Chapter 12 Pain Management
A nurse is caring for a client who is receiving morphine via a patient controlled analgesia (PCA) infusion device after abdominal surgery. Which of the following client statements indicates that the client understands how to use the device? a) "I'll wait to use the device until absolutely necessary" b) "I'll be careful about pushing the button so I don't get an overdose" c) "I should tell the nurse if the pain doesn't stop after I use this device" d) " I will ask my son to push the dose button when I am sleeping"
"I should tell the nurse if the pain doesn't stop after I use this device"
Which of the following statements when made by a cancer patient with moderate-to-severe pain prescribed oxymorphone (Opana IR) indicates further instruction is required? a) "The IR indicates I will get fast relief when I take the medication" b) "I will stop drinking beer while I'm on this medication" c) "I can also have this medication in an extended release tablet" d) "I will take this medication with breakfast for the best results"
"I will take this medication with breakfast for the best results"
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 0-10" c) "My pain feels like I'm being stabbed by a knife" d) "The pain is worse when i bend over at my waist"
"My pain feels like I'm being stabbed by a knife"
The advance practice nurse is treating a patient experiencing a neuropathic pain syndrome. Which of the following statements when made by the patient demonstrates an understanding of concepts related to neuropathic pain? a) "Neuropathic pain is the body's normal response to tissue damage causing pain" b) "Neruopathic pain will only last a few days and is easily treated with COX-2 analgesic agents" c) "My phantom limb pain serves no purpose, and I may need to take antidepressants to help" d) "When the inflammation in my foot resolves I will no longer have pain from neuropathy"
"My phantom pain serves no purpose, and I may need to take antidepressants to help"
The nurse applies a transdermal patch of fetanyl for a patient with pain due to cancer of the pancreas. The patient puts the call light on 1 hour later and tells the nurse that it has not helped. What is the best response by the nurse? a) "it will take approximately 12-18 hours for the medication to begin to work, so I will give you something else now to relieve the pain" b) "it should have begun working 30 minutes ago. I will ask the doctor to prescribe something stronger" c) " You have probably developed a tolerance to the medication" d) "it will take about 24 hours for the medication to work. I can't give you anything else or you will overdose.
"it will take approximately 12 to 18 hours for the medication to begin to work, so I will gibe you something else now to relieve the pain"
Nociception includes four specific processes: transduction, perception, and modulation. Which of the following actions illustrates the nociception process of pain transmission? a) A surgeon making an incision to perform surgery b) A patient taking tramadol (ultram) to enhance pain management c) A mother in labor utilizing imagery to reduce pain d) A child quickly removing a hand when touching a hot object
A child quickly removing a hand when touching a hot object
Which of the following is a true statement regarding placebos? a) A placebo should be used as the first line of treatment for the patient b) A placebo effect is an indication that the person does not have pain c) A positive response to a placebo indicates that the person's pain is not real d) A placebo should never be used to test the person's truthfulness about pain
A placebo should never be used to test the person's truthfulness about pain
When a person who has been taking opioids becomes less sensitive to the drug's analgesic properties, that person is said to have developed which of the following? a) A balanced analgesia b) A dependence c) An addiciton d) A tolerance
A tolerance
What medication can the nurse administer to the patient intravenously for the control of pain and fever? a) Hydrocodone b) Acetaminophen/oxycodone c) Hydromorphone d) Acetaminophen
Acetaminophen (Ofermev)
Tissue damage from surgery, trauma, burns ( short duration, resolves with normal healing) time limited, injury limited
Acute pain
A chronic neurologic and biologic disease defined by pain specialists and characterized by behaviors that include one or more of the following; impaired control over drug use, compulsive use, continued use despite harm, and craving to use the opioid for affects other than pain relief. a) adjuvent analgesic agent b) hydrophillic c) intraspinal d) addiction
Addiction
A patient is being treated in a substance abuse unit of a local hospital. The nurse understands that when a patient as compulsive behavior to use a drug for its psychic effect, the patient needs to be monitored for which of the following? a) Dependence b) Addiction c) Tolerance d) Placebo effect
