry, and consolability.

    Respiratory Depression

    A condition where breathing becomes slow and shallow, potentially life-threatening.

    Naloxone (Narcan)

    An antidote used to reverse opioid overdoses and respiratory depression.

    Salicylate Toxicity

    A condition caused by excessive salicylate intake, indicated by specific symptoms like tinnitus.

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    COX-2 Inhibitor

    A type of NSAID that primarily reduces pain with fewer gastrointestinal side effects.

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    GI Bleeding

    A possible side effect of long-term salicylate use but not a toxicity indicator.

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    Elderly Pain Assessment

    Consideration of tools like FLACC for effective pain management in nonverbal elderly patients.

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    NSAIDs vs. Salicylates

    NSAIDs like COX-2 inhibitors are preferred over salicylates for fewer adverse effects.

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    Opiate Withdrawal Symptoms

    Signs of withdrawal from opiates include muscle spasms, nausea, vomiting, and diarrhea.

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    Contradicted Medication with Warfarin

    Aspirin enhances the anticoagulant effect of warfarin and is contraindicated.

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    Effective Pain Evaluation

    The best way to evaluate pain is through a verbal report on a scale, such as 1-10.

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    Severe Pain Management

    Morphine is typically used to treat severe pain effectively.

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    Withholding Opiate Agonist

    Opiate agonists should be withheld if respiratory rate drops below 12 breaths/min.

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    Signs of Opiate Withdrawal

    Withdrawal includes symptoms like diarrhea, increased temperature, and anxiety.

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    Opiate Agonist Definition

    An opiate agonist is a medication that activates opioid receptors for pain relief.

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    Effects of Salicylates

    Salicylates can amplify the blood-thinning effects of warfarin, increasing bleeding risk.

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    Tylenol vs. Aspirin Effectiveness

    Tylenol does not relieve inflammation, unlike aspirin.

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    Pain Perception

    Pain perception is the awareness of pain, also known as nociception.

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    Pain Tolerance

    Pain tolerance is the ability to endure pain.

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    Pain Threshold

    Pain threshold is the point at which pain is first recognized.

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    Neuropathic Pain

    Neuropathic pain results from injury to the nervous system.

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    Nociceptive Pain

    Nociceptive pain comes from stimulation of pain receptors.

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    Visceral Pain

    Visceral pain originates from the abdominal and thoracic regions.

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    Post-Administration Pain Assessment

    Assess pain effectiveness 15 to 30 minutes after parenteral meds.

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    Postural hypotension

    A drop in blood pressure when standing up, often occurring with new therapy.

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    Expected adverse effect of opiate agonists

    Constipation is a common side effect of opiate medications.

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    Pain management priority

    Encourage patients to report pain early to prevent severity.

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    Quality of pain

    Describes the sensation of pain, like cramping or burning.

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    Fentanyl patch effect time

    Fentanyl patches take 12 to 24 hours to reach steady blood levels.

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    Response to severe pain with fentanyl patch

    Provide additional PRN analgesic medication for immediate relief.

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    Pain severity description

    A patient's pain level is described on a scale, such as 1-10.

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    Importance of adequate pain relief

    Medication doses must be sufficient to manage pain effectively.

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    Myocardial Infarction

    A medical condition caused by reduced blood flow to the heart, leading to tissue damage.

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    NSAIDs Drug Interactions

    NSAIDs can interact with warfarin, lithium, and diuretics, enhancing their effects.

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    Baseline Neurologic Assessment

    An assessment that includes orientation and mental alertness prior to NSAID administration.

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    Salicylates Mechanism

    Salicylates inhibit prostaglandins affecting pain, fever, and inflammation.

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    Prostaglandins and NSAIDs

    Prostaglandins are chemical signals that NSAIDs inhibit to alleviate pain and inflammation.

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    Meperidine (Demerol)

    An opiate agonist used for moderate to severe pain relief.

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    Pain Level Assessment

    Subjective measurement of pain, rated from 0 (no pain) to 10 (worst possible pain).

