Podcast
Questions and Answers
What is the primary reason pain is described as a 'personal experience'?
What is the primary reason pain is described as a 'personal experience'?
- An individual's life events and experiences shape their perception of pain. (correct)
- Pain is a universal experience with consistent characteristics across individuals.
- The intensity of pain can be objectively measured using standardized tools.
- Pain is solely determined by the extent of tissue damage.
A patient reports experiencing pain for longer than six months. Which type of pain is the patient most likely experiencing?
A patient reports experiencing pain for longer than six months. Which type of pain is the patient most likely experiencing?
- Chronic pain (correct)
- Acute pain
- Nociceptive pain
- Breakthrough pain
Which of the following is a key characteristic that distinguishes acute pain from chronic pain?
Which of the following is a key characteristic that distinguishes acute pain from chronic pain?
- Acute pain always requires opioid treatment, while chronic pain does not.
- Acute pain serves as a protective mechanism, while chronic pain does not. (correct)
- Chronic pain is always associated with visible tissue damage, while acute pain is not.
- Acute pain is primarily psychological, whereas chronic pain is primarily physical.
A patient with advanced dementia is unable to verbally communicate their pain. Which assessment tool is most appropriate for the nurse to use?
A patient with advanced dementia is unable to verbally communicate their pain. Which assessment tool is most appropriate for the nurse to use?
During the transmission phase of pain, what is the role of peripheral nerve endings?
During the transmission phase of pain, what is the role of peripheral nerve endings?
A patient reports pain that is described as 'localized and throbbing.' This is most characteristic of what kind of pain?
A patient reports pain that is described as 'localized and throbbing.' This is most characteristic of what kind of pain?
A patient who suffered a spinal cord injury reports burning, shooting pain in their lower extremities. What type of pain is this patient most likely experiencing?
A patient who suffered a spinal cord injury reports burning, shooting pain in their lower extremities. What type of pain is this patient most likely experiencing?
Which of the following best describes the role of modulation in the pathophysiology of pain?
Which of the following best describes the role of modulation in the pathophysiology of pain?
During a pain assessment, which principle is considered the 'gold standard'?
During a pain assessment, which principle is considered the 'gold standard'?
A patient reports a pain level of 8 on a 0-10 numeric pain scale. According to the WHO pain ladder, which category of analgesics should be considered first?
A patient reports a pain level of 8 on a 0-10 numeric pain scale. According to the WHO pain ladder, which category of analgesics should be considered first?
What is the primary purpose of using adjuvant medications in pain management?
What is the primary purpose of using adjuvant medications in pain management?
Which of the following is a common side effect of opioid analgesics that requires proactive nursing intervention?
Which of the following is a common side effect of opioid analgesics that requires proactive nursing intervention?
What is the mechanism of action of naloxone?
What is the mechanism of action of naloxone?
A nurse is educating a patient about the safe use of acetaminophen. Which instruction is most important to emphasize?
A nurse is educating a patient about the safe use of acetaminophen. Which instruction is most important to emphasize?
Which of the following non-pharmacological interventions is most appropriate for a patient experiencing muscle tension due to anxiety and pain?
Which of the following non-pharmacological interventions is most appropriate for a patient experiencing muscle tension due to anxiety and pain?
An elderly patient in a long-term care facility exhibits changes in behavior, such as increased agitation and withdrawal. What should the nurse consider first?
An elderly patient in a long-term care facility exhibits changes in behavior, such as increased agitation and withdrawal. What should the nurse consider first?
Which statement best describes the ethical considerations surrounding the use of placebo analgesia in pain management?
Which statement best describes the ethical considerations surrounding the use of placebo analgesia in pain management?
You are caring for a patient who is receiving pain medication through a PCA (Patient-Controlled Analgesia) pump. What is paramount patient safety education you must discuss with the patient and their family?
You are caring for a patient who is receiving pain medication through a PCA (Patient-Controlled Analgesia) pump. What is paramount patient safety education you must discuss with the patient and their family?
A patient experiencing chronic pain expresses feelings of hopelessness and isolation, stating, “There's no point in trying anything anymore.” Which intervention is most appropriate for the nurse to initiate?
A patient experiencing chronic pain expresses feelings of hopelessness and isolation, stating, “There's no point in trying anything anymore.” Which intervention is most appropriate for the nurse to initiate?