Addiction
A drug that has a primary indication other than pain (anticonvulsants, antidepressants, sodium channel blockers, or muscle relaxant) but is an analgesic agent for some painful condition; sometimes referred to as co-analgesics a) titration b) refractory c) adjuvant analgesic agent d) antagonist
Adjuvant analgesic agent
A 75 year old patient had surgery for her hip fracture yesterday. She is under stress due to the pain, the medications, sleep deprivation, and hospital surroundings. Which of the following nursing interventions to treat the patient's pain when ordered by the doctor should the nurse question? a) Use of transelectrical nerve stimulator (TENS) b) Advil for pain management c) Acetaminophen for pain management d) Morphine rather than Advil for pain management
Advil for pain management
Called nociceptors, located in the skin, subcutaneous tissue, visceral organ tissue, and (somatic) musculoskeletal structures
Afferent neurons
A type of opioid (Nalbuphrine [Nubain], and Butorphonal [stadol]) that binds to the kappa opioid receptor site acting as an agonist (capable of producing analgesia) and simultaneously to the mu-opioid receptor site acting as an antagonist (reversing mu-agonist effects) a) breakthrough pain b) ceiling effect c) agonist-antagonist d) antagonist
Agonist-antagonist
Pain due to a stimulus that does not normally provoke pain; such as touch; typically experienced in the skin around the areas affected by nerve injury and commonly seen with many neuropathic pain syndromes. a) central sensitization b) comfort function goal c) hydrophillic d) allodynia
Allodynia
The nurse understands that which of the following is true about tolerance and addiction? a) Addiction to opioids commonly develops b) The nurse must be primarily concerned about development of addiction by the patient in pain c) Although patients may need increasing levels of opioids, they are not addicted d) tolerance to opioids is uncommon
Although patients may need increasing levels of opioids, they are not addicted
A drug that competes with agonists for opioid receptor sites, can displace agonists, there by inhibiting their action a) lipophilic b) antagonist c) metabolite d) mu-agonist
Antagonist
Prior to starting a peripheral intravenous line on a patient, what intervention can the nurse provide to decrease the pain from the needle puncture? a) Give an oral opioid analgesic 30 minutes before the procedure b) Apply diclofenac gel over the site 1 hour before the procedure c) Apply eutectic mixture of local anesthetic cream 30 minutes prior to the procedure d) Inject lidocaine 2% with epinephrine locally around the potential procedure site
Apply eutectic mixture of local anesthetic cream 30 minutes prior to the procedure
A home health nurse is visiting a patient who has been taking the same dose of hydocodone/acetaminophen (Lortab) for 2 months. To monitor for the presence of expected side effects of this medication, what should the nurse include in the assessment of the patient? a) Ask about the patient's bowel pattern b) Observe respiratory rate and depth c) Take the patient's blood pressure d) Assess level of consciousness
Ask about the patient's bowel pattern
When administering a fentanyl patch, the last dose of sustained-release morphine should be administered at what point? a) Prior to respiratory assessment b) There are no administration requirements c) At the same time the first patch is applied d) Immediately following the morning shower
At the same time the first patch is applied
The nurse is performing an assessment for a patient reporting pain but finds no physical cause. What nursing action is appropriate with the patient's continued report of pain? a) Believe the patient when he or she states is present b) Doubt that the pain exists when no physical origin can be identified c) Realize that patients frequently imagine and state that they have pain without actually feeling painful sensations d) Assume that the patient may be a drug seeker and should be given other methods for pain control
Believe the patient when he or she states its presence
The nurse is assisting the anesthesiologist with the insertion of an epidural catheter and the administration of an epidural opioid for pain control. What adverse effect of epidural opioids should the nurse monitor for? a) Asystole b) Hypertension c) Bradypnea d) Tachycardia
Bradypnea
A nurse is monitoring a client who is receiving opioid analgesia. Which of the following findings should the nurse identify as adverse effects of opioid analgesics? (select all that apply) a) Urinary incontinence b) Diarrhea c) Bradypnea d) Orthostatic hypotension e) Nausea
Bradypnea, Orthostatic hypotension, Nausea
A transitory increase in pain that occurs on a background of otherwise controlled persistent pain. a) allodynia b) breakthrough pain c) efficacy d) half-life
