Pain Management

Term
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Which of the following signs or symptoms in a patient who is opioid-naïve is of greatest concern to the nurse when assessing the patient 1 hour after administering an opioid?
1. Oxygen saturation of 95%
2. Difficulty arousing the patient
3. Respiratory rate of 12 breaths/min
4. Pain intensity rating of 5 on a scale of 0 to 10
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Terms in this set (10)
Which of the following signs or symptoms in a patient who is opioid-naïve is of greatest concern to the nurse when assessing the patient 1 hour after administering an opioid?
1. Oxygen saturation of 95%
2. Difficulty arousing the patient
3. Respiratory rate of 12 breaths/min
4. Pain intensity rating of 5 on a scale of 0 to 10
2. Difficulty arousing the patient
A health care provider writes the following order for a patient who is opioid-naïve who returned from the operating room following a total hip replacement: "Fentanyl patch 100 mcg, change every 3 days." On the basis of this order, the nurse takes the following action:
1. Calls the health care provider and questions the order
2. Applies the patch the third postoperative day
3. Applies the patch as soon as the patient reports pain
4. Places the patch as close to the hip dressing as possible
1. Calls the health care provider and questions the order
A patient is being discharged home on an around-the-clock (ATC) opioid for postoperative pain. Because of this order, the nurse anticipates an additional order for which class of medication?
1. Opioid antagonists
2. Antiemetics
3. Stool softeners
4. Muscle relaxants
3. Stool softeners
A new medical resident writes an order for oxycodone CR 10 mg PO q2h prn. Which part of the order does the nurse question?
1. The drug
2. The time interval
3. The dose
4. The route
2. The time interval
The nurse reviews a patient's medical administration record (MAR) and finds that the patient has received oxycodone/acetaminophen (5/325), two tablets PO every 3 hours for the past 3 days. What concerns the nurse the most?
1. The patient's level of pain
2. The potential for addiction
3. The amount of daily acetaminophen
4. The risk for gastrointestinal bleeding
3. The amount of daily acetaminophen
When using ice massage for pain relief, which of the following is correct? (Select all that apply.)
1. Apply ice using firm pressure over the skin.
2. Apply ice for 5 minutes or until numbness occurs.
3. Apply ice no more than 3 times a day.
4. Limit application of ice to no longer than 10 minutes.
5. Use a slow, circular steady massage.
1. Apply ice using firm pressure over the skin.
2. Apply ice for 5 minutes or until numbness occurs.
5. Use a slow, circular steady massage.
A patient with a 3-day history of a stroke that left her confused and unable to communicate returns from interventional radiology following placement of a gastrostomy tube. The patient had been taking hydrocodone/APAP 5/325 up to four tablets/day before her stroke for the past year to manage her arthritic pain. The health care provider's order reads as follows: "Hydrocodone/APAP 5/325 1 tab, per gastrostomy tube, q4h, prn." Which action by the nurse is most appropriate?
1. No action is required by the nurse because the order is appropriate.
2. Request to have the order changed to around the clock (ATC) for the first 48 hours.
3. Ask for a change of medication to meperidine (Demerol) 50 mg IVP, q3h, prn.
4. Begin the hydrocodone/APAP when the patient shows nonverbal symptoms of pain.
2. Request to have the order changed to around the clock (ATC) for the first 48 hours.
Place the following steps in the correct order for administration of patient-controlled analgesia:
1. Insert drug cartridge into infusion device and prime tubing.
2. Wipe injection port of maintenance IV line vigorously with antiseptic swab for 15 seconds and allow to dry.
3. Demonstrate to patient how to push medication demand button.
4. Secure connection and anchor PCA tubing with tape.
5. Instruct patient to notify a nurse for possible side effects or changes in the severity or location of pain.
6. Insert needleless adapter into injection port nearest patient.
7. Apply clean gloves. Check infuser and patient-control module for accurate labeling or evidence of leaking.
8. Program computerized PCA pump as ordered to deliver prescribed medication dose and lockout interval.
9. Attach needleless adapter to tubing adapter of patient-controlled module.
3. Demonstrate to patient how to push medication demand button.
5. Instruct patient to notify a nurse for possible side effects or changes in the severity or location of pain.
7. Apply clean gloves. Check infuser and patient-control module for accurate labeling or evidence of leaking.
1. Insert drug cartridge into infusion device and prime tubing.
9. Attach needleless adapter to tubing adapter of patient-controlled module.
2. Wipe injection port of maintenance IV line vigorously with antiseptic swab for 15 seconds and allow to dry.
6. Insert needleless adapter into injection port nearest patient.
4. Secure connection and anchor PCA tubing with tape.
8. Program computerized PCA pump as ordered to deliver prescribed medication dose and lockout interval.
When teaching a patient about transcutaneous electrical nerve stimulation (TENS), which of the following represent an accurate description of the nonpharmacological therapy? (Select all that apply.)
1. Turn TENS on before patient feels discomfort.
2. TENS works peripherally and centrally on nerve receptors.
3. TENS does not require a health care provider order.
4. Remove any skin preparations before attaching TENS electrodes.
5. Placing electrodes directly over or near the pain site works best.
2. TENS works peripherally and centrally on nerve receptors.
4. Remove any skin preparations before attaching TENS electrodes.
5. Placing electrodes directly over or near the pain site works best.
Categorize the following as acute pain or chronic pain.
A. Has a protective effect
B. Lasts more than 3 to 6 months
C. Usually has identifiable cause
D. Dramatically affects quality of life
E. Viewed as a disease
F. Eventually resolves with or without treatment
Acute pain:
A. Has a protective effect
C. Usually has identifiable cause
F. Eventually resolves with or without treatment

Chronic Pain:
B. Lasts more than 3 to 6 months
D. Dramatically affects quality of life
E. Viewed as a disease