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The client presents to the clinic for cast placement following a fractured tibia. The client reports a pain level of 6/10 at the site of the fracture with movement. The nurse knows this client is reporting which type of pain?

D- nociceptive pain

What statement by a client is reflective of the existence of referred pain?

"It can't be my heart, the pain is in my left arm."

A client in chronic pain states that the pain medication does not work. What is the best response by the nurse?

"Take your medications regularly, not waiting until pain occurs."

Explain the role of analgesics in pain management; name classes of analgesics and specific uses for each.

-NSAIDS- aspirin, ibuprofen- mild to moderate pain - Opioids/ narcotic- morphine- used to manage pain in moderate to severe oain -Adjuvant - anticonvulsants/depressions- used to enhance the effectiveness of another drug

What characteristics are factors considered in the diagnosis of chronic pain? Select all that apply.

-Pain that interfering with an individual's normal functioning -Discomfort continues for 6 months or longer

List and describe several tools used to quantify a client's pain.

-scale of 0-10, face pain scale, nonverbal pain scale

. The nurse is gathering subjective data regarding pain from a client. What is important for the nurse to consider when gathering this information?

. Culture

The nurse is gathering data regarding a 2-year-old child's pain level. What scale would be most effective for obtaining this information?

. The FLACC scale

Three types of analgesics

1. Nonopioid nonsteroidal anti-inflammatory drugs (NSAIDS)- include aspirin, ibuprofen, naproxen- given to mild to moderate pain 2. Opioids/narcotic drugs- include- morphine, manage pain for clients to moderate to severe pain 3. Adjuvant drug- medication or treatment is one that enhances the effectiveness of another, medications like- anticonvulsants/depressants/ acupuncture, -helps muscles relax, pain improves, endorphins are increased

The nurse is attempting to get a complete description of a client's pain. Which description by the client describes the character of the client's pain?

A) Aching and burning

What chemicals and foods decrease the endorphin production? Select all that apply

A) Caffeine B) Nicotine D) Alcohol E) Sugar

What statements accurately describe the guidelines included in The Joint Commission accreditation standards to improve the management of pain? Select all that apply.

A) Clients have the right to appropriate assessment and management of pain. B) On-going pain assessment should include the nature and intensity of pain. C) Pain management interventions must be evaluated for effectiveness. D) Staff must be oriented and competent in assessment and management of pain.

What characteristics should the nurse include in the documentation of pain in the electronic medical record? Select all that apply.

A) Level of pain B) Description of pain C) Action taken to relieve pain E) Response to pain medication

Which statement describes one's pain threshold?

A) Lowest intensity of a stimulus that causes the subject to recognize pain

Which classification of pain medication would be appropriate for the nurse to administer to the client reporting mild to moderate pain?

A) Nonopioid-nonsteroidal anti-inflammatory drugs

A nurse is caring for a client reporting acute pain. Which nursing intervention requires an order from the physician?

A) Providing a heat application

In which way does deep relaxation help in pain management?

A) Relieves pain by relaxing taut muscles

Which conditions are possible physical causes of pain? Select all that apply.

A) Trauma B) Surgical incision C) Tumor growth

The nurse is caring for a client in pain. Which interventions would the nurse include in the care plan? Select all that apply.

A- encourage the client to concentrate on a specific image, C- apply a warm or cool compress to the area as ordered, D- offer a craft project, TV show, or visit from staff, E- assist the client in deep breathing and relaxing

Differentiate between the two major categories of pain.

Acute pain- range from mild to severe, caused by abruptly in response to trauma -referred pain- pain originating in one body part but perceived elsewhere- Cancer pain- results of malignancy, may be severe, considered untreatable and chronic-Chronic pain- unknown cause that causes discomfort that continues for 6+ months -Neuropathic pain- injury or malfunction of nerves from CNS or PNS-Intractable pain- chronic pain that resists therapeutic intervention

How do individuals with chronic pain typically report the character of their pain? Select all that apply.

B) Burning C) Tingling sensations D) Shooting pain

What treatment is considered for chronic back pain that has not responded to other treatments?

B) Cutting the nerves that transmit the pain

What are symptoms of depression that the nurse needs to assess in a client with chronic pain? Select all that apply.

B) Extreme fatigue C) Disturbed sleeping pattern D) Lack of interest in surroundings E) Sexual impotence

A client diagnosed with a terminal illness is experiencing a phase of depression and decreased self-esteem. Which intervention should the nurse include in the client's care plan to help the client express feelings?