Breakthrough pain
When a nurse asks a patient to describe the quality of the pain, what type of descriptive term does the nurse except the patient to use? a) Burning b) Chronic c) Intermittent d) Severe
Burning
Are isoenzymes of COX that produce the effects of non-opioid analgesics (NSAID)
COX-1 and COX-2
An analgesic dose above which further dose increments produce no change in effect. a) antagonist b) allodynia c) comfort-function goal d) ceiling effect
Ceiling dose effect
A key central mechanism of neuropathic pain; the abnormal hyper-excitability of central neurons in the spinal cord which results from complex changes induced by the incoming afferent barrages of nociceptors. a) central sensitization b) neurophallic c) opioid naive d) physical dependence
Central sensitization
Cancer or non-cancer origin, can be time limited or persistent through out ones life
Chronic pain
When taking a patient history, the nurse notes that the patient has been taking herbal remedies in addition to acetaminophen for several years. Based on the admission history, the nurse understands that the patient is experiencing which of the following types of pain after an amputation? a) Breakthrough pain b) Acute pain c) Phantom pain d) Chronic pain
Chronic pain
A nurse is caring for two patients of different cultural backgrounds. Both patients returned from the same type of surgery 2 hours 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
Class of medication used to treat acute postoperative pain
The pain-rating identified by the individual patient above which the patient experiences interference with function and quality of life ( activities the patient needs or wishes to perform) a) metabolite b) hydrophillic c) half-life d) comfort-function goal
Comfort-function goal
The nurse observes the anesthesiologist administer a single-dose extended-release drug in an epidrual catheter for a patient undergoing a major surgical procedure. What does the nurse determine is being administered? a) Codeine b) Demerol c) Dilauded d) Depodur
Depodur
The nurse is assessing a patient reporting severe pain. What physiologic indicator does the nurse recognize as significant of acute pain? a) Diaphoresis b) Bradycardia c) Hypotension d) Decreased respiratory rate
Diaphoresis
Which of the following interventions should a nurse perform when caring for a patient who is prescribed opiate therapy for pain? a) Monitor blood counts and liver function tests. b) Do not administer if respirations are less than 12 per minute c) Avoid caffeine or other stimulants, such as decongestants. d) Monitor weight, vital signs, and serum glucose level.
Do not administer if respirations are less than 12 per minute
The extent to which a drug or another treatment "works" and can produce the effect in question-analgesia in this context. a) opioid tolerant b) nociceptor c) efficacy d) placebo
Efficacy
A patient has been prescribed a Fentanyl patch for pain control. The nurse understands that this patch should be replaced how often? a) Every 24 hours b) Every 72 hours c) Every 48 hours d) Every 36 hours
Every 72 hours
The physician has prescribed a mu-opioid analgesic for a patient with pain. What drug does the nurse anticipate administering? a) Nalbuphine hydrochloride b) Butorphanol c) Buprenorphine d) Fetanyl
Fetanyl
The advance nurse practitioner treating a patient diagnosed with neuropathic pain decides to start adjuvant analgesic agent therapy. Which of the following medications is appropriate for the nurse practitioner? a) Hydormorphone (dilaudid) b) Tramadol (Ultracet) c) Gabapentin (neurontin) d) Ketamine (Ketalar)
Gabapentin (Neurontin)
The time it takes for the plasma concentration (amount of drug in the body) to be reduced by 50% (after starting a drug, or increasing its dose, four to five half-lifes are required to approach a steady-state level in the blood, irrespective of the dose, dosing interval, or route of administration; after 4-5 half-lives , a drug that has been discontinued generally is considered to be mostly eliminated from the body. a) intraspinal b) neuroplacticity c) nonopioid d) half-life
Half-life
About which of the following issues should the nurse inform patients who use pain medications on a regular basis? a) Consume the medications just before or along with meals b) Avoid harsh sunlight for 2 hours after administering analgesic agents or salicylates? c) Inform the primary health care provider about the use of salicylates before any procedure, and avoid OTC analgesics consistently without consulting a physician d) Minimize the intake of fiber during therapy
Inform the primary physician about the use fo salicylates before any procedure, and avoid OTC analgesics consistently without consulting with a physician
"With-in the spine" refers to the spaces or potential spaces surrounding the spinal cord into which medications can be administered, a) neurophillic b) mu-agonist c) intraspinal d) metabolite