A patient with a history of opioid use disorder is admitted for a surgical procedure. The patient expresses concern about receiving adequate pain relief post-operatively, but the provider is reluctant to prescribe opioids, citing addiction risk. What is the most appropriate course of action?
A patient with a history of opioid use disorder is admitted for a surgical procedure. The patient expresses concern about receiving adequate pain relief post-operatively, but the provider is reluctant to prescribe opioids, citing addiction risk. What is the most appropriate course of action?
A patient reports feeling pain even after the expected healing time for their injury has passed. What type of pain are they most likely experiencing?
A patient reports feeling pain even after the expected healing time for their injury has passed. What type of pain are they most likely experiencing?
What is the primary physiological process involved in transduction during the experience of pain?
What is the primary physiological process involved in transduction during the experience of pain?
A patient with diabetic neuropathy reports continuous, burning pain in their feet. What type of pain is this patient experiencing?
A patient with diabetic neuropathy reports continuous, burning pain in their feet. What type of pain is this patient experiencing?
When assessing a patient's pain, what does the acronym 'WHAT'S UP' help the healthcare provider remember to evaluate?
When assessing a patient's pain, what does the acronym 'WHAT'S UP' help the healthcare provider remember to evaluate?
Which pain assessment tool is most suitable for a patient who is nonverbal due to advanced dementia?
Which pain assessment tool is most suitable for a patient who is nonverbal due to advanced dementia?
What physiological effect is the body attempting to achieve during the 'modulation' phase of pain?
What physiological effect is the body attempting to achieve during the 'modulation' phase of pain?
A patient reports back pain that is actually caused by a kidney infection. What type of pain is this?
A patient reports back pain that is actually caused by a kidney infection. What type of pain is this?
What is a crucial step for the LPN when managing a patient's pain using a PCA (patient-controlled analgesia) device?
What is a crucial step for the LPN when managing a patient's pain using a PCA (patient-controlled analgesia) device?
Which of the following is a common side effect of opioid analgesics that patients should be educated about?
Which of the following is a common side effect of opioid analgesics that patients should be educated about?
A patient has been prescribed acetaminophen for mild pain. What is the most important instruction to give regarding its safe use?
A patient has been prescribed acetaminophen for mild pain. What is the most important instruction to give regarding its safe use?
When administering naloxone to a patient experiencing opioid-induced respiratory depression, what is the primary expected outcome?
When administering naloxone to a patient experiencing opioid-induced respiratory depression, what is the primary expected outcome?
Which of the following non-pharmacological interventions can help in managing muscle tension associated with pain?
Which of the following non-pharmacological interventions can help in managing muscle tension associated with pain?
An elderly patient in a long-term care facility is exhibiting increased agitation and confusion. What is an essential first step the nurse should take?
An elderly patient in a long-term care facility is exhibiting increased agitation and confusion. What is an essential first step the nurse should take?
What is the ethical consideration regarding the use of placebos in pain management?
What is the ethical consideration regarding the use of placebos in pain management?
A post-operative patient reports a pain level of 7 out of 10. According to the WHO pain ladder, which class of analgesics should be considered?
A post-operative patient reports a pain level of 7 out of 10. According to the WHO pain ladder, which class of analgesics should be considered?
A patient is prescribed gabapentin as an adjuvant medication for chronic neuropathic pain. What should the nurse include in patient education regarding this medication?
A patient is prescribed gabapentin as an adjuvant medication for chronic neuropathic pain. What should the nurse include in patient education regarding this medication?
An individual who is opioid-dependent undergoes surgery and requires post-operative pain management. How can healthcare providers balance pain relief and addiction concerns?
An individual who is opioid-dependent undergoes surgery and requires post-operative pain management. How can healthcare providers balance pain relief and addiction concerns?
Which statement best differentiates between opioid dependence and opioid addiction?
Which statement best differentiates between opioid dependence and opioid addiction?
A researcher is studying a new pain medication that shows promise in clinical trials, but also has several unknown long-term effects. Which ethical principle should guide the researcher's decision whether or not to publicize the new medication?
A researcher is studying a new pain medication that shows promise in clinical trials, but also has several unknown long-term effects. Which ethical principle should guide the researcher's decision whether or not to publicize the new medication?
