Chapter 35: Comfort & Pain
Which misconception is common in clients in pain?
"I will get addicted to pain medications."
A client with cancer pain is taking morphine for pain relief. Knowing constipation is a common side effect, what would the nurse recommend to the client?
"Increase fluids and high-fiber foods, and use a mild laxative."
A mother calls the nurse practitioner to say, "I don't know what is wrong with my baby. He cried all night and kept pulling at his ear." How would the nurse respond?
"That means his ear hurt. Bring him in to be checked."
The nurse talks with a client who states, "My primary care provider wants me to try a TENS unit for my pain. How can electricity decrease my pain?" Which of the following responses is most appropriate?
"The mild electrical impulses block the pain signal before it can reach the brain."
A nurse is teaching an alert client how to use a PCA system in the home. How will she explain to the client what he must do to self-manage pain?
"When you push the button, you will get the medicine."
The Joint Commission supports the client's right to pain management, and published standards for assessment and management of pain in hospitals, ambulatory care settings, and home care settings (Joint Commission, 2008b). Which of the following are recommended guidelines for pain management? Select all that apply.
-Teach all clients to use a pain rating scale. -Determine a pain-rating goal with each client. -Manipulate factors that affect the pain experience.
Which of the following clients would be classified as having chronic pain?
A client with rheumatoid arthritis
What is the term used to describe a pharmaceutical agent that relieves pain?
Analgesic
How may a nurse demonstrate cultural competence when responding to clients in pain?
Avoid stereotyping responses to pain by clients.
Which statement accurately describes pain experienced by the older adult?
Boredom and depression may affect an older person's perception of pain.
A client having acute pain tells the nurse that her pain has gradually reduced, but that she fears it could recur and become chronic. What is a characteristic of chronic pain?
Chronic pain has far-reaching effects on the client.
A middle-age client is complaining of acute joint pain to a nurse who is assessing the client's pain in a clinic. Which of the following questions related to pain assessment should the nurse ask the client?
Does your pain level change after taking medications?
A client has been taught relaxation exercises before beginning a painful procedure. What chemicals are believed to be released in the body during relaxation to relieve pain?
Endorphins
A nurse implements a back massage as an intervention to relieve pain. What theory is the motivation for this intervention?
Gate control theory
A nurse is assessing the vital signs of a client who is moaning due to the acute onset of pain. What would be the expected objective findings?
Increased pulse and blood pressure
A nurse asks a client to rate his pain on a scale of 0 to 10, with 0 being no pain and 10 being worst pain. What characteristic of pain is the nurse assessing?
Intensity
The nurse is caring for a client with terminal bone cancer. The client states, My pain is getting worse and worse, and the morphine doesn't help anymore. The nurse determines the client's pain is which of the following?
Intractable
The nurse is caring for a client who is receiving morphine via a patient-controlled analgesia (PCA) pump. The nurse notes that the client's respiratory rate is 10 breaths per minute. The client is somnolent, with minimal response to physical stimulation. The nurse should prepare to administer which of the following medications?
Intravenous naloxone (Narcan)
Why is acute pain said to be protective in nature?
It warns an individual of tissue damage or disease.
Which client would be most likely to have decreased anxiety about, and response to, pain as a result of past experiences?
One who had pain but got adequate relief
Which client would benefit from a p.r.n. drug regimen?
One who had thoracic surgery four days ago
A nurse is assessing a mentally challenged, adult client who is in pain after a fall. Which of the following scales should the nurse use to assess the client's pain?
Pain Assessment in Advanced Dementia (PAINAD)
A nurse is assessing a client with arthritis. Which of the following should the nurse consider in the initial assessment of the client?
Pain level
A client has an order for a narcotic analgesic every three to four hours and he received his last dose three hours earlier. Which of the following actions is most appropriate for the nurse to take in response to the client's request for pain medication on his first postoperative day?
Provide the client with pain medication
A client in the emergency department is diagnosed with a myocardial infarction (heart attack). The client describes pain in his left arm and shoulder. What name is given to this type of pain?
Referred pain
A cyclist reports to the nurse that he is experiencing pain in the tendons and ligaments of his left leg, and the pain is worse with ambulation. The nurse will document this type of pain as which of the following?
Somatic pain
A nurse is ordered to apply a transcutaneous electrical nerve stimulation (TENS) unit to a client recovering from abdominal surgery. Which of the following is a consideration when using this device?
TENS involves the electrical stimulation of large-diameter fibers to inhibit the transmission of painful impulses carried over small-diameter fibers.
Pet therapy is commonly used in long-term facilities for distraction. If a client is experiencing pain and the pain is temporarily decreased while petting a visiting dog or cat, this is an example of which type of distraction technique?
Tactile kinesthetic distraction
A client who has breast cancer is said to be in remission. What does this term signify?
The disease is present but the client is not experiencing symptoms.
Of the following individuals, who can best determine the experience of pain?
The person who has the pain
A client tells the nurse that she is experiencing stabbing pain in her mouth, gums, teeth, and chin following brushing her teeth. These are symptoms of which of the following pain syndromes?
Trigeminal neuralgia
The nurse has just completed programming of a patient-controlled analgesia (PCA) pump using prescribed parameters. Which of the following actions should you take next?
Verify the settings with another nurse.
A client has a severe abdominal injury with damage to the liver and colon from a motorcycle crash. What type of pain will predominate?
Visceral pain
A nurse is caring for a client with acute back pain. When should the nurse assess the client's pain?
Whenever the vital signs are measured and documented
Besides controlling pain of the post-abdominal surgery client with narcotics, the nurse suggests to the client that he ...
use distraction