Intraspinal
The preferred route of administration of medication i the most acute care situations is through which of the following routes? a) Subcutaneous b) Epidural c) Intramuscular d) Intravenous
Intravenous
A patient slipped and fell on the floor in the hospital room, causing a back injury, and the patient now reports pain. ow can the nurse determine that the pain is characteristic of acute pain? a) It does not respond well to treatment b) It is associated with a specific injury c) It serves no useful purpose d) it responds well to placebos
It is associated wit a specific injury
Readily absorbed into fatty tissues a) efficacy b) titration c) tolerance d) lipophillic
Lipophillic
A patient comes into the clinic frequently with reports of pain. What would the nurse recognize as chronic benign pain in a patient? a) A migraine headache b) An exacerbation of Rheumatoid arthritis c) Low back pain d) Sickle cell crisis
Low back pain
The product of biochemical reactions during drug metabolism a) self-report b) refractory c) metabolite d) mu-agonist
Metabolite
Any opioid that binds to the mu-opioid receptor subtype and produces analgesic effects (morphine) used interchangeably with the terms full agonist, pure agonist, and morphine like drug. a) refractory b) mu-agonist c) neurophillic d) lipophillic
Mu-agonist
An acronym for nonsteroidal anti-inflammatory drugs; (pronounced en-said) also referred to as aspirin like a) opioid b) NSAID c) neuroplacticity d) breakthrough pain
NSAID
The patient develops respiratory depression after the nurse administers fentanyl for pain. What medication can the nurse anticipate administering to counteract the effects of the fetanyl? a) Nalbuphine b) Morphine c) Naloxone d) Lidocaine
Naloxone
Pain sustained by injury or dysfunction of the peripheral or central nervous systems and distinctly different from nociceptive (physiologic pain) a) opioid tolerant b) nonopioid c) Opioid d) neurophillic (physiological pain)
Neurophillic (physiologic pain)
Pain that is sustained by ongoing activation of the sensory system that conducts the perception of noxious stimuli implies the existence of damage to somatic or visceral tissues sufficient to activate the nociceptive system. a) nociceptor b) NSAID c) preemptive analgesic agents d) nociceptive (physiologic pain)
Nociceptive (physiologic pain)
Acute "normal" pain transmission
Nociceptive pain
A type of primary afferent neuron that has the ability to respond to a noxious stimulus or to a stimulus that would be noxious if prolonged a) NSAID b) nociceptor c) opioid d) allodynia
Nociceptor
Any medication or procedure, including surgery that produces an effect in a patient because of its implicit or explicit intent and not because of its specific physical or chemical properties. a) self-report b) titration c) placebo d) refractory
Placebo
A high school football player hurts his foot while playing a game. He complains of intense pain with muscle spasms and swelling of the toe. Which of the following pain assessment tools will the nurse most likely use to assess the patient's pain level? a) Numeric Rating Scale b) Visual Analog scale c) Wong Baker FACES pain rating scale d) Verbal Descriptor Scales
Numeric Rating Scale
A nurse is assessing a client who is reporting pain despite the analgesia. Which of the following actions should the nurse take to assess the intensity of the client's pain? a) Ask the client what precipitates his pain b) Questions the client about the location of his pain c) Offer the client a pain scale to measure his pain d) Use open ended questions to identify the sensation of his pain
Offer the client a pain scale to measure his pain
The nurse is assessing an older adult patient just admitted to the hospital. Why is it important that the nurse carefully assess pain in the older adult patient? a) Older adults are expected to experience chronic pain b) Older adults have a decreased pain threshold c) Older adults experience reduced sensory perception d) Older adults have increased sensory perception
Older adults experience reduced sensory perception
Denotes a person who has taken opioids long enough at doses high enough to develop tolerances to many of the opioid effects; including anagesia and sedation a) tolerance b) non-opioid c) ceiling effect d) opioid tolerant
Opioid tolerant
A nurse is discussing pain assessment with a newly licensed nurse. Which of the following information should the nurse include? a) Most clients exaggerate their level of pain. b) Pain must have an identifiable source to justify the use of opioids c) Objective data are essential in assessing pain d) Pain is whatever the client says it is
Pain is whatever the client says it is
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 (Dilauded)
Pentazocine (Talwin)