After administering an opioid to a patient, the nurse assesses a decreased level of consciousness, a respiratory rate of 8 breaths per minute, and pinpoint pupils. Besides administering naloxone, what is the nurse's most critical next action to treat the most immediate life-threatening issue?
After administering an opioid to a patient, the nurse assesses a decreased level of consciousness, a respiratory rate of 8 breaths per minute, and pinpoint pupils. Besides administering naloxone, what is the nurse's most critical next action to treat the most immediate life-threatening issue?
Which of the following best describes referred pain?
Which of the following best describes referred pain?
A patient reports experiencing pain that is not well-localized and is described as cramping. What type of pain is this most likely?
A patient reports experiencing pain that is not well-localized and is described as cramping. What type of pain is this most likely?
Which of the following is a key consideration when using the Faces Pain Scale to assess a patient's pain level?
Which of the following is a key consideration when using the Faces Pain Scale to assess a patient's pain level?
A patient with advanced dementia is being assessed for pain. During the assessment, the nurse observes the patient exhibiting a tense body language, distressed pacing, and fidgeting. According to PAINAD scale, what score should the nurse assign?
A patient with advanced dementia is being assessed for pain. During the assessment, the nurse observes the patient exhibiting a tense body language, distressed pacing, and fidgeting. According to PAINAD scale, what score should the nurse assign?
When educating a patient about the side effects of opioid analgesics, which of the following should the nurse prioritize?
When educating a patient about the side effects of opioid analgesics, which of the following should the nurse prioritize?
A patient prescribed acetaminophen for pain should be educated to avoid exceeding what maximum daily dosage to prevent liver toxicity?
A patient prescribed acetaminophen for pain should be educated to avoid exceeding what maximum daily dosage to prevent liver toxicity?
Naloxone is administered to a patient with opioid-induced respiratory depression. What is the expected primary therapeutic effect?
Naloxone is administered to a patient with opioid-induced respiratory depression. What is the expected primary therapeutic effect?
Which of the following non-pharmacological interventions is most suitable for reducing anxiety and promoting relaxation in a patient experiencing pain?
Which of the following non-pharmacological interventions is most suitable for reducing anxiety and promoting relaxation in a patient experiencing pain?
What is a crucial nursing action when managing a patient's pain using a PCA (patient-controlled analgesia) device?
What is a crucial nursing action when managing a patient's pain using a PCA (patient-controlled analgesia) device?
What is the most important consideration when addressing pain management in older adults?
What is the most important consideration when addressing pain management in older adults?
What is the primary ethical consideration when using placebos in pain management?
What is the primary ethical consideration when using placebos in pain management?
According to the WHO pain ladder, which class of analgesics should be considered first for a patient with mild to moderate pain?
According to the WHO pain ladder, which class of analgesics should be considered first for a patient with mild to moderate pain?
Which of the following is a common example of an adjuvant medication used in pain management?
Which of the following is a common example of an adjuvant medication used in pain management?
A patient reports that their chronic back pain intensifies with movement but is somewhat relieved by rest. This pain could be classified as:
A patient reports that their chronic back pain intensifies with movement but is somewhat relieved by rest. This pain could be classified as:
A surgical patient is prescribed an opioid analgesic for post-operative pain. What is the most critical instruction the nurse should provide regarding respiratory function?
A surgical patient is prescribed an opioid analgesic for post-operative pain. What is the most critical instruction the nurse should provide regarding respiratory function?
What is the significance of 'modulation' in the context of the pain pathway?
What is the significance of 'modulation' in the context of the pain pathway?
In the context of pain management, what is the primary distinction between opioid dependence and opioid addiction?
In the context of pain management, what is the primary distinction between opioid dependence and opioid addiction?
During a pain assessment, a patient is unable to verbally communicate due to intubation. What would be the most appropriate alternative method to assess their pain?
During a pain assessment, a patient is unable to verbally communicate due to intubation. What would be the most appropriate alternative method to assess their pain?
Which ethical principle is most challenged when a nurse decides to administer a placebo, without the patient's knowledge, to assess if the patient's pain is real?
Which ethical principle is most challenged when a nurse decides to administer a placebo, without the patient's knowledge, to assess if the patient's pain is real?
