Chapter 18: Pain & Comfort

The older adult is at a higher risk for acute psychological pain than a younger adult because older adults

experience more loss.

When educating a client on the use of an adjuvant medication, which statement best demonstrates the nurse's understanding of this therapy?

"These drugs are used in combination with analgesics to increase the effect of the analgesics."

Which conditions are likely to cause an older adult chronic pain?

- Bone metastasis - Compression fracture - Postherpetic neuralgia

Which of the following statements are true about pain in older adults?

- Pain is not a normal aging process. - Opioid analgesics are often the best treatment for persistent pain.

A nurse is caring for an older adult with cognitive impairment who recently had hip surgery. The nurse assesses the client for pain. The nurse would suspect that the client is in pain when the client demonstrates which of the following?

- The client pushes caregivers away when they attempt to change the dressing on her hip. - The client rocks back and forth repetitively when sitting in a chair. - The client cries out repeatedly when anyone approaches her.

An older aphasic client has severe osteoarthritis, bilateral contractures of the lower extremities, and a stage IV pressure ulcer. The nurse practitioner prescribes analgesic medications to be administered around the clock, with as-needed doses to be administered as appropriate. What observation by the nurse would indicate that the pain regimen is effective?

- The client slept throughout the night. - The client slept during dressing change. - The client cooperative during morning care. - The client ate 80% of breakfast, 70% of lunch, and 100% of dinner.

Each of the following is a pharmacologic intervention for pain except which one?

Acupuncture treatments

An older adult admitted for back surgery asks for opioid pain medication. The nurse knows the patient asks for pain medication 15 minutes before it is due. Which recommendation should the nurse implement?

Administer the pain medication as requested by the patient.

The nurse admits an older man who had abdominal surgery. Admission vital signs are heart rate (pulse) (P), 73 beats/min; respiration rate (R), 20 breaths/min; and blood pressure (BP), 136/84 mm Hg. He is receiving intravenous (IV) fluids but has not requested pain medication since surgery. Seven hours later, his vital signs are P, 98 beats/min; R, 26 breaths/min; and BP, 164/90 mm Hg, and he denies pain. Which intervention should the nurse implement?

Ask if he has about discomfort at the surgical site or any other location.

Compared with acute pain, which of the following statements is true of persistent pain?

Can bring about long-term changes in lifestyle

An older Hispanic man states that he is not having pain, but he had knee replacement surgery 2 days ago. Which is the best pain assessment tool as recommended by the Hartford Institute for Geriatric Nursing (HIGN) from "Try This" for the nurse to apply for this man?

Faces Pain Scale-revised (FPS-R)

An older woman had hip replacement surgery 1 day ago, and the nurse thinks that the woman also has dementia. Which patient assessment does the nurse use to determine whether this woman is experiencing pain?

Holds her abdomen tightly

The nurse administers an opioid analgesic to an older male postoperative patient in the surgical unit. Which is the most important intervention for the nurse to implement before leaving the patient's room?

Instruct him to ask for help before getting up.

An older client who was recently admitted to the subacute setting after having a knee replacement, is very anxious and refuses to get out of bed, stating that it is too painful. Which intervention will the nurse implement?

Offer pain medication, administer the medication, and wait 20 minutes before getting her out of bed.

The nurse uses comfort measures to enhance an older adult's pharmacologic pain management. Which of the following would be most helpful for the nurse to use to identify the relationships between the comfort measures, activity, and pharmacotherapy, and the older adult's pain level?

Older adult's pain diary

Which of the following pain sensations are associated with neuropathic pain?

Postamputation

Which of the following statements is true about analgesic medications for older adults?

Stool softeners and laxatives should be used with opioids.