Pain Engage Fundamentals Flashcards

1
Q

A nurse is caring for a patient just transferred from the PACU following an abdominal hysterectomy. The patient receiving PCA with IV morphine sulfate 2 mg every 15 min with a 30mg/4hr lockout. One hour after the patient has returned to the unit, the patient tells the nurse that her pain is still unbearable. The nurse checks the PCA monitor and determines that the patient has made six attempts within the last hour. Which of the following actions should the nurse take after performing a pain assessment?

A. Check the IV site and PCA pump for proper functioning.
B. Teach the patient proper use of the PCA system.
C. Ask the provider to increase the morphine dose and shorten the interval between doses.
D. Encourage family members to “push the pain button” when the patient is in too much pain to do it herself.

A

A. Check the IV site and PCA pump for proper functioning.

The PCA delivery system should be assessed to determine if there is any malfunction in the delivery of the medication.

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2
Q

A nurse is planning to administer a dose of intravenous morphine sulfate for a postoperative patient. Which of the following is a pain management protocol that should be used by the nurse in this situation?

A. Withhold this medication for a respiratory rate of less than 14/min.
B. Perform the intravenous injection over 1 min.
C. Avoid administering opioid agonists on a fixed schedule.
D. Have an opioid antagonist available during the administration.

A

D. Have an opioid antagonist available during the administration.

The nurse should assure that an opioid antagonist, such as naloxone (Narcan), is available, as well as equipment for providing respiratory support.

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3
Q

A patient who has been experiencing frequent, severe migraine headaches tells the nurse she has heard that biofeedback is effective in treating migraines. The patient asks the nurse to describe how this pain-relief method works. The nurse should reply that biofeedback involves:

A. measuring skin tension and using learned techniques to relieve pain.
B. relating soothing visual images identified by the patient to promote relaxation.
C. listening to an increasing volume of music until the pain subsides.
D. stimulating the skin with a mild electric current when pain occurs.

A

A. measuring skin tension and using learned techniques to relieve pain

This describes biofeedback, which gradually helps the patient to identify physiological responses that can control migraines and other types of pain.

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4
Q

A nurse is caring for two patients of different cultural backgrounds. Both patients returned from the same type of surgery 2 hr ago. Which of the following should the nurse expect to be the same for both patients?

A. Patient perception of the intensity of postoperative pain
B. Class of medication used to treat acute postoperative pain
C. Goal of pain management for each patient
D. Level of pain indicated by each patient on a numeric pain scale

A

B. Class of medication used to treat acute postoperative pain

Opioid analgesics are the class of medication used to treat acute postoperative pain; this is true regardless of the patient’s cultural background.

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5
Q

A nurse is about to use the Wong-Baker FACES pain scale to assist a patient in assessing his pain level. Which of the following should the nurse know in order to use this pain scale?

A. Face #10 is chosen when the patient is crying because of severe pain.
B. Face #0 is chosen when the patient “hurts a little bit.”
C. This scale is useful for adult patients who have cognitive impairments.
D. The nurse matches a face on the scale with that of the patient’s face when he is in pain.

A

C. This scale is useful for adult patients who have cognitive impairments.

This pain scale is used for young children as well as for adult patients who have cognitive impairments that create difficulty with descriptive and numeric pain scales.

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6
Q

A nurse is caring for a patient admitted to the emergency department with severe pain following a fall from a ladder. The initial assessment reveals long-term use of opioids for chronic pain. Which of the following provider prescriptions for initial pain relief should the nurse question?

A. Morphine sulfate
B. Pentazocine (Talwin)
C. Meperidine (Demerol)
D. Hydromorphone (Dilaudid)

A

B. Pentazocine (Talwin)

Pentazocine is an opioid agonist/antagonist agent. This is not an appropriate medication for this patient because it may cause opioid withdrawal in a patient who is physically dependent on opioids.

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7
Q

During a pain assessment, a nurse asks questions about the quality of an adult patient’s pain. Which of the following statements by the patient refers to pain quality?

A. “The pain in my abdomen began last night and has gotten worse and worse.”
B. “My pain is at a 9 on a scale of 0 to 10.”
C. “My pain feels like I’m being stabbed by a knife.”
D. “The pain is worse when I bend over at my waist.”

A

C. “My pain feels like I’m being stabbed by a knife.”

This statement describes the quality of the patient’s pain.

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