A patient reports pain in their lower back caused by a kidney stone. The patient describes the pain as radiating down their flank and into their groin. Which of the following best describes this pain pattern?
A patient reports pain in their lower back caused by a kidney stone. The patient describes the pain as radiating down their flank and into their groin. Which of the following best describes this pain pattern?
Which of the following statements best reflects Margo McCaffery's definition of pain?
Which of the following statements best reflects Margo McCaffery's definition of pain?
According to the International Association for the Study of Pain (IASP), pain is best defined as:
According to the International Association for the Study of Pain (IASP), pain is best defined as:
What physiological process does 'transduction' refer to in the context of pain?
What physiological process does 'transduction' refer to in the context of pain?
Which of the following neurotransmitters are released during the transduction phase of nociception?
Which of the following neurotransmitters are released during the transduction phase of nociception?
What is the physiological significance of 'modulation' in the pain pathway?
What is the physiological significance of 'modulation' in the pain pathway?
Which best describes the mechanism of action of opioid analgesics?
Which best describes the mechanism of action of opioid analgesics?
What is a critical nursing consideration when administering opioid analgesics?
What is a critical nursing consideration when administering opioid analgesics?
Which statement accurately differentiates between tolerance and addiction in the context of opioid use?
Which statement accurately differentiates between tolerance and addiction in the context of opioid use?
What is a key characteristic of 'pseudoaddiction' in pain management?
What is a key characteristic of 'pseudoaddiction' in pain management?
Which intervention is most appropriate for managing opioid-induced constipation?
Which intervention is most appropriate for managing opioid-induced constipation?
What statement is true regarding the use of placebos in pain management?
What statement is true regarding the use of placebos in pain management?
A patient reports pain that is sharp, localized, and throbbing. This is most representative of:
A patient reports pain that is sharp, localized, and throbbing. This is most representative of:
A patient with diabetic neuropathy describes their pain as constant burning in both feet. This is most indicative of:
A patient with diabetic neuropathy describes their pain as constant burning in both feet. This is most indicative of:
What is the significance of recognizing cultural differences in pain management?
What is the significance of recognizing cultural differences in pain management?
What is the primary advantage of using a Patient-Controlled Analgesia (PCA) pump?
What is the primary advantage of using a Patient-Controlled Analgesia (PCA) pump?
What is a crucial teaching point for patients and families regarding PCA pump use?
What is a crucial teaching point for patients and families regarding PCA pump use?
Which of the following is a common example of an analgesic adjuvant medication?
Which of the following is a common example of an analgesic adjuvant medication?
What is a primary benefit of using a 'balanced analgesia' approach?
What is a primary benefit of using a 'balanced analgesia' approach?
What is hyperalgesia?
What is hyperalgesia?
When applying heat as a nonpharmacological intervention, why should it be avoided in areas with decreased sensation?
When applying heat as a nonpharmacological intervention, why should it be avoided in areas with decreased sensation?
What is the MOST accurate statement regarding the use of distraction techniques for pain management?
What is the MOST accurate statement regarding the use of distraction techniques for pain management?
What is the primary reason for the recommendation in the text to avoid meperidine (Demerol) for older adults?
What is the primary reason for the recommendation in the text to avoid meperidine (Demerol) for older adults?
What is the MOST important reason for scheduling pain medications ATC (around-the-clock)?
What is the MOST important reason for scheduling pain medications ATC (around-the-clock)?
Why must nurses be vigilant about recognizing side effects in a patient unaccustomed to opioids?
Why must nurses be vigilant about recognizing side effects in a patient unaccustomed to opioids?
Which statement MOST accurately describes the use of the WHO analgesic ladder?
Which statement MOST accurately describes the use of the WHO analgesic ladder?
Which is NOT a Cognitive Behavioral Intervention?
Which is NOT a Cognitive Behavioral Intervention?
Which action should the nurse implement to enhance patient safety and prevent complications when caring for a patient who is receiving opioids?
Which action should the nurse implement to enhance patient safety and prevent complications when caring for a patient who is receiving opioids?
Which nursing action is most crucial for promoting comfort and managing pain effectively in an older adult patient with cognitive impairment?
Which nursing action is most crucial for promoting comfort and managing pain effectively in an older adult patient with cognitive impairment?
What nonpharmacological therapies are considered physical agents?
