Ch. 35 Pain Management

Question 1

Pain is…

1. often the primary reason patients seek healthcare
2. whatever the experiencing person says it is, existing whenever he says it does
3. an individual phenomenon that is subjective in nature
4. all of the above

Answer 1

4. all of the above

Question 2

Critical domains of pain management include all except:

1. Prioritize objective data over patient subjective report of pain
2. assess systematically
3. deliver interventions in a coordinated way
4. reassessment treatment regularly

Answer 2

1. Prioritize objective data over patient subjective report of pain

Question 3

Which phenomenon is exhibited when larger doses of an opioid drug are required to produce the desired effect?

1. dependance
2. addiction
3. tolerance
4. withdrawal

Answer 3

?

Question 4

In preparing a care plan for a patient receiving opioid analgesics, the nurse selects which of the following as an applicable nursing diagnosis associated with side effects of opioid use?

1. diarrhea
2. bowel incontinence
3. constipation
4. impaired urinary elimination

Answer 4

3. constipation

Question 5

What are pain pathways and processes?

Answer 5

• Transduction
• Transmission
• Perception
• Modulation

Question 6

What are types of pain?

Answer 6

• Acute
• Persistent/chronic
• Cancer
• Nociceptive
• Neuropathic

Question 7

What are domain affecting pain perception?

Answer 7

• Affective (emotions)
• Behavioral (response)
• Cognitive (meaning)

Question 8

What are the two categories of manifestations of pain?

Answer 8

• Physiological

- Behavioral

Question 9

What techniques can help you physically asses for pain?

Answer 9

• Inspection

- Palpation

Question 10

What are the critical domains for successful pain management? (ABCDE)

Answer 10

A: Ask regularly, assess systematically
B: Believe pt’s self report
C: Choose treatment options based on comprehensive assessments
D: Deliver interventions in a coordinated way
E: Evaluate treatment effectiveness by reassessment

Question 11

What are nonpharmacological nursing interventions for pain?

Answer 11

• Basic comfort measures
• Cutaneous stimulation
• Cognitive and behavioral strategies

Question 12

What are pharmacologic interventions for pain?

Answer 12

• Nonopioid analgesics
• Opioid analgesics
• Adjuvant analgesics
• Adjuvants

Question 13

What are nonopijoid analgesics?

Answer 13

Acetaminophen (APAP) and NSAIDs

Question 14

What are opioid analgesics?

Answer 14

Opioid antagonists and agonists

Question 15

What are adjuvant analgesics?

Answer 15

Drugs with only secondary indications for pain

Question 16

What are adjuvants?

Answer 16

Drugs that treat related symptoms that may exacerbate pain

Question 17

What are adverse effects of analgesics?

Answer 17

• GI and renal side effects
• Sedation
• Respiratory depression

Question 18

Nonopioids have a limit amount that can be taken each day called what?

Answer 18

Analgesic ceiling

Question 19

APAP may cause what?

Answer 19

• liver toxicity

- do not take more than 4 g in 24 hours

Question 20

What are benefits of taking NSAIDs?

Answer 20

• Inhibits prostaglandin production which protects the stomach and kidneys
• Inhibits platelet aggregation

Question 21

What is a PCA pump?

Answer 21

Patient-controlled analgesia:

Allows patient to self-administer drugs by a variety of routes.

Question 22

What routes can a PCA pump be used?

Answer 22

• Subcutaneously
• Intravenously
• Epidurally

Question 23

How should evaluation of adverse effects of opioid administration be done?

Answer 23

• Oxygen saturation monitoring

- Ventilation monitoring ( EtCO2/ Capnography)