Comfort

what medication should always be kept on hand in case of opioid overdose

narcan

examples of adjuvant medications include ___________, __________, and __________.

- local anesthetic (lidocaine) - anticonvulsants (gabapentin) - antidepressants (duloxetine)

examples of opioid analgesics are __________, __________, __________.

- morphine - fentanyl - hydrocodone

what are the 2 types of pain

- nociceptive pain - neuropathic pain

what are 3 types of analgesics

- nonopioid - opioid - adjuvant

side effects of opioids include:

- sleepiness - constipation - N/V - itching - trouble urinating - difficulty breathing

this type of medication is used to treat pain, swelling, and joint damage for moderate to severe RA. it may take weeks or months to take effect.

DMARDs

an autoimmune disease that affects the bilateral joints causing serious joint damage.

rheumatoid arthritis

unrelieved pain can prolong the __________ response

stress response

which gender is more likely to suffer from RA?

women

which pain scale is used to determine the pain level in infants

FLACC

migraine and phantom limb pain are examples of ___________ pain syndrome

mixed pain syndrome

opioid analgesics are used to treat ________ to ___________ pain

moderate to severe pain

symptoms of RA are worse after a period of __________

inactivity

what DMARD medication is the first line treatment for RA?

methotrexate

__________ pain syndrome is a complex mixture of nociceptive and neuropathic pain. initial nervous system dysfunction or injury may trigger inflammatory mediators which leads to neurogenic inflammation.

mixed pain syndrome

___________ pain is described as "sharp", "stabbing", "shooting", "burning"

neuropathic pain

______________ pain is usually chronic and is typically not reversible

neuropathic pain

pain that comes from abnormal processing of sensory input by the nervous system as the results of damage to the brain, spinal cord, or peripheral nerves

neuropathic pain

anticonvulsants and antidepressants help to relieve what specific type of pain

neuropathy

examples of nonopioid analgesics are ___________ and _________

- NSAIDs - tylenol

RA treatment options include ________, __________, and __________

- OT - medications - exercise

what type of medications are used to treat RA?

- analgesics - NSAIDs - corticosteroids - DMARDs - biologics

_________ of all cancer patients experience pain at some point

90%

the _________ pain tool is a tool comprised of 6 questions that are used to determine the type of pain

ID pain tool

what route of medication is contraindicated in the patient with cancer

IM injections, because it can cause mets

the nurse should educate the laboring mother that laying on the ________ side if best for the baby's circulation because it gets the uterus off of the vena cava.

L side

a charge nurse is supervising a newly licensed nurse provide care for a client who has a PCA pump. which of the following statements made by the nurse requires further action by the charge nurse? a. "I discarded the remaining 2 milligrams of morphine from the PCA pump. please document that you witnessed it." b. "I noted that my client pushed the PCA button 6 times in the last hour, and the PCA lockout is set for 10 minutes." c. "I gave my client a bolus dose of morphine when I initiated the PCA pump." d. "I told the client's family that they must not push the PCA button for the client."

a. "I discarded the remaining 2 milligrams of morphine from the PCA pump. please document that you witnessed it."

corticosteroids are only used in the ________ phase of RA

acute phase

at what age does RA usually develop

age 30-50

is cancer pain typically acute or chronic?

chronic, with acute exacerbations

what is the primary focus of palliative care

comfort

postherpetic neuralgia, diabetic neuropathy, phantom limb pain, post stroke pain syndrome, spinal cord injury, and back pain are examples of ______________ pain

neuropathic pain

surgery pain, trauma, burns, tumor growth, labor pain, and IBS are examples of _________ pain

nociceptive

for __________ pain, when the damaged tissue heals the pain resolves

nociceptive pain

nerves that sense and respond to parts of the body that suffer damage

nociceptors

what is a nonverbal cue that a patient is experiencing increased labor pain

breathing pattern changes

why are biologics not used in the early to moderate phases of RA?

- because it blocks part of the immune system and therefore places the patient at increased risk of infection

what age group is at highest risk for pain

- elderly, because they suffer from many conditions associated with pain - neonates, because they are nonverbal and unable to tell you when they are hurting

what pharmacological options are available for the mother experiencing labor pain

- epidural block - spinal block - narcotic medications

signs and symptoms of RA include joint _______ and _________, ________-like symptoms, __________, ___________, and loss of __________ of the affected joint.

- joint pain and swelling - flu-like symptoms - tiredness - fever - loss of function of the affected joint

a nurse is coaching four clients in the use of relaxation techniques to manage stress. which of the following findings indicates that the techniques are effective? select all that apply a. arousal reduction b. decreased blood pressure c. decreased heart rate d. increased oxygen consumption e. increased peripheral skin temperature

a. arousal reduction b. decreased blood pressure c. decreased heart rate e. increased peripheral skin temperature

a nurse is assessing a client who reports acute pain. the nurse should anticipate which of the following findings? a. increased heart rate b. decreased respiratory rate c. hyperactive bowel sounds d. decreased blood pressure

a. increased heart rate

a nurse is planning care for a 2 month old infant following a surgical procedure. which of the following pain rating scales should the nurse plan to use to determine the infant's level of pain? a. FACES scale b. OUCHER scale c. FLACC scale d. PANAD scale

c. FLACC scale

a nurse is caring for a client who is 1 day postoperative following gynecological surgery and reports incisional pain. which of the following actions should the nurse take first? a. determine the time the client last received pain medication b. measure the client's vital signs, including temperature c. ask the client to rate her pain on a scale of 0-10 d. reposition the client and give her a backrub

