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Comfort and Pain Management PrepU

Terms in this set (48)

A client reports after a back massage that his lower back pain has decreased from 8 to 3 on the pain scale. What opioid neuromodulator does the nurse know is released with skin stimulation and is more than likely responsible for this increased level of comfort?
Endorphins
A client prescribed pain medication around the clock experiences pain one hour before the next dose of the pain medication is due. Which is the most appropriate action by the nurse?
Assess for medication order for breakthrough pain
While caring for a client with chronic pain, the nurse talks with a family member. Which family member statement does the nurse identify as consistent with caregiver role strain?
"Sometimes it seems like I can never get a moment to myself."
The nurse is conducting an admission assessment, and asks the client what medication is taken for pain. The client responds, "I take a little white pill to control my pain, but I don't know the name of it," and presents the nurse with a plastic baggie full of white pills. What is the priority nursing intervention?
Ask the client if he or she has the bottle the drug was dispensed in from the pharmacy.
A client who has been harassed at her place of work tells the nurse, "Every time I think of my job, I get a debilitating headache and have to go lie down to make the pain go away." Which nursing intervention will the nurse perform to practice according to the Gate Control Theory?
providing temple massage when head hurts
A client has required frequent scheduled and breakthrough doses of opioid analgesics in the 6 days since admission to the hospital. The client's medication regimen may necessitate which intervention?
Stool softeners and increased fluid intake
A nurse is caring for a client who was administered opioid narcotics. The client reports constipation. What is another potential side effect of opioid narcotics?
Sedation
The nurse has completed a preoperative education session with a client who will receive morphine via a patient-controlled analgesia pump (PCA) after surgery. Which statements by the client indicates the need for further education?
"I will remind my family member to push the PCA pump button for me if I doze off during the day."
A student nurse is preparing a presentation on pain management. What information regarding nonpharmacologic interventions should he include?
Use cold packs for muscle spasms and surgical site pain
Ice packs should not be left on longer than 20 minutes
Massage can stimulate circulation
Distraction is useful for short pain periods
A nurse implements cutaneous stimulation for a client as part of a strategy for pain relief. Which nursing action exemplifies the use of this technique?
The nurse gives the client a massage before bed
Besides controlling pain of the postabdominal surgery client with narcotics, the nurse suggests to the client that he:
use distraction
The nurse is assessing a patient for the chronology of the pain she is experiencing. Which is an example of an appropriate interview question to obtain this data?
How does the pain develop and progress?
The nurse recognizes common pain syndromes that cause neuropathic pain. Which clients would the nurse place at risk for this type of pain?
a client with postherpetic neuralgia
a client with phantom limb pain
a client with diabetic neuropathy
A client with complex regional pain syndrome
The nurse manager hears a nurse and a nurse aide talking about a female client who reports pain of 8 out of 10 on a 1-10 after a Caesarean birth to deliver twins. The nurse states, "I don't believe this client has any pain at all. I'm sure she is just drug seeking." What is the appropriate nurse manager action?
Ask the nurse to speak privately for a moment, and educate about bias in pain treatment
A patient is in the terminal stage of an illness and has become increasingly delirious and agitated over the past 48 hours. The patient's son has come to visit and sharply criticized the nurse for failing to "keep her comfortable and calm in her last days." How should the nurse best respond?
"I know it must be very difficult to see your mother suffering. From your experience caring for her, is there anything more we could be doing to relieve her anxiety?"
Based on your knowledge of pain and the body's response, when assessing a client in pain, you would anticipate the:
pupils are dilated
After the nurse has instructed a client with low-back pain about the use of a transcutaneous electrical nerve stimulation (TENS) unit for pain management, the nurse determines that the client has a need for further instruction when the client states what?
"I could use the TENS unit if I feel pain somewhere else on my body."
The nurse recognizes which of the following statements is true of chronic pain?
It may cause depression in clients
A client in pain believes that their pain is a punishment from God, and feels angry and resentful. Which of the following is the most appropriate action by the nurse?
Encourage client to confer with a spiritual advisor
A client states that he is pain and requests the ordered pain medication. When entering the client's room, the client is laughing with visitors and does not appear to be in pain. What is the appropriate action by the nurse?
Administer the pain medication.
Which guideline regarding pain should be included in the nurse's education plan for a group of parents with infants and toddlers?
Pain can be a source of fear and threat to the toddler's security
A client has an order for a narcotic analgesic every 3 to 4 hours and he received his last dose 3 hours earlier. Which action 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 is ordered pain medication every 4 to 6 hours as needed. When the nurse enters the client's room to administer the medication, the client is laughing with visitors. The client's pulse rate is 64, respirations 16, and blood pressure 120/80. The client states that they are in pain and wants the medication. What is the most appropriate action by the nurse?