What nonpharmacological therapies are considered physical agents?
What does the nursing assessment reveal about the need for home health care when a patients is being dischared?
What does the nursing assessment reveal about the need for home health care when a patients is being dischared?
As a final step after implementing all facets of a plan of care, nurses need to evaluate all efforts. Which question requires a nurse to asses which facet of pain she needs to evaluate?
As a final step after implementing all facets of a plan of care, nurses need to evaluate all efforts. Which question requires a nurse to asses which facet of pain she needs to evaluate?
You're caring for Jim, who's prescribed morphine for chronic back pain. After a week, he needs higher doses for the same relief. He's worried about addiction. What's the BEST response?
You're caring for Jim, who's prescribed morphine for chronic back pain. After a week, he needs higher doses for the same relief. He's worried about addiction. What's the BEST response?
Janet, with severe pain from pancreatitis and a drug abuse history, keeps asking for more morphine. You feel like she's received enough already. What is your BEST course of action?
Janet, with severe pain from pancreatitis and a drug abuse history, keeps asking for more morphine. You feel like she's received enough already. What is your BEST course of action?
I must use caution when giving IV Narcan to a patient receiving medication for pain because:
I must use caution when giving IV Narcan to a patient receiving medication for pain because:
What statement from a 75 year olf patient is the BEST indicator that care and teachinng is successful?
What statement from a 75 year olf patient is the BEST indicator that care and teachinng is successful?
You receive an order for 1 mL of normal saline IM. Why is it UNETHICAL to carry out the task?
You receive an order for 1 mL of normal saline IM. Why is it UNETHICAL to carry out the task?
Mr. Sebastian has lung cancer and is headed home, requiring morphine. Given that there are syringes prefilled with morphine grains 1/6 per mL, what is the correct amount of milliliters needed?
Mr. Sebastian has lung cancer and is headed home, requiring morphine. Given that there are syringes prefilled with morphine grains 1/6 per mL, what is the correct amount of milliliters needed?
According to Margo McCaffery, what best describes pain?
According to Margo McCaffery, what best describes pain?
What is the primary purpose of pain?
What is the primary purpose of pain?
Why can unrelieved pain be detrimental?
Why can unrelieved pain be detrimental?
During which process of pain transmission are neurotransmitters released from damaged tissue?
During which process of pain transmission are neurotransmitters released from damaged tissue?
Which of the following best describes somatic pain?
Which of the following best describes somatic pain?
A patient reports persistent, poorly localized pain with shooting sensations after herpes zoster. Which type of pain is the patient experiencing?
A patient reports persistent, poorly localized pain with shooting sensations after herpes zoster. Which type of pain is the patient experiencing?
What is a key feature of chronic pain?
What is a key feature of chronic pain?
What is the defining characteristic of analgesics?
What is the defining characteristic of analgesics?
What is meant by the 'ceiling effect' of nonopioid analgesics?
What is meant by the 'ceiling effect' of nonopioid analgesics?
What is the primary action of opioids in the body?
What is the primary action of opioids in the body?
Which guideline is most important to follow when administering a controlled-release opioid?
Which guideline is most important to follow when administering a controlled-release opioid?
What does the term 'adjuvant' refer to in the context of pain management?
What does the term 'adjuvant' refer to in the context of pain management?
What is the key nursing consideration when administering benzodiazepines for pain management?
What is the key nursing consideration when administering benzodiazepines for pain management?
What is the rationale for administering pain medications 'around-the-clock' (ATC)?
What is the rationale for administering pain medications 'around-the-clock' (ATC)?
Which instruction should the nurse provide to a patient using a Patient-Controlled Analgesia (PCA) pump?
Which instruction should the nurse provide to a patient using a Patient-Controlled Analgesia (PCA) pump?
According to the World Health Organization (WHO) analgesic ladder, what is the typical first step in pain management?
According to the World Health Organization (WHO) analgesic ladder, what is the typical first step in pain management?
Which nonpharmacological approach can help a patient understand and actively participate in their pain assessment and control?
Which nonpharmacological approach can help a patient understand and actively participate in their pain assessment and control?
What is one primary concern when using heat applications for pain relief?
What is one primary concern when using heat applications for pain relief?
In the context of cultural sensitivity, what is the best approach for assessing a patient's pain?
