pain management Flashcards
A client with which diagnosis has a chronic pain condition?
- Osteoarthritis
- Cluster headaches
- Fibromyalgia
- Pernicious anemia
3
Option 1:
Osteoarthritis is an illness that causes moderate to severe joint pain in older adults. This condition is common in the aging population. It is not a chronic pain condition.
Option 2:
Cluster headaches can be painful, but they are not a chronic pain condition.
Option 3:
Fibromyalgia is a chronic pain condition, which causes moderate to severe pain that is unexplained by other causes.
Option 4:
Pernicious anemia is a chronic illness, which is caused by a vitamin B12 deficiency. Pain is not a symptom.
Which type of pain is more prevalent among women?
- Cluster headaches
- Muscle pains
- Visceral pain syndromes
- Neuropathic pain
4
Option 1:
Cluster headaches are more prevalent among men than women.
Option 2:
Men are more likely to experience muscle pains than women.
Option 3:
Visceral pain syndromes are mostly observed in men.
Option 4:
Neuropathic pain conditions are more prevalent among women.
Which question should be asked to determine the aggravating and alleviating factors of pain in a client?
- “Is your pain sharp or stabbing?”
- “What do you believe is causing this pain?”
- “How long have you been suffering with this pain?”
- “If you change your position, does that make the pain better?”
4
Option 1:
Asking about the type of pain or if the pain feels a certain way can determine the quality of pain.
Option 2:
Asking the client about their perceived cause of pain can determine the onset of pain.
Option 3:
Asking a client about the length of time that they have felt pain determines the duration of pain.
Option 4:
Aggravating and alleviating factors and associated symptoms of pain can be determined by asking questions related to pain after changing positions.
The nurse is caring for a 78-year-old client with lower back pain. Which treatment regimen will likely provide the most relief?
- Steroids and guided imagery
- Acupressure and music therapy
- Nonsteroidal anti-inflammatory drugs and cold pack
- Relaxation training with deep massage and antispasm medications
4
Option 1:
Steroid doses should be minimized in clients with reduced kidney function. Guided imagery is used to relieve orofacial pain.
Option 2:
Complementary therapies alone may not be efficient for older clients with low back pain.
Option 3:
Nonsteroidal anti-inflammatory drugs can be effective in treating low back pain, but a cold pack is only effective in the first 24 hours after an injury. Heat would be more effective for this client.
Option 4:
Relaxation training with deep massage and antispasm medications are effective in the treatment of low back pain in older adults.
A client is undergoing treatment for arthritis. During a follow-up visit, the client complains of increased weight and blood glucose levels. Which drug is likely to be responsible for the condition?
- Aspirin
- Lidocaine
- Ibuprofen
- Prednisone
4
Option 1:
Clients who are under aspirin medication are likely to have risk of thrombocytopenia because it inhibits platelet aggregation.
Option 2:
Lidocaine is the local anesthetic which causes tissue necrosis when used along with epinephrine.
Option 3:
Ibuprofen is the non-steroidal anti-inflammatory drug which causes gastrointestinal bleeding.
Option 4:
Prednisone is the corticosteroid which causes severe side effects such as weight gain and hyperglycemia.
Which is most important action of the nurse after administering an IV opioid to a client for pain management?
- Monitor weight
- Monitor platelet levels
- Monitor glucose levels
- Monitor respiratory rate
4
Option 1:
Corticosteroids, such as hydrocortisone, may lead to increased weight. Therefore, weight should be monitored regularly in a client who is under corticosteroid treatment.
Option 2:
Drugs such as aspirin may lead to decreased platelet levels due to its antiplatelet activity. Therefore, platelets levels should be monitored in a client who is under aspirin medication.
Option 3:
Corticosteroids, such as hydrocortisone, can cause hyperglycemia. Therefore, glucose levels should be monitored regularly in such clients.
Option 4:
Opioids depress the central nervous system and respiratory depression can be a major side effect. Therefore, respiration should be monitored in a client who is taking opioid medications.
Which best describes piroxicam?
- Short half-life; low potency
- Long half-life; high potency
- Short half-life; high potency
- Intermediate half-life; intermediate potency
2
Option 1:
Drugs such as ibuprofen have a short half-life and low potency.
Option 2:
Piroxicam is a nonsteroidal anti-inflammatory drug which has high potency and a long half-life.
Option 3:
Drugs such as diclofenac and ketorolac have short half-life and high potency.
Option 4:
Drugs such as diflunisal and naproxen have intermediate potency and intermediate half-life.
The nurse is caring for a client that is receiving opioids. What adverse effects may occur? Select all that apply.
- Urinary frequency
- Constipation
- Increased appetite
- Hyperactivity
- Respiratory depression
2, 5
Option 1:
Opioids may cause urinary retention, not frequency.
Option 2:
Pain may cause decreased oral intake and activity; these circumstances, along with the opioid effects on the GI system may cause constipation.
Option 3:
Opioids may cause nausea and vomiting and decreased oral intake.
Option 4:
Opioids have sedative effects.
Option 5:
Respiratory depression is the most critical adverse effect of opioids and requires close monitoring.
After assessing a client’s condition, the nurse concludes that the client has visceral pain. Which observations in the client helped the nurse reach this conclusion? Select all that apply.