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    Adverse Effects of Opiate Agonists

    Common side effects include dizziness, orthostatic hypotension, respiratory depression, and confusion.

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    Nursing Interventions for Pediatric Pain Management

    Effective strategies include diversional activities, allowing rest, hygiene care, and parental involvement.

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    Signs of Constipation in Pain Management

    Absence of bowel movement after opioid use indicates a risk for constipation.

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    Common Uses of Salicylates

    Salicylates can manage conditions like migraine headaches, swollen joints, fevers, and muscle aches.

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    Prioritizing Nursing Diagnoses

    Assess and prioritize based on patient symptoms and risks, such as altered breathing patterns.

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    Study Notes

    Pharm Final Exam Chapter 19: Pain Management and Medications

    • Pain Scale Selection:

      • FLACC scale is most accurate for nonverbal adult patients.
      • Other scales like TPPPS, POCIS, and MOPS are not suitable for this patient group.

    • Respiratory Depression in Morphine Patients:

      • Shallow, irregular breathing (6 breaths/minute) indicates respiratory depression.
      • Administer naloxone (Narcan) as the antidote.

    • Salicylate Toxicity Symptoms:

      • Tinnitus (ringing in ears) is a key symptom.
      • Other symptoms include GI bleeding (over time), increased bleeding times, nausea (not a specific symptom,), fever, lethargy, and dizziness.

    • COX-2 Inhibitors in NSAIDs:

      • COX-2 inhibitors have fewer gastrointestinal (GI) adverse effects compared to other NSAIDs.
      • Aspirin is a less expensive alternative, but has more GI adverse effects.

    • Tylenol (Acetaminophen) vs. Aspirin:

      • Tylenol is an analgesic and antipyretic, but not an anti-inflammatory.
      • Unlike aspirin, Tylenol is not effective for inflammatory discomfort

    • Patient Pain Assessment for Opioid Withdrawal:

      • Assessment of diarrhea is crucial for detecting opioid withdrawal

    • Pain Management Timeline:

      • Pain medication effectiveness is best assessed within 15-30 minutes after administration of parenteral pain medication
      • The next assessment should be done to evaluate the effectiveness of the parenteral medication

    • Pain Perception:

      • Pain perception (nociception) is the awareness of the feeling of pain and is different from tolerance or pain thresholds

    • Neuropathic Pain vs. Nociceptive Pain:

      • Neuropathic pain is caused by nerve injury,
      • Nociceptive pain results from a stimulus to pain receptors. It's often described as dull or aching. Usually involving the abdominal region

    • Pain Management Strategies:

      • Diversional Activities: Coloring, puzzles, and games are effective in pain management for children
      • Parental Involvement: Encouraging parental participation can reduce a child's anxiety.
      • Adequate Hydration Encourage the patient to drink plenty of fluids.

    • Warfarin Interactions:

      • Avoid Aspirin when taking Warfarin, as Salicylates enhance the anticoagulant effect.
      • Acetaminophen, Propoxyphene, and Morphine are not contraindicated with Warfarin.

    • Opiate Agonist Effectiveness Evaluation:

      • Assessing the patient's verbal report of pain using a scale (0-10) is the best way to evaluate opioid effectiveness.

    • Opiate Agonist Contraindications:

      • Administering an opiate agonist should be avoided when there's respiratory rate less than 12 respirations per minute.

    • Drug Interactions:

      • NSAIDs may interact with Warfarin (Coumadin), lithium, and diuretics.

    • Neurologic Assessment (Before NSAIDs):

      • Assess vital signs, orientation, mental alertness, and bowel sounds
      • Assess for concurrent use of anticoagulants before administering an NSAID medication

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    Description

    Test your knowledge on pain management techniques and the implications of using NSAIDs and opioids in nonverbal adult patients. This quiz covers key concepts such as pain scales, salicylate toxicity, and potential medication side effects. Perfect for nursing students and healthcare professionals.

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