In the context of cultural sensitivity, what is the best approach for assessing a patient's pain?
A patient consistently requests pain medication immediately when their family leaves. What action should the nurse take?
A patient consistently requests pain medication immediately when their family leaves. What action should the nurse take?
A nurse suspects a person is drug-seeking, what action should the nurse take?
A nurse suspects a person is drug-seeking, what action should the nurse take?
A patient has stable pain, and their doctor orders a Fentanyl patch. How does the nurse know the placement is most effective?
A patient has stable pain, and their doctor orders a Fentanyl patch. How does the nurse know the placement is most effective?
What is the MAIN role for a nurse who is providing care for a person in pain?
What is the MAIN role for a nurse who is providing care for a person in pain?
A patient has post-operative surgical pain of level "6", what medications, and route, is appropriate?
A patient has post-operative surgical pain of level "6", what medications, and route, is appropriate?
A diabetic patient has neuropathic pain. Knowing this, the nurse will assess for?
A diabetic patient has neuropathic pain. Knowing this, the nurse will assess for?
A patient recovering from surgery is ordered Tylenol #3, and is also ordered regular Tylenol. What is crucial for the nurse to educate the patient?
A patient recovering from surgery is ordered Tylenol #3, and is also ordered regular Tylenol. What is crucial for the nurse to educate the patient?
A patient is on continuous Morphine. Which behavior calls for extra nursing education and monitoring?
A patient is on continuous Morphine. Which behavior calls for extra nursing education and monitoring?
Which person on the care team is responsible for assessing pain
Which person on the care team is responsible for assessing pain
All are facts about pain relief for geriatric patients EXCEPT:
All are facts about pain relief for geriatric patients EXCEPT:
What must the nurse do with all pain assessment tools
What must the nurse do with all pain assessment tools
All are cognitive-behavioral pain interventions EXCEPT:
All are cognitive-behavioral pain interventions EXCEPT:
What will heat packs to sore muscles cause?
What will heat packs to sore muscles cause?
During the post op period, a nurse can anticipate ALL, EXCEPT:
During the post op period, a nurse can anticipate ALL, EXCEPT:
ALL, EXCEPT which action is appropriate with pain meds
ALL, EXCEPT which action is appropriate with pain meds
A women states her pain control is not the best it can be. She says she ration those meds. What statement by the nurse is best?
A women states her pain control is not the best it can be. She says she ration those meds. What statement by the nurse is best?
A person has severe pain and hx of drug abuse, keeps asking. What is the BEST action?
A person has severe pain and hx of drug abuse, keeps asking. What is the BEST action?
Why is it imperative to assess a patient receiving Narcan?
Why is it imperative to assess a patient receiving Narcan?
A nurse taught and assisted a senior on methods of relieving comfort, which show its effective?
A nurse taught and assisted a senior on methods of relieving comfort, which show its effective?
What is a long term goal for a dying lung cancer patient
What is a long term goal for a dying lung cancer patient
You must not administer the medication
You must not administer the medication
A person recovering is returning home, but needs morphine. How many of 1/6mg per mll per syringe needed?
A person recovering is returning home, but needs morphine. How many of 1/6mg per mll per syringe needed?
A patient taking opioids for chronic pain reports persistent constipation. Besides a stool softener, which adjuvant medication could also help manage this side effect?
A patient taking opioids for chronic pain reports persistent constipation. Besides a stool softener, which adjuvant medication could also help manage this side effect?
A patient is being discharged with a prescription for a fentanyl transdermal patch for chronic pain. Which instruction is most important for the nurse to provide concerning the safe use of this medication?
A patient is being discharged with a prescription for a fentanyl transdermal patch for chronic pain. Which instruction is most important for the nurse to provide concerning the safe use of this medication?
Which statement accurately differentiates between tolerance and addiction in the context of opioid use for pain management?
Which statement accurately differentiates between tolerance and addiction in the context of opioid use for pain management?
A patient reports having pain but exhibits no outward signs and denies any changes in their routine. Considering the impact of cultural differences on pain expression, what is the MOST appropriate approach for the nurse?
A patient reports having pain but exhibits no outward signs and denies any changes in their routine. Considering the impact of cultural differences on pain expression, what is the MOST appropriate approach for the nurse?
