Pain Assessment and Management
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Questions and Answers

In order to provide the optimum nursing care, it is important for the nurse to know that the standard of pain and pain control is best determined by which person?

  • Patient's family
  • Physician
  • Patient (correct)
  • Nurse
  • The nurse clarifies the basics of the gate theory of pain control. Which information should the nurse include?

  • Pain is perceived as opening a 'gate' to pain symptoms.
  • The 'gate' can be closed to pain by the use of nonpainful stimuli. (correct)
  • The 'gate' swings back and forth, first allowing pain, then blocking it.
  • The patient can be trained to close the 'gate' to pain.
  • The culturally competent nurse is aware that a patient may deny pain because of their cultural beliefs. The nurse expects which behavior from the patient?

  • The patient ignores somatic interventions such as heat and massage.
  • The patient prefers a pill to an injection.
  • The patient confesses to pain but refuses pain medication.
  • The patient maintains a stoic affect about pain. (correct)
  • The nurse is caring for a patient who is having constant nociceptor pain. Which intervention best addresses the patient's pain during the perception phase of pain?

    <p>Engage the patient in conversation regarding his family, hobbies, and plans following discharge from the facility.</p> Signup and view all the answers

    The patient is experiencing phantom pain following the amputation of her foot. Which type of pain is most associated with phantom pain?

    <p>Neuropathic</p> Signup and view all the answers

    The nurse explains that the pain threshold and pain tolerance are different. Which statement about the pain threshold is true?

    <p>Pain threshold is the point at which pain is perceived.</p> Signup and view all the answers

    The patient who had abdominal surgery this morning refuses the opioid pain medication for fear of addiction. How should the nurse respond?

    <p>Fewer than 3% of people become addicted to drugs used for pain relief.</p> Signup and view all the answers

    Which student nurse's note in the patient's record features proper documentation of a pain assessment?

    <p>Pt complains of local sharp pain (4/5) in lower abdomen upon standing.</p> Signup and view all the answers

    The nurse is educating the home health patient about indications for acetaminophen. Which information should the nurse include in the teaching plan?

    <p>Take acetaminophen before pain becomes severe.</p> Signup and view all the answers

    While bathing a patient, the nurse notes that a transdermal patch that was meant to be on the patient for 3 days is now gone on the second day. What action should the nurse take?

    <p>Document the loss and apply a fresh patch to be replaced in 3 days.</p> Signup and view all the answers

    The patient on frequent doses of meperidine (Demerol) complains of constipation. Which initial intervention is best?

    <p>Increase oral fluid intake.</p> Signup and view all the answers

    The home health nurse educates the 75-year-old patient about the ice pack he is using on his swollen elbow. Which information is most important to include in the teaching plan?

    <p>Allow the ice pack to remain in place for 15 to 20 minutes.</p> Signup and view all the answers

    The hospitalized postsurgical patient is reluctant to take the opioid pain medication because of drowsiness. Which response is most informative for the nurse to make?

    <p>Sleep and pain relief promote healing.</p> Signup and view all the answers

    To help with pain control, how should the nurse time the distraction activities for a patient?

    <p>To bridge the time between administration and onset</p> Signup and view all the answers

    A patient reports pain relief after having received a placebo. Which conclusion is most accurate for the nurse to determine?

    <p>The patient was relieved of the anxiety that there is no ready source of pain remedy.</p> Signup and view all the answers

    The nurse is caring for a patient that is receiving intravenous morphine sulfate. The patient breaks out in hives and begins to itch. What should the nurse do first?

    <p>Stop the infusion.</p> Signup and view all the answers

    The nurse is planning to teach a family member about effective massage techniques. Which information is most important to include in the teaching plan?

    <p>Use long, firm strokes while avoiding areas of inflammation.</p> Signup and view all the answers

    The nurse explains that acupressure and acupuncture are effective pain relief modalities that focus on specific body areas. Which term best describes these therapies?