B) Suggest participation in a support group.

A nurse is assessing a client for pain. The client does not speak English and has difficulty expressing himself. What method would be best for the nurse to use to rate the intensity of pain?

B) Wong-Baker Faces Pain Scale

The nurse asks the client to describe the character of the pain being reported. The nurse would further assess and provide education if the client used which term? Select all that apply?

B- constant, A- fatigue, E- severe

A client is experiencing pain secondary to a sprained ankle. The healthcare provider has prescribed an ointment containing a local anesthetic. When education the client on the medication, the nurse identifies which as the function of this ointment?

B- improves circulation in the area

The nurse is preparing a client for surgery who is experiencing chronic pain. The client is most likely diagnosed with which condition?

B- pinched nerve

When caring for a 1-year-old child with a wound, the nurse observes the child crying and kicking the legs. According the FLACC Nonverbal Pain Scale, the nurse should give which score for the child's action represented by his leg movement?

C) 2

How does the guided imagery technique help in pain management?

C) Enables visualization of destruction of the origin of pain

A nurse is assessing a client for pain. Which scales require the client to describe the nature and intensity of the pain to the nurse? Select all that apply.

C) McGill-Melzack Pain Questionnaire D) Numerical scale 0 to 10 E) Pain Distress scale

A nurse is caring for a client whose cast has just been taken off after the treatment of his fractured hand. Which instruction should the nurse provide the client when performing exercises after the cast has been taken off?

D) Monitor body cues of discomfort during exercise.

.A client with chronic pain has been asked by the healthcare provider to exercise regularly. Which should the nurse tell the client with reference to exercising?

D- increase activity levels gradually and steadily

A client in pain experiencing fatigue, stress, conflict, and a lower pain threshold. Which is next in the pain cycle?

D- muscle tension

A nurse is observing an infant for pain behaviors, the nurse notes the infant has a clenched jaw, and has drawn up legs with rigid posture. The parent attempts to console the infant with no change in the infants steady crying. What score would the nurse document for the infant according to the FLACC scale?

D- total score of 10

A nurse is caring for a client with a myocardial infarction. Which factor is the typical trigger for the chest pain experienced by the client?

Decreased blood supply to the heart muscle

. Identify types/routes of analgesic administration.

IV, pills, IM injections, epidural, catheter along side the wound

Which definition of pain is the foundation for the planning of nursing care for the client in pain?

Pain is whatever the experiencing person says it is, existing whenever he says it does.

A client with a fractured leg is in pain. The nurse understands that the client is experiencing which kind of pain?

Nociceptive pain

The nurse plans to use guided imagery with a client experiencing pain sensation. What is the goal for guided imagery?

Pain relief

What statement descripts one's pain tolerance?

Point at which a person can no longer endure the pain

A client reports no relief of pain after administration of an opioid analgesic. What nonpharmacologic action can the nurse provide to assist with relieving the pain?

a. Give the client a back rub

A client is experiencing chronic pain related to a back injury. What suggestions can the nurse make to help control pain perception? Select all that apply.

a. Limit the intake of caffeine. b. Avoid smoking. c. Perform regular exercise.

The nurse is caring for a client with chronic pain. The provider orders an antidepressant for the client. The client asks the nurse why the provider ordered an antidepressant because " I don't think I am depressed." The nurse knows this medication is acting as what for the client?

adjuvant drug

modulation

body activates needed response to the effects of pain,

Describe the relationships between endorphins and pain management.

endorphins act on the opiate receptors in the brain and they reduce pain and boost pleasure. Pain management can be pharmacology or nonpharmacologic that help release endorphins in the brain

Describe how surgery is used to provide pain relief.

ex- herniated disc cause lower back pain, the disc can be removed

transmission

impulses travel from their original site to the brain

transduction

nervous system changes painful stimuli in the nerve endings to impulses

Discuss the concept of pain as the fifth vital sign.

pain perception has a feeling of distress, factors affecting the perception, pain is feeling meaning it can be treated

perception

the brain recognizes, defines, and responds to pain,

Identify major underlying causes of pain.

trauma, surgical, tumor, excessive pressure, heat, cold, chemicals released when tissues are damaged, muscle spasms

Discuss the impact of chronic pain on a person's life and on their significant others.

unknown cause created discomfort for long period of time, 6+ months, can lead person to be emotionally different (anger, despair), be withdrawn, go into depression