A patient consistently requests opioid pain medication immediately when their family leaves the room and reports that the pain is only 'manageable' when alone. What further assessment by the nurse is MOST warranted to understand these behaviors, while optimizing pain relief?
A patient consistently requests opioid pain medication immediately when their family leaves the room and reports that the pain is only 'manageable' when alone. What further assessment by the nurse is MOST warranted to understand these behaviors, while optimizing pain relief?
Flashcards
What is pain?
What is pain?
Unpleasant sensory and emotional experience associated with actual or potential tissue damage.
Acute Pain
Acute Pain
Pain that is short-term, prompts an inflammatory response, and lessens over time. Signs and symptoms are usually objective and physical.
Chronic Pain
Chronic Pain
Pain that lasts longer than the anticipated healing time, usually longer than 6 months. Signs and symptoms are persistent, and patients may not always appear to be in pain.
Nociceptive Pain
Nociceptive Pain
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Neuropathic Pain
Neuropathic Pain
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Referred Pain
Referred Pain
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Pain Assessment Acronym
Pain Assessment Acronym
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Analgesics
Analgesics
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Adjuvant Medications
Adjuvant Medications
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Non-Opioid Analgesics
Non-Opioid Analgesics
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Opioid Analgesics
Opioid Analgesics
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Opioid Antagonist
Opioid Antagonist
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Non-Pharmacologic Pain Treatment
Non-Pharmacologic Pain Treatment
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Tolerance
Tolerance
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Physical Dependence
Physical Dependence
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Addiction
Addiction
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Pseudoaddiction
Pseudoaddiction
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Side Effects of Opioids
Side Effects of Opioids
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LPN Role in Pain Management
LPN Role in Pain Management
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Patient Education
Patient Education
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Faces Pain Scale
Faces Pain Scale
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Modulation of Pain
Modulation of Pain
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Suffering
Suffering
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Cultural Assessment
Cultural Assessment
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Pain Management Approach
Pain Management Approach
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Nonverbal Pain Indicators
Nonverbal Pain Indicators
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Patient-Controlled Analgesia (PCA)
Patient-Controlled Analgesia (PCA)
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PCA Role: Nursing
PCA Role: Nursing
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Surgical Pain Example
Surgical Pain Example
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Pain Medication Scheduling
Pain Medication Scheduling
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Pain Med Safety
Pain Med Safety
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Gold standard in pain assessment
Gold standard in pain assessment
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Transduction of pain
Transduction of pain
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Severity Scale for Pain
Severity Scale for Pain
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Pain Assessment - WHAT'S UP?
Pain Assessment - WHAT'S UP?
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Level of Sedation Scale
Level of Sedation Scale
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Routes of administration (pain)
Routes of administration (pain)
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Analgesic Adjuvants
Analgesic Adjuvants
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Balanced Analgesia
Balanced Analgesia
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Around-the-Clock (ATC) Dosing
Around-the-Clock (ATC) Dosing
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Nociception
Nociception
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Ceiling Effect
Ceiling Effect
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Modulation
Modulation
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Transduction
Transduction
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Transmission
Transmission
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Constipation
Constipation
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Placebo
Placebo
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Corticosteroids
Corticosteroids
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Morphine
Morphine
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Naloxone (Narcan)
Naloxone (Narcan)
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Study Notes
### What is Pain?
- Pain can cause emotional responses like sadness and anger, and lead to social isolation.
- The International Association for the Study of Pain (IASP) defined pain in 2011 as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.”
### Acute vs. Chronic Pain
- Acute pain is immediate and follows injury to the body and prompts an inflammatory response, and subsides as healing takes place; persistent acute pain may become chronic
- Chronic pain typically lasts 3 months or longer, and patients with can have both nociceptive and neuropathic components.
### Pathophysiology of Pain
- The specificity theory, developed by Descartes in 1644, proposed that trauma sends a message directly to the brain.
- Melzack and Wall proposed the gate control theory, which describes the dorsal horn of the spinal cord as a gate, allowing impulses to go through when there is a pain stimulus and closing the gate when those impulses are inhibited.
- Chemical neurotransmitters released from damaged tissue during transduction, like prostaglandins, bradykinin, serotonin, and substance P.
### Mechanisms of Pain
- Nociception refers to the body’s normal reaction to noxious stimuli, with the release of pain-producing substances.