    <p>Meridians</p> Signup and view all the answers

    The nurse is caring for a patient who is 1-day postoperative following a colon resection. The patient has degenerative joint disease and uses a pain medication patch to control this chronic pain. Which consideration is most important when planning care for this patient?

    <p>Realize that this patient will most likely require more pain medication than most patients undergoing a colon resection.</p> Signup and view all the answers

    The nurse is using the gate theory as a guide to pain management. Which intervention(s) should the nurse plan to offer? (Select all that apply.)

    <p>Interactive distraction</p> Signup and view all the answers

    What is/are the functions of endorphins? (Select all that apply.)

    <p>Inhibition of unpleasant stimuli</p> Signup and view all the answers

    The nurse is caring for the patient with neuropathic pain. Which agents will most effectively control this patient's pain? (Select all that apply.)

    <p>Anticonvulsants</p> Signup and view all the answers

    Although the patient with a kidney stone denies pain, the nurse assesses cues that indicate that pain is perceived. Which assessments indicate that pain may be present? (Select all that apply.)

    <p>Nausea</p> Signup and view all the answers

    Study Notes

    Pain Assessment and Management

    • Optimal nursing care requires pain standards to be defined by the patient.
    • The gate theory of pain control states that the "gate" can be closed to pain through nonpainful stimuli.
    • Culturally competent nurses should recognize that some patients may respond to pain with a stoic demeanor based on cultural beliefs.

    Types of Pain

    • Nociceptor pain is constant and can be addressed by engaging patients in conversation about their interests to improve pain management.
    • Phantom pain following amputation is classified as neuropathic pain.
    • Pain threshold is defined as the minimal point at which pain is perceived.

    Opioids and Pain Relief

    • Concerns about opioid addiction are common; however, fewer than 3% of patients become addicted when used for pain relief.
    • Proper documentation in pain assessments is crucial; for example, indicating patient-reported pain levels like "sharp pain (4/5) in lower abdomen."

    Pain Management Techniques

    • Acetaminophen is most effective when taken before pain escalates.
    • For missing transdermal patches, documentation is key, along with applying a fresh patch based on the original schedule.
    • In cases of opioid-induced constipation, increasing oral fluid intake is a prudent initial intervention.

    Patient Education

    • Important to instruct patients using ice packs to keep them on for 15 to 20 minutes to reduce swelling.
    • Emphasize that sleep and pain relief are important for healing after surgery.
    • Distraction techniques can be timed to occur between the administration of pain relief and its onset.

    Patient Response to Placebo

    • Placebo effectiveness may stem from reduced anxiety rather than actual pain relief.

    Managing Side Effects

    • In case of allergic reactions to medications (e.g., hives from morphine), prioritize stopping the infusion.

    Massage and Alternative Therapies

    • Effective massage techniques should avoid areas of inflammation and focus on long, firm strokes.
    • Acupressure and acupuncture operate using the concept of meridians in the body for pain relief.

    Special Considerations

    • Patients with chronic pain may require more pain management post-surgery and could fear requesting additional medication due to addiction concerns.

    Pain Management Strategies

    • Effective interventions according to the gate theory include massage, social activities, music, and interactive distraction.
    • Endorphins function to inhibit unpleasant stimuli, relieve pain, diminish anxiety, and produce feelings of euphoria.

    Neuropathic Pain Control

    • Agents effective against neuropathic pain include antidepressants and anticonvulsants, rather than typical analgesics or opioids.

    Indicators of Pain Presence

    • Even if a patient denies experiencing pain, signs such as increased pulse rate, diaphoresis, muscle tension, and nausea may indicate pain perception.

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    Description

    This quiz covers essential concepts in pain assessment and management, emphasizing the roles of patients and culturally competent care. Topics include pain types, opioid concerns, and the gate theory of pain control. Test your knowledge on the principles vital for effective nursing practice.

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