A key peripheral machanism of neuropathic pain that occurs when there are changes in the number and location of ion channels; in particular sodium channels abnormally accumulate in injured nociceptors, producing a lower nerve depolarization threshold, ectopic discharges, and an increase in the response to stimuli. a) opiod tolerant b) physical dependence c) peripheral sensitization d) titration
Peripheral sensitization
They breakdown into arachidonic acid then cyclooxygenase acts on arachidonic acid to produce prostaglandins
Phospholipids
The body's normal response to administration of an opioid for 2 or more weeks; withdraw symptoms may occur if an opioid is abruptly stopped or an antagonist is administered. a) refractory b) tolerance c) physical dependence d) placebo
Physical dependence
Which of the following, approved by the United States Food and Drug Administration, is the only use for lidocaine 5% (Lidoderm)? a) Postherpetic neuralgia b) General anesthesia c) Epidural anesthesia d) Diabetic Neuropathy
Postherpetic neuralgia
Pre-injury pain treatments (preoperative epidural analgesia and pre-incision local anesthetic infiltration) to prevent establishment of peripheral and sensitization of pain. a) tolerance b) Pre-emptive analgesic agents c) tolerance d) self-report
Pre-emptive analgesic agents
A nurse is assessing the pain level of a client who came to the emergency department reporting severe abdominal pain. The nurse asks the client whether he has nausea and has been vomiting. The nurse is assessing which of the following components of a pain assessment? a) Presence of associated manifestations b) Location of the pain c) Pain quality d) Aggravating and relieving factors
Presence of associated manifestations
The nurse is caring for a patient who has been hospitalized on several occasions for lower abdominal pain related to Crohn's disease. How may this chronic pain be described? a) Attributed to a specific cause b) Prolonged duration c) Rapidly occurring and subsiding with d) Separate from any central or peripheral pathology
Prolonged duration
Initiate inflammatory processes that increase tissue swelling and pain that are lipid compounds
Prostaglandins
Which of the following route of medication administration should the nurse consider first in an NPO postoperative patient following IV removal? a) Subcutaneous b) Topical c) Intrathecal d) Rectal
Rectal
Non-responsive or resistant to therapeutic interventions such as analgesic agents a) allodynia b) antagonist c) refractory d) titration
Refractory
The nurse's major area of assessment for a patient receiving patient-controlled is assessment of which system? a) Cardiovascular b) Integumentary c) Neurologic d) Respiratory
Respiratory
The nurse administers an opioid analgesic to a patient. What serious side effect should the nurse carefully monitor for? a) Renal toxicity b) Respiratory depression c) Seizure activity d) Hypertension
Respiratory depression
What does the nurse understand is the advantage of using intraspinal infusion to deliver analgesics? (select all that apply) a) It is easily accessible b) Higher doses may be administered c) Side effects of systemic analgesia are reduced d) Effects on pulse, respirations, and pressure are reduced e) The need for injections decreases in frequency
Side effects of systemic analgesia are reduced, Effects on pulse, respirations, and pressure are reduced, The need for injections decrease in frequency
What pain assessment scale would be best to use for a 5 year old child? a) A pain assessment scale is inappropriate for a 5 year old child b) A visual Analog scale c) A numerical Pain scale d) The FACES scale
The FACES scale
The nurse needs to carefully monitor a patient with traumatic injuries. Which of the following actions by the nurse demonstrates understanding of the most essential component of the patient's pain assessment? a) The nurse assesses the response to medication after every meal consumed by the patient. b) The nurse administers pain medication based on the patient's reported pain level. c)The nurse validates the patient's report of pain by assessing the patient's blood pressure d) The nurse administers ketorlac (toradol) on admission to the unit.
The nurse administers pain medication based on the patient's reported pain level.
The nurse informs the patient that a preventative approach for pain relief will be used, involving nonsteroidal anti-inflammatory drugs. What will the nurse educate the patient about regarding this method? a) The pain medication will be administered before the pain becomes severe b) The pain medication will be administered before the pain is experienced c) The pain medication will be administered when the pain is at its peak d) The pain medication will be administered when the level of pain tolerance has been exceeded
The pain medication will be administered before the pain is experienced
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.