c. ask the client to rate her pain on a scale of 0-10

a nurse is caring for a 6 month old infant. which of the following findings should indicate to the nurse that the client is experiencing pain following a procedure? a. decreased heart rate b. decreased respiratory rate c. increased formula consumption d. increased crying episodes

d. increased crying episodes

a nurse is caring for a client who overdosed on morphine and has a respiratory rate of 6/min. which of the following medications should the nurse plan to administer? a. epinephrine b. protamine c. flumazenil d. naloxone

d. naloxone

a nurse is assessing a client prior to the administration of morphine. the nurse should recognize that which of the following assessments is the priority? a. pupil reaction b. urine output c. bowel sounds d. respiratory rate

d. respiratory rate

a hospice nurse is caring for a client who has terminal cancer and takes PO morphine for pain relief. the client reports that he had to increase the dose of morphine this week to obtain pain relief. which of the following scenarios should the nurse document as the explanation for this situation? a. the client has not been taking the medication properly b. the client is experiencing episodes of confusion c. the client has become addicted to the medication d. the client developed a tolerance to the medication

d. the client developed a tolerance to the medication

a nurse is reviewing the medication administration records of four clients who have received a prescription for morphine PRN. which of the following findings should the nurse identify as a contraindication to the medication? a. the client is experiencing an MI b. the client who is 24 hours postoperative following hip arthroplasty c. the client who has bronchitis pleurisy d. the client has a paralytic ileus

d. the client has a paralytic ileus

the nurse is providing education to a patient who has been sent home with a prescription for a transdermal patch. what information should the nurse include in the teaching?

do not apply a heating pad on top of a transdermal patch because it can cause increased absorption and result in the patient receiving a higher dose at a time than was desired

what nonpharmacological therapy is used to treat RA?

hot and cold therapy

what is the purpose of OT for the patient with RA?

to help the patient adapt to life with RA and stay as independent as possible

what are nonpharmacological options for the mother experiencing labor pain

- lamaze breathing - position changes - ambulation - emotional support

if narcotics are given in the last 15 minutes of labor there is an increased potential for the baby to come out very _________ or not as eager to __________.

- sleepy - not as eager to breathe

labor pain is a result of _________ and distention of ______ and __________

- uterine contractions - distention of cervix and perineum

signs of opioid overdose include:

- weakness - trouble breathing - confusion - dizzuness

biologics are typically used in conjunction with what other type of drug?

DMARDs - methotrexate

a nurse is caring for a client who requires cold applications with an ice bag to reduce the swelling and pain of an ankle injury. which of the following actions should the nurse take? a. apply the ice bag for 30 minutes at a time b. reapply the bag 30 minutes after removing it c. allow room for some air in the bag d. place the bag directly onto the skin

a. apply the bag for 30 minutes at a time

a nurse is caring for a client who is postoperative following a cholecystectomy and reports pain. which of the following actions should the nurse take? select all that apply a. offer the client a backrub b. remind the client to use incisional splinting c. identify the client's pain level d. assist the client to ambulate e. change the client's position

a. offer the client a backrub b. remind the client to use incisional splinting c. identify the client's pain level e. change the client's position

a nurse is monitoring a client who is postoperative and unable to respond to questions. which of the following non-verbal behaviors should the nurse identify as an indication the client is experiencing pain? select all that apply a. restlessness b. grimacing c. moaning d. clenching d. drowsiness

a. restlessness b. grimacing d. clenching

____________ medications are drugs with a primary indication other than pain that have analgesic properties.

adjuvant medications

a nurse is talking with a client who is about to start using transcutaneous nerve stimulation (TENS) to manage chronic pain. which of the following statements should the nurse identify as an indication that the client needs further teaching? a. "I wish I didn't have to attach the electrodes to my skin" b. "It's unfortunate that I have to be in the hospital for this treatment" c. "I'll have to shave the hair off of the skin where I apply the electrodes" d. "I hope I don't have to take as many pain pills"

b. "It's unfortunate that I have to be in the hospital for this treatment"

a nurse is preparing to administer morphine IV to a client. which of the following medications should the nurse plan to have available? a. flumazenil b. naloxone c. protamine d. neostigmine

b. naloxone

a nurse is assessing a client 15 minutes after administering morphine sulfate 2 mg via IV push. the nurse should recognize which of the following as an adverse effect of the medication? a. sleepy, but arousing when her name is called b. respiratory rate 8/min c. pain level of 6 on a scale from 0-10 d. Sa02 94%

b. respiratory rate 8/min

a nurse is performing a pain assessment for a client who is alert. the nurse should recognize that which of the following measures is the most reliable indicator of pain? a. vital signs b. self-report of pain c. severity of the condition d. nonverbal behavior

b. self-report of pain

a nurse is teaching a client who has a new prescription for ibuprofen to treat hip pain. which of the following instructions should the nurse include in the teaching. a. expect ringing in your ears b. take the medication with food c. store the medication in the refrigerator d. monitor for weight loss

b. take the medication with food

this type of medication is used to slow progression of joint damage for moderate to severe RA by blocking the part of the immune system that contributes to inflammation.

biologics

a nurse is caring for a 6 month old infant. which of the following findings indicates to the nurse that the infant may be experiencing pain? a. dry palms and feet b. decreased muscle tone c. furrowed brow d. eyes wide open

c. furrowed brow

nonopioid analgesics are used to treat _______ to __________ pain

mild to moderate