- Low heart rate
- Excessive sweating
- Numbness around pain region
- Worsening of pain during night
- Reflex muscle contractions and muscle tenderness
1, 2
Option 1:
Conditions such as low heart rate and hypotension are often observed in a client with visceral pain because visceral pain can impact the autonomic nervous system.
Option 2:
Sweating is observed in client with visceral pain.
Option 3:
A client with cutaneous pain may experience numbness around the area to which injury and/or pain is in.
Option 4:
A client with neuropathic pain likely suffers with increased pain at night.
Option 5:
Reflex muscle contractions and muscle tenderness are often present in a client with somatic pain.
A nurse is teaching a student nurse regarding tricyclic antidepressants used for pain management. Which statement made by the student nurse indicates a need for further teaching?
- “Imipramine is administered orally.”
- “Desipramine is the first line of drug.”
- “Doxepin is given with nortriptyline for improved analgesia.”
- “Amitriptyline is preferred drug for pain management in older adults.”
4
Option 1:
All the antidepressant drugs are given orally.
Option 2:
Desipramine is now preferred as first line of drug due to fewer side effects.
Option 3:
Doxepin is given in combination with nortriptyline for improved analgesic effect.
Option 4:
Older adults are sensitive to anticholinergic side effects. Therefore, Desipramine and nortriptyline are preferred agents over amitriptyline.
The nurse is caring for a 70-year-old client with severe orofacial pain. Which complementary treatment regimen is most useful in addition to the prescribed analgesics?
- Acupressure and music therapy
- Relaxation training with deep massage
- Exercise regimen with focused stretching
- Deep tissue massage and heat application
1
Option 1:
Acupressure, guided imagery, and music therapy have proved beneficial for older clients with severe orofacial pain.
Option 2:
Relaxation training combined with deep massage and antispasm medications are effective at relieving lower back pain, not orofacial pain.
Option 3:
Exercise and focused stretching is often advised in conjunction with nonsteroidal anti-inflammatory medications to help relieve pain caused by arthritis.
Option 4:
Deep tissue massage and heat application may be helpful in relieving pain caused by muscle overuse, but is unlikely to be beneficial for alleviating orofacial pain.
A client complains of recurrent pain when the prescribed pain management therapy reaches the effective end of its doses. What does the nurse infer about the client’s condition given this information?
- The client is suffering from acute pain.
- The client is suffering from chronic pain.
- The client is suffering from persistent pain.
- The client is suffering from breakthrough pain.
3
Option 1:
Acute pain generally responds to pain management approaches and resolves as tissue heals. It does not reoccur.
Option 2:
Chronic pain mostly are resistant to pain management therapies and take around 3-6 months to get cured. The chronic pain does not reoccur at the effective end of the treatment.
Option 3:
In persistent pain, the client gets pain relief by some therapeutic interventions, but the pain reoccurs often when the pain management therapies are at the effective end of their doses.
Option 4:
Breakthrough pain can occur at or near the end of the medication dose. It does not reoccur frequently.
A client reports a “pins and needles” type of pain and loss of sensation in fingers and hands. What type of pain is the client experiencing?
- Somatic
- Visceral
- Cutaneous
- Neuropathic
4
Option 1:
“Pins and needles” pain and loss of sensation is not associated with somatic pain, which occurs deeper in the bones and joints.
Option 2:
“Pins and needles” pain and loss of sensation is not associated with visceral pain. Visceral pain originates in the organs.
Option 3:
“Pins and needles” pain and loss of sensation is not associated with cutaneous pain. In cutaneous pain, the pain originates in the superficial areas.
Option 4:
When a client feels “pins and needles” type pain and loss of sensation in some parts of the body, it indicates that the client is suffering from neuropathic pain.
The nurse is assessing a client with chest pain. Which statement made by the client indicates the severity of the pain? Select all that apply.
- “I am not able to sleep.”
- “I cannot sit for long periods of time.”
- “I can feel the pain as though somebody is stabbing me.”
- “The pain moves near my abdomen sometimes.”
- “I can feel the pain for 10-15 seconds three or four times a day.”
1, 2
Option 1:
When a client says that he/she is not able to sleep, he/she is describing how the pain is impacting his/her life. This reflects the severity of the pain from which the client is suffering.
Option 2:
When a client indicates that he/she is not able to sit for long periods of time, he/she is indicating that the pain has an impact on his/her life. This describes the severity of the client’s pain.
Option 3:
When a client describes his/her pain in such a way that the pain is like someone stabbing them, it indicates the quality of pain.
Option 4:
When the client explains that his/her pain sometimes moves to a different region of the body, it reflects the region and radiation of pain.
Option 5:
If a client specifies that the pain he/she feels occurs at a certain frequency several times a day, he/she is describing the duration of the pain.
Which condition is most likely to cause neuropathic pain?
- Appendicitis
- Post-surgical pain
- Induced myalgia
- Spinal root compression
4
Option 1:
Appendicitis may cause visceral pain in the client.
Option 2:
Post-surgical pain may cause cutaneous pain in the client.
Option 3:
Induced myalgia may cause somatic pain in the client.
Option 4:
Spinal root compression may cause neuropathic pain in a client.
