Pain Assessment and Management: Fundamentals Midterm
How does a PCA pump work?
Allows patient the power to control their medication Set deliver a small, constant flow of pain medication with additional doses given to the patient as they push the button. Patient cannot give themselves too much Decreases anxiety and leads to decreased medication use
TENS unit
Applies electrical impulses to the nerve endings and blocks transmission of pain signals.
A nurse strains a back muscle when moving a patient up in bed. Which can the nurse do at home that utilizes the gate-control theory of pain relief to minimize the discomfort?
Apply a cold compress to the site for 20 minutes
A client is admitted with a diagnosis of terminal cancer and he is experiencing severe pain. The doctor has written an order for pain medication every 3 hours PRN. How will the nurse plan to administer the pain medication?
Assess the client and determine the need for pain medication every 3 hours
A patient request pain medication for severe pain. Which should the nurse do first when responding to this patient's request?
Assess the various aspect of the patient's pain
Which is the best goal for the nurse to include in the plan of care related to the problem statement of "acute pain related to strain on muscles with movement?"
Client reports pain of less than 1 on a 0 to 10 scale after pain medication
A neonatal nurse is assessing a 2 week olds pain level following open heart surgery. To assess the pain level using an age appropriate scale, which scales would be appropriate? (Select all that apply)
FLACC scale NIPS
A nurse is assessing a patient experiencing chronic pain. Which characteristic is more common with chronic pain than acute pain? (Select all that Apply)
Gradual onset Long duration Psychologically depleting
A transcutaneous electrical nerve stimulation (TENS) unit is a battery-operated device that some people use to treat pain. Which is the best explanation of how a TENS unit works?
It sends stimulating pulses through the skin to block the pain signals from reaching the brain
Non-pharamacological interventions
Massage therapy; cold and heat applications; relaxation techniques; acupuncture; distraction; music therapy
location of pain
The area of or location of pain.
gate control theory of pain
The theory that pain is a product of both physiological and psychological factors that cause spinal gates to open and relay patterns of intense stimulation to the brain, which perceives them as pain.
quality of pain
The words the patient uses to describe their pain. Such as cramping, burning, pins and needles, sharp, dull or achy, tingling, stabbing and so on
True or false: a patient's self report of pain is the single most reliable indicator of the existence and intensity of pain. (meaning you should medicate patient's based on this report, not their behaviors)
True
True or false: pain is the fifth vital sign.
True
True or false: pain medications work on pain in different ways (interrupt pathways in different points/ways), so can combine different types for maximal pain relief.
True
To assess the quality of a client's pain, the nurse asks which question?
What word best describes your pain?
Patient-controlled analgesia (PCA)
a drug delivery system that uses a computerized pump with a button the patient can press to deliver a dose of an analgesic through an intravenous catheter
NON-OPOID ANALGESICS
acetaminophen (tylenol) nonsteroidal anti-inflammatory drugs (NSAIDs)
adjuvants/co-analgesics
antidepressants; anticonvuslants
Analgesics (pain medications)
are important to prevent unnecessary discomfort/suffering.
respiratory opioid side effects
bradypnea hypoventilation
What are some medications that improve breathing?
bronchodilators, mucolytics HIGH PRIORITY
gastrointestinal opioid side effects
constipation N/V delayed gastric emptying
severity of pain
description of how bad the pain is, often described on a scale of 1 to 10
The nurse considers interventions to include in the plan of care for pain. Before implementing any interventions, what action is most important for the nurse to take?
discuss the plan of care with the client
Goal of palliative care
earn how to live life fully with an incurable condition.
What is the most important thing nurses can do when it comes to pain management?
establish a positive culture of pain management is actively listen to patients when they describe their pain
What behavior does a client exhibit that the nurse would document as an objective sign of acute pain?
frequent grimacing
endocrine opioid side effects
hormonal and sexual dysfunction hypoglycemia-reported with tramadol and methadone
relief measures of pain
how patients relieve their pain
Cardiac opioid side effects
hypotension bradycardia peripheral edema
Which of the following medications are non-steroidal anti-inflammatory drugs (NSAIDs) used to reduce inflammation and pain?
ibuprofen/motrin
immunological opioid side effects
immune system impairment possible with chronic use
musculoskeletal opioid side effects
muscle rigidity and contractions osteoporosis
Opioids
narcotics
Chronic pain
not protective in nature; lasts longer than 6 months constant or recurring and does not always have an identifiable cause does not respond to treatment well and leads to problems such as job loss, inability to perform daily activities, sexual dysfunction, and social isolation vital signs are usually unaffected
tolerance
over time, increased doses needed to obtain analgesic effect
analgesics
pain relievers
Acute pain
protective in nature, sudden onset, short duration, limited tissue damage; emotional response predictive ending and an identifiable cause; treated aggressively; vital signs are elevated
PQRST
provocative/palliative, quality, region/radiation, severity, timing
skin opioid side effects
pruritus (itching)
Ocular opioid side effects
pupil constriction
withdrawal syndrome
rapid or sudden cessation or marked does reduction may cause rhinitis, chills, pupil dilation, diarrhea, "gooseflesh"
What should you monitor in those using opioids/narcotics?
respiratory rate and depth (patient may develop effect of sedation and respiratory depression)
STAT
signify a single dose of a medication to be given immediately and only once.
Central Nervous System (CNS) toxicity
thought and memory impairment drowsiness, sedation, and sleep disturbance confusion hallucinations, potential for diminished psychomotor performance delirium depression dizziness and seizures
Pain
unpleasant but protective mechanism of defense serves as a warning related to physical, emotional, cognitive factors subjective & individualized
genitourinary opioid side effects
urinary retention
aggravating or precipitating factors
various factors or conditions conditions precipitate or aggravate pain
Pain is ______ the experiencing person says it is, occurring ____ whenever they say it does.
whatever; whenever
pregancy and breastfeeding opioid side effects
when at all possible, avoid opioid use during pregnancy to prevent fetal risks
Timing of pain: onset, duration, frequency
when did pain begin? how long has it lasted? does it occur at the same time each day? how often does it occur?