NURS 360

Opioid analgesics are effective pain management tools for many clients. A significant portion of a nurse's practice is older adults who suffer from chronic pain. What impact does a client's age have on initial dosing? A. Older clients should receive a reduced dose. B. Age has no impact on dosing. C. Opioid analgesics should not be used to treat older adults. D. Older clients should receive an increased dose.

A. Older clients should receive a reduced dose

Which of the following is a disadvantage to using the IV route of administration for analgesics? A. Short duration B. No risk of respiratory depression C. Slower entry into bloodstream D. Long duration

A. Short duration

How should the administration of analgesics be scheduled to provide a uniform level of pain relief to a client?

Administering the analgesics on a regular basis

A female client with sickle-cell disease is hospitalized for pain management. The client's BUN is 24 mg/dL and creatinine is 1.6 mg/dL. To assist with management of the pain, the nurse Applies warm soaks to the extremities Places the lower extremities in a dependent position Administers meperidine (Demerol) intravenously Obtains cold packs to place on the joints

Applies warm soaks to the extremities Warm soaks may help to alleviate pain in the client with sickle-cell disease. Meperidine is not recommended in clients experiencing renal dysfunction. This client's renal studies show some dysfunction. Cold will cause the blood cells to lump even more and constrict blood vessels, increasing pain. Lowering the extremity to a dependent position will encourage blood to pool, particularly in the joints, increasing pain.

The nurse is assisting the anesthesiologist with the insertion of an epidural catheter and the administration of an epidural opioid for pain control. What adverse effect of epidural opioids should the nurse monitor for? A. Tachycardia B. Bradypnea C. Asystole D. Hypertension

B. Bradypnea

A teenage client is undergoing a dressing change to burns on the thigh. The client refuses pain medication and states, "I do not hurt, and I don't need it." He is withdrawn, grimaces, and turns away during the dressing change. He was last medicated 8 hours ago. What is the best statement by the nurse? A. "You are so brave to not take your pain medication when the dressing change will hurt." B. "If you need pain relief, I can give you some medication when I have completed the dressing change." C. "I saw you grimacing during the dressing change. Please explain the reason you refused the pain medication." D. "You are so right to not take your pain medication. You can become dependent on the medication."

C. "I saw you grimacing during the dressing change. Please explain the reason you refused the pain medication."

Which of the following is a misconception about pain and analgesia?

Chronic pain is due to a psychological disturbance.

A client being treated for rheumatoid arthritis has been prescribed a glucocorticosteroid. How should the nurse best ensure this client's safety during treatment? Teach the client the signs and symptoms of gastrointestinal bleeding. Educate the client about the need to avoid grapefruit and grapefruit juice during treatment. Educate the client about the difference between tolerance and dependence. Ensure the client knows to taper down the dose if it is discontinued by the care provider.

Ensure the client knows to taper down the dose if it is discontinued by the care provider.

The nurse is administering a narcotic analgesic for the control of a newly postoperative client's pain. What medication will the nurse administer to this client?

Fentanyl (Duragesic)

When drafting a nursing care plan for a patient in pain, it is important for the nurse to determine if the pain is acute or chronic. Choose the best example of chronic pain.

Intervertebral disk herniation

The nurse is administering an analgesic to an older adult patient. Why is it important for the nurse to assess the patient carefully?

Older people are more sensitive to drugs.

The nurse has given an older adult an oral opioid for postoperative pain. What should the nurse do first to make the pain medication more effective?

Position the client for comfort.

Which condition is a heightened response that occurs after exposure to a noxious stimulus?

Sensitization

The client is taking oxycodone (Oxycontin) for chronic back pain and reports decreased pain relief when he began taking a herb to improve his physical stamina. The nurse asks if the herb is valerian chamomile kava-kava ginseng

ginseng

When taking a client history, the nurse notes that the client has been taking herbal remedies in addition to acetaminophen for several years. Based on the admission history, the nurse understands that the client is experiencing which type of pain?

chronic pain

When using transdermal Fentanyl, the nurse and patient should be aware of which sign or symptom of Fentanyl overdose? Insomnia Hyperventilation Hyperalertness Confusion

confusion

The nurse sees an order for a lidocaine 5% patch. What use is approved for by the US Food and Drug Administration for this patch?

postherpetic neuralgia

A client who has undergone extensive fracture repair continues to request opioid pain medication with increasing frequency. The initial surgeries occurred more than 2 months ago, and the nurse is concerned about the repeated requests. What does the nurse suspect to be the cause of the client's frequent appeals for pain medication?

tolerance

A client has been taking opioid analgesics for more than 2 weeks to control post-surgical pain. Although pleased with the client's progress, the surgeon decides to change the analgesic to a non-opioid drug. The surgeon prescribes a gradually lower opioid dose and increasingly larger non-opioid doses. The surgeon is changing medications in this manner to avoid:

withdrawal symptoms