Med Surg Chapter 07: Care of Patients with Pain

The patient who had abdominal surgery this morning refuses the opioid pain medication for fear of addiction. How should the nurse respond?

"Fewer than 3% of people become addicted to drugs used for pain relief."

The hospitalized postsurgical patient is reluctant to take the opioid pain medication because of drowsiness. Which response is most informative for the nurse to make?

"Sleep and pain relief promote healing."

A patient tells the LPN/LVN that using a mentholated rub, which is bought as an over-the-counter product, helps with muscle pain. Which of these instructions should the nurse give the patient?

"Wash your hands well after applying the menthol rub."

The home health nurse educates the 75-year-old patient about the warm compresses he is using on his swollen elbow. Which information is most important to include in the teaching plan?

Allow the compress to remain in place for 15 to 20 minutes

The nurse is caring for the patient with neuropathic pain. Which agents will most effectively control this patient's pain? (Select all that apply.)

Antidepressants Anti-inflammatory agents Anticonvulsants

The nurse is caring for a patient who is having constant nociceptor pain. Which intervention best addresses the patient's pain during the perception phase of pain?

Engage the patient in conversation regarding his family, hobbies, and plans following discharge from the facility.

When assessing a patient who is experiencing acute pain and comparing the findings with the patient's baseline, what can the LPN/LVN expect to find?

Increase in blood pressure

The patient on frequent doses of meperidine (Demerol) complains of constipation. Which initial intervention is best?

Increase oral fluid intake.

Although the patient with a kidney stone denies pain, the nurse assesses cues that indicate that pain is perceived. Which assessments indicate that pain may be present? (Select all that apply.)

Increased pulse rate Diaphoresis Muscle tension Nausea

The nurse is using the gate theory as a guide to pain management. Which intervention(s) should the nurse plan to offer? (Select all that apply.)

Massage Social activities A quiet environment

The nurse explains that acupressure and acupuncture are effective pain relief modalities that focus on specific body areas. Which term best describes these therapies?

Meridians

The nurse is caring for a patient receiving a strong narcotic for pain control. During the assessment, the nurse notes the patient's respiratory rate to be 8 respirations per minute. Which medication may be necessary for this patient?

Naloxone

The patient is experiencing phantom pain following the amputation of her foot. Which type of pain is most associated with phantom pain?

Neuropathic

The nurse explains that the pain threshold and pain tolerance are different. Which statement about the pain threshold is true?

Pain threshold is the point at which pain is perceived.

In order to provide the optimum nursing care, it is important for the nurse to know that the standard of pain and pain control is best determined by which person?

Patient

Which student nurse's note in the patient's record features proper documentation of a pain assessment?

Pt. complains of local sharp pain (4/5) in lower abdomen upon standing.

The nurse is caring for a patient who is 1-day postoperative following a colon resection. The patient has degenerative joint disease and uses a pain medication patch to control this chronic pain. Which consideration is most important when planning care for this patient?

Realize that this patient will most likely require more pain medication than most patients undergoing a colon resection.

A patient receives an analgesic. Several hours later, the patient develops hives and itching. Which action is essential for the LPN/LVN to take immediately?

Report the finding.

When reviewing medical records, the nurse notes that the patient has chronic back pain. Which characteristics of chronic pain is this patient likely to exhibit? (Select all that apply.)

Spontaneous relief is unusual. Can affect ability to earn a living.

The nurse is caring for a patient that is receiving intravenous morphine sulfate. The patient breaks out in hives and begins to itch. What should the nurse do first?

Stop the infusion

The nurse is educating the home health patient about indications for acetaminophen. Which information should the nurse include in the teaching plan?

Take acetaminophen before pain becomes severe.

Arrange the sequence of nociceptive pain in the order in which the process occurs. a. Transmission b. Modulation c. Transduction d. Perception

Transduction Transmission Perception Modulation

The nurse clarifies the basics of the gate theory of pain control. Which information should the nurse include?

The "gate" can be closed to pain by the use of nonpainful stimuli.

Which is an understanding the LPN/LVN should have concerning pain?

The person who has pain is the one to decide if the pain is tolerable.

To help with pain control, how should the nurse time the distraction activities for a patient?

To bridge the time between administration and onset

Because of the threat of lowering the seizure threshold, the home health nurse would suggest that the 85-year-old patient limit the use of which pain medication?

Tramadol (Ultram)

The nurse is caring for a patient receiving epidural analgesia. The patient should be monitored for which side effect?

Urinary retention

The nurse is planning to teach a family member about effective massage techniques. Which information is most important to include in the teaching plan?

Use long, firm strokes while avoiding areas of inflammation.

Pain receptors in the skin, connective tissue, bone, joints, and muscles are classified as __________.

nociceptors

The nurse is planning care plans for multiple patients. Which patient does the nurse anticipate will experience the highest level of pain?

79-year-old experiencing pain related to osteoarthritis

The nurse is providing medication information to a patient receiving pain medication with codeine. Which side effect should the nurse tell the patient is most likely to occur?

Constipation

The nurse has just administered pain medication to a patient. To prevent complications, the LPN/LVN should take which action when administering analgesic medications? (Select all that apply.)

Document reactions to medications after they are given Record the patient's use of adjunctive measures (e.g., massage) Promptly notify the primary health care provider if any problems occur Ask the patient to rate the pain on a pain scale before and after the medication has been given

While bathing a patient, the nurse notes that a transdermal patch that was meant to be on the patient for 3 days is now gone on the second day. What action should the nurse take?

Document the loss and apply a fresh patch to be replaced in 3 days.

What is/are the functions of endorphins? (Select all that apply.)

Inhibition of unpleasant stimuli Diminished anxiety Relief of pain Feeling of euphoria

The nurse is caring for a 45-year-old male Arab patient who is in pain. Which action can most likely be attributed to the patient's cultural belief about pain?

The patient asks for pain relief to control pain.

When giving care to a 30-year-old Hispanic male, which action can most likely be attributed to the patient's cultural beliefs about pain?

The patient maintains a stoic affect about pain.

A patient reports pain relief after having received a placebo. Which conclusion is most accurate for the nurse to determine?

The patient was relieved of the anxiety that there is no ready source of pain remedy.

An 84-year-old patient is admitted to the hospital because of kidney stones. The patient is in acute pain. Which statement about administering analgesics to the elderly is accurate?

The patient will require careful monitoring for side effects.