Administer the pain medication
A nurse is treating a young boy who is in pain but cannot vocalize this pain. What would be the nurse's best intervention in this situation?
Ask the boy to draw a cartoon about the color or shape of his pain
Which principle should the nurse integrate into the pain assessment and pain management of pediatric clients?
Pain assessment may require multiple methods in order to ensure accurate pain data.
A client describes pain in the lower leg and has been diagnosed with a herniated lumbar disk. The pain in the leg is what type of pain?
referred pain
The nurse is teaching a client how to manage their post-operative pain through a Patient Controlled Analgesia (PCA) pump. The nurse determines that additional teaching is needed when the client states which of the following?
"I should only take medication when my pain is intense."
After sedating a client, the nurse assesses that the client is frequently drowsy and drifts off during conversations. What number on the sedation scale would the nurse document for this client?
3
A client with chronic pain uses a machine to monitor his physiologic responses to pain. The unit transforms the data into a visual display and through seeing the pain responses, the client is taught to regulate his physiologic response and control pain through relaxation, imagery, or breathing exercises. This technique for pain control is known as:
biofeedback
A postoperative client who has been receiving morphine for pain management is exhibiting a depressed respiratory rate and is not responsive to stimuli. Which drug has the potential to reverse the respiratory-depressant effect of an opioid?
Naloxone
A client tells a nurse, "I have this pounding feeling on the side of my head, like someone is hitting my head with a hammer." The nurse should identify what characteristic of pain assessment?
Quality
A client asks the nurse which vitamins should be taken daily for feelings of fatigue, anxiety, and depression 1 week before menses. Which of the following is the correct response by the nurse?
Vitamin B6
A male college student age 20 years has been experiencing increasingly sharp pain in the right, lower quadrant of his abdomen over the last 12 hours. A visit to the emergency department and subsequent diagnostic testing have resulted in a diagnosis of appendicitis. What category of pain is the client most likely experiencing?
Visceral pain
A postoperative vaginal hysterectomy client complains of pain that is more intense than this morning. This factor should be explained to the client as
"Acute pain tends to increase during the day and is called a routine pain response"
The nurse that ascribes to the gate control theory of pain would be most likely to prescribe which of the following for the relief of pain?
massage, heat, cold
A nurse administers pain medication to clients on a med-surg ward. The client that would benefit from a p.r.n. drug regimen as an effective method of pain control would be the client:
in the postoperative stage with occasional pain.
How should the nurse position the head of the bed for a client receiving epidural opioids?
Elevated 30 degrees
Three days after surgery, a patient continues to have moderate to severe incisional pain. Based on the gate control theory, what action should the nurse take?
Reposition the patient and gently massage the patient's back
A patient has been experiencing increasingly severe pain after suffering burns in a workplace accident. What pain management strategy is most likely to address the patient's pain?
Around-the-clock, scheduled dosing of analgesics supplemented by additional doses when needed
A nurse is caring for a client who is receiving morphine via a patient controlled analgesia (PCA) pump. When assessing the client, she notes that his respiratory rate is 4. What should the nurse do first?
Stop the PCA pump
The nurse is developing a plan of care for a client in acute pain. Which of the following should the nurse include?
Encourage deep breathing
Play the client's favorite music
Promote a restful environment
The nurse is administering oxycodone to a client. To which category of analgesics does this belong?
Opioid
After the nurse has instructed a client with low-back pain about the use of a transcutaneous electrical nerve stimulation (TENS) unit for pain management, the nurse determines that the client has a need for further instruction when the client states what?
"I could use the TENS unit if I feel pain somewhere else on my body."
The physician has ordered a patient controlled analgesia (PCA) pump for a client. Which assessment finding would cause the nurse to question the order?
confused to time and place
A nurse is caring for a client who complains of an aching pain in the abdomen. The nurse also noted that the client is guarding the area. What kind of pain is the client experiencing?
Visceral pain
A postoperative client who has been receiving morphine for pain management is exhibiting a depressed respiratory rate and is not responsive to stimuli. Which drug has the potential to reverse the respiratory-depressant effect of an opioid?
Naloxone
When performing a pain assessment on a client, the nurse observes that the client guards his arm, which was fractured in a car accident, and he refuses to move out of his chair. The nurse notes this reaction as what type of pain response?
Behavioral
The nurse is caring for a client who has experienced significant pain following a surgical procedure. Which nursing interventions are appropriate?
Assess for pain control 30 minutes after administering an analgesic
Consider cultural implications of the perception of pain
Provide pain medication before activity that may increase pain
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