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fundamentals of nursing > final exam: chapter 36 (pain and management and comfort) > Flashcards

final exam: chapter 36 (pain and management and comfort) Flashcards

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1
Q

nature of pain includes: __, __, and __ components (pec)

A

physical; emotional; cognitive

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2
Q

pain is __ (subj/obj)

A

subj

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3
Q

pain __ (is/is not) measurable objectively

A

is not

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4
Q

the 3 categories of pain are: __ (dle)

A

duration (acute and chronic) | localization/location | etiology

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5
Q

onset: rapid
intensity: mild to severe
warnings: tissue damage or organ disease
resolution: after underlying cause is resolved

is this acute or chronic pain?

A

acute

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6
Q

duration: beyond normal healing period (1-6mo)
- varies greatly
- difficult to describe/assess
- remission/exacerbation

acute or chronic pain?

A

chronic

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7
Q

location of pain can be these 4 things: __ (hint: csvr)

A

cutaneous | somatic | visceral | referred

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8
Q

cutaneous pain is
a. deep, diffused/scattered in tendons ligaments, bones, blood vessels, and nerves
b. superficial pain (involves skin or sq tissue)
c. poorly localized and originates in body organs (thorax, cranium, abd)
d. originates in one part of the body & perceived in another area

A

b

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9
Q

referred pain is:
a. deep, diffused/scattered in tendons ligaments, bones, blood vessels, and nerves
b. superficial pain (involves skin or sq tissue)
c. poorly localized and originates in body organs (thorax, cranium, abd)
d. originates in one part of the body & perceived in another area

A

d

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10
Q

somatic pain is:
a. deep, diffused/scattered in tendons ligaments, bones, blood vessels, and nerves
b. superficial pain (involves skin or sq tissue)
c. poorly localized and originates in body organs (thorax, cranium, abd)
d. originates in one part of the body & perceived in another area

A

a

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11
Q

visceral pain is:
a. deep, diffused/scattered in tendons ligaments, bones, blood vessels, and nerves
b. superficial pain (involves skin or sq tissue)
c. poorly localized and originates in body organs (thorax, cranium, abd)
d. originates in one part of the body & perceived in another area

A

c

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12
Q

pain can be caused because its either __, __, __, or __ (nipp)

A

neuropathic; intractable; phantom; psychogenic

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13
Q

match the pain etiologies with their appropriate definition:
a. neuropathic
b. phantom
c. psychogenic
d. intractable
1. pain caused by lesion or disease of peripheral or central nerves; duration: short; frequently chronic
2. resistant to therapy and persists despite variety of interventions
3. occurs w/absent limb where receptors/nerves are clearly absent
4. a physical cause for pain; cannot be identified

A

a.1
b. 3
c. 4
d. 2

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14
Q

a pt moves away from painful stimuli, is grimacing, moaning, and crying, and reports of restlessness. she is protecting the painful area, but is not moving. what kind of pain response is this?

A

behavioral

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15
Q

a pt comes to the clinic with exaggerated weeping. they appear anxious and fearful. when asked, the pt reports of depression and has lost hope/power in themselves. what kind of pain response is this?

A

affective

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16
Q

moderate and superficial pain responses are conducted by the __ (sns/pns)

A

sns

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17
Q

a pt has increased bp, hr, and rr. they have dilated pupils, exhibit pallor, has muscle tension, and increased adrenaline and blood glucose. what kind of physiologic pain response is this?

A

moderate and superficial

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18
Q

the severe and deep pain response is conducted by the __ (sns/pns/ans)

A

pns (parasympathetic nervous system)

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19
Q

a 55 yo man comes in feeling nauseous and later vomits. he has a decreased bp and hr with rapid, irregular rr. after talking with him, he felt dizzy and fainted. what kind of physiologic pain response is this?