The scale is useful for adult patients who have cognitive impairments
Which of the following actions when preformed by the nurse indicates understanding of one basic principle of providing effective pain management? a) Administering pain medications on a PRN basis b) Administering a dose of an analgesic agent via patient controlled analgesia (PCA) during rounds c) Wakening a new postoperative patient to take his or her pain medication d) Continuing to provide around the clock pain medications 72 hours following a surgical procedure
Wakening a new postoperative patient to take is or her pain medication
A nurse is caring for a patient just transferred from PACU following an abdominal hysterectomy. The patient is receiving PCA with IV morphine sulfate 2mg every 15 minutes with a 30 mg/4 hour lockout. One hour after the patient has returned to the unit, the patient tells the nurse that her pain is unbearable. The nurse checks the PCA monitor and determines that the patient has made 6 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
check the IV site and PCA pump for proper functioning
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/minute b) perform the intravenous injection over 1 minute c) avoid administering opioid agonists on a fixed schedule d) have an opioid antagonist available during the administration
have an opioid antagonist available during the administration
Readily absorbed in aqueous solution a) hydrophillic b) intraspinal c) NSAID d) opioid tolerant
hyrdophillic
Prostaglandins are chemical substances with which of the following properties? a) increased sensitivity of pain receptors b) inhibition of the transmission of noxious stimuli c) inhibition of the transmission of pain d) reduction of the perception of pain
increased sensitivity of pain receptors
A patient who has been experiencing frequent, severe migraine headaches tells the nurse she has heard that biofeedback is effect 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
measuring skin tension an using learned techniques to relieve pain
The ability of the peripheral and central nervous systems to change both structure and function as a result of noxious stimuli. a) nociceptor b) nonopioid c) neuroplacticity d) opioid tolerant
neruoplacticity
Peripheral neuropathy, back pain, neck pain, osteoarthritis
non-cancer pain
Refers to analgesic agents that include acetaminophen and non-steroidal anti-inflammatory drugs; term is used instead of "non-narcotic" a) nociceptor b) non-opioid c) opioid dose-sparing effect d) antagonist
non-opioid
The nurse is administering an analgesic to an older adult patient. Why is it important for the nurse to assess the patient carefully? a) older adults metabolize drugs more rapidly b) older adults have increased hepatic, renal, and gastrointestinal function c) older adults are more sensitive to drugs d) older adults have lower ratios of body fat and muscle mass
older adults are more sensitive to drugs
Refers to codeine, morphine, and other natural semisynthetic and synthetic drugs that relieve pain by binding to multiple types of opioid receptors; term is preferred to "narcotic" a) nociceptor b) opioid c) opioid tolerant d) placebo
opioid
Occurs when a non-opioid or adjuvent is added to an opioid; allowing the opioid dose to be lowered without diminishing affects. a) opioid naive b) physical dependence c) opioid dose sparing effect d) opioid
opioid dose-sparing effect
Denotes a person who has not recently taken enough opioid on a regular enough basis to become tolerant to the opioids effects. a) peripheral sensitization b) opioid naive c) titration d) self-report
opioid naive
A phenomenon in which exposure to an opioid induces increased sensitivity or a lowered threshold, to the neural activity conducting pain perception; it is the flip side of tolerance. a) peripheral sensitization b) physical dependence c) opiod-induced hyperalgesia d) tolerance
opioid-induced hyperalgesia
An unpleasant sensory and emotional experience associated with actual or potential tissue damage, that can impact a persons psychosocial, emotional, and physical functioning.
pain
The ability of an individual to give a report, in this case of pain especially intensity; the most essential component of pain assessment a) self-report b) tolerance c) refractory d) antagonist
self-report
What are the excitatory compounds released during noxious stimuli?
serotonin, bradykinin, histamine and substance P
Upward or downward adjustment of the amount (dose) of an analgesic agent. a) refractory b) titration c) tolerance d) lipophillic
titration
A process characterized by decreasing effects of a drug at its previous dose, or the need a higher dose of drug to maintain an effect. a) tolerance b) self-report c) nociceptor d) ceiling effect
tolerance
What are the four processes of nociceptive pain?
transduction, transmission,perception, and modulation