- Neuropathic pain is associated with injury to either the peripheral or central nervous system
### Managing Pain
- Effective pain management helps to reduce costs by minimizing the side effects of opioids, preventing complications related to inadequate pain control, and reducing the length of hospital stay or period of recovery.
### Myths and Barriers to Effective Pain Management
- Myth: A person who is laughing and talking is not in pain
- Fact: A person in pain is likely to use laughing and talking as a form of distraction which can be effective in managing pain, especially when used with appropriate drug therapies, and Patients may be more easily distracted when they have visitors and may ask for pain medication as soon as their family or significant other goes home.
- Myth: Respiratory depression is common in patients receiving opioid pain medications.
- Fact: Respiratory depression is uncommon in patients receiving opioid pain medications and is preventable if patients are monitored carefully when they are at risk, such as with the first dose of an opioid or when a dose is increased, and a patient’s respiratory status and level of sedation (LOS) should be routinely monitored using an LOS scale.
- Myth: Pain medication is more effective when given by injection.
- Fact: Oral administration is the first choice if possible, or whenever the IV route is not an option and the IV route has the most rapid onset of action and is the preferred route for postoperative administration but intramuscular (IM) injections are not recommended because they are painful, have unreliable absorption from the muscle, and have a lag time to peak effect and rapid falloff compared with oral administration.
- Myth: Teenagers are more likely to become addicted than older patients.
- Fact: Addiction to opioids is uncommon in all age groups when taken for pain by patients without a prior drug abuse history.
- Myth: Pain is a normal part of aging.
- Fact: While many older adults have medical conditions that cause pain, pain is not a normal or anticipated part of aging and should be treated proactively with Effective pain treatment for older people helps them to maintain their mobility longer and improve overall health.
### Opioid analgesics
- Inappropriate prescribing can lead to hyperalgesia, or increased sensitivity to pain and Patients with hyperalgesia have pain at the slightest touch, such as the moving of sheets, and require further medical intervention
- Institutions must have policies and procedures in place related to opioids to prevent medication errors and reduce the risk of serious side effects and It is especially important to be vigilant for side effects in patients unaccustomed to opioids, the most common of which are constipation, confusion, and fatigue, which can increase a patient’s risk for falls
- Opioid-naïve patients are those unaccustomed to opioids
- Controlled-release opioids such as oxycodone (OxyContin) and morphine (MS Contin) are effective for prolonged, continuous pain and Whenever a controlled-release form of medication is used, it is important to have an immediate-release medication available for breakthrough pain (transient pain that arises during generally effective pain control), such as oral morphine solution, oxycodone immediate-release (OxyIR), or hydromorphone immediate-release (Dilaudid).
- NEVER crush a controlled- or time-release tablet, because the tablet is designed to deliver a dose of medication over time, crushing it could deliver the entire dose at once, resulting in overdose.
### Opioid Antagonists
- Caution must be used when giving naloxone to a patient who is receiving opioids for pain control; if too much naloxone is given too fast, it can reverse not only the unwanted effects but the desired effect of analgesia as well.
- Some antagonists are shorter acting than the opioid that is being used, and if the antagonist is given because of respiratory depression, the dose may need to be repeated because its effect may wear off before the opioid wears off.
- Common drugs that are combined agonists and antagonists or partial agonists include butorphanol (Stadol) and nalbuphine (Nubain) so If a patient receives sustained-release morphine every 12 hours to control metastatic bone pain, but the patient develops breakthrough pain between doses, the butorphanol will antagonize, or counteract, some of the effects of the morphine, and the patient may experience acute pain.
### Non-Pharmacologic Treatment
- Effectiveness of acupressure on relieving pain: Acupressure can be efficiently conducted by health care professionals as an adjuvant therapy in general practice for pain relief.
### Terminology
- pseudoaddiction: pseudo (false) + addiction (psychological dependence)
- antagonist: ant (against) + agonist (stimulates receptor site)
- equianalgesic: equi (equal) + analgesic (relieving pain)
- nociception: noci (pain) + ception (reception)
- neuropathic: neuro (nerves) + pathy (disease, suffering)
- analgesic: an (not) + gesia (pain)
- transdermal: trans (across) + dermal (skin)
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