A

severe and deep

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20
Q

what are the 6 factors that affect pain experience: __ (hint: acefpr)

A

anxiety & other stressors | culture & ethnic variables | environment & support ppl |family, sex, gender, & age variables | past pain experience | religious beliefs

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21
Q

list the 7 pain assessment characteristics (ldcqaas)

A

location | duration | contributing/related factors | quality | alleviators | aggravators | severity

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22
Q

the pain scale rates pain from __ to __

A

0;10

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23
Q

the flacc scale is used for:
a. adults
b. teens
c. infants to 7yo
d. school age children

A

c

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24
Q

flacc stands for __

A

face | legs | activity | cry | consolability

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25
Q

the wong baker’s faces scale is appropriate for __

A

3 yo

26
Q

painad stands for __

A

pain assessment in advanced dementia scale

27
Q

the maximum score for the flacc scale is __ (8/10/12)

A

10

28
Q

the max score for the painad scale is __

A

10

29
Q

are all of these options appropriate non-pharmacological interventions for pain?
a. distraction
b. humor
c. music
d. imagery
e. relaxation & cutaneous stimulation (massage, tens unit, cold/heat application, acupressure)
f. acupuncture
g. hypnosis
h. therapeutic touch
i. animal-facilitated therapy

A

yes

30
Q

when pain is noted, start treatment __ (later/immediately/after a head to toe assessment)

A

immediately

31
Q

true or false. use scheduled meds for chronic or persistent pain

A

true

32
Q

if pain is __ (neuropathic/intractable/phantom), use appropriate meds

A

neuropathic

33
Q

adjust dose to indiv’s __ and assess

A

pain level

34
Q

acetaminophen is a __ analgesic

A

non-opioid

35
Q

acetaminophen is used for what kind of pain?

A

mild-moderate

36
Q

acetaminophen is safest for __ (short/long)-term and __ (is/is not) an anti-inflammatory)

A

long; is not

37
Q

you should consider __ (hepatic/cephalic/peripheral) effects when using acetaminophen

A

hepatic

38
Q

the max dose of acetaminophen is __ (2/3/4) g/day

A

4

39
Q

nsaids are __

A

non-steroidal anti-inflammatory drugs

40
Q

nsaids treats __ (inflammation/cough/pain) and is used for __ (mild-moderate/moderate-severe) pain

A

inflammation; mild-moderate

41
Q

side effects of nsaids include __ bleeding and __ (severe/minimal) side effects (nausea), and interacts w/__

A

gi; minimal; anti-hypertensives

42
Q

aspirin, ibuprofen, and naproxen are all examples of __ (acetaminophen/nsaids/bayer)

A

nsaids

43
Q

__ meds are not typically used for pain, but can be helpful for pain management and enhancing the effect of opioids

A

adjuvant pain

44
Q

antidepressants, anticonvulsants, corticosteroids, and biphosphonates are examples of __ (nsaids/adjuvant pain meds)

A

adjuvant pain meds

45
Q

this med is aka “narcotic”/controlled substance

A

opioid

46
Q

opioid are used for __ pain

A

moderate to severe

47
Q

nausea, constipation, sedation, and resp depression are all side effects of __ (opioids/nsaids)

A

opioids

48
Q

codeine, oxycodone (ir, controlled release), oxycodone & acetaminophen (percocet), and codeine & acetaminophen are all __ analgesics that treat mild to moderate pain

A

opioid

49
Q

onset of action is from __ to __ minutes for mild to moderate pain opioid analegsics

A

30; 60

50
Q

morphine and hydromorphone (dilaudid) are opioid analgesics used for __ to __ pain

A

moderate to severe

51
Q

transdermal opioid patches are used for __ pain

A

persistent

52
Q

what kind of patch is this based on the administration process?
- remove old one
- rotate sites and dispose of properly
- clean skin w/water
- flat areas only

A

transdermal opioid patch

53
Q

the onset of action for the transdermal opioid patch takes __ to __ hours, peak is __ (24/72) hours, and duration is __ (24/72) hours

A

6; 8; 24; 72

54
Q

__ (nsaids/painad/btp) is a temporary flare-up of moderate-severe pain when pt is on around the clock (atc) regimen

A

btp (breakthrough pain)

55
Q

how do you treat btp? (2 things)

A
  1. use supplemental dose of NON-OPIOID on PRN basis
  2. rapid onset opioids via oral, buccal, intranasal, or sublingual route
56
Q

how do we treat cancer pain?

A

orally if possible

57
Q

do we treat cancer pain prn? or atc?

A

atc

58
Q

pca stands for __

A

patient controlled analgesia

59
Q

these 3 meds are administered in IV admin for pca

A

morphine | fentanyl | hydromorphone

60
Q

you must check these 3 things when using a programmable pump for pca

A
  1. basal rates & “on-demand” doses are programmed
  2. locked settings
  3. check at shift change
61
Q

what is pca used for? and where?

A

acute & temporary pain management; post-op

fundamentals of nursing (17 decks)

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