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Fund ch 16
Fundamentals Ch 16 - Pain Management
| Question | Answer |
|---|---|
| What is McCaffery's description of pain? | “Pain is whatever the experiencing person says it is, existing whenever he says it does” |
| What type of pain is intense and of short duration, usually lasting less than 6 months. | Acute |
| What are the natural morphinelike substances within the body that are activated by pain or stress? | Endorphins |
| Which drug delivery system allows patients to administer analgesics whenever needed. | PCA or patient-controlled analgesia |
| What types of scales are commonly used to qualify the intensity of the pain experience? | Categorical scales, numerical scales, and visual analog scales |
| Which theory suggests that pain impulses can be regulated or even blocked by gating mechanisms located along the central nervous system? | Gates Theory |
| For more than 20 years various studies have shown that the likelihood of addiction occurring as a result of taking opioids for pain relief, even over a long period, is what percentage? | Less than 1% |
| Which system is a pocket-sized, battery-operated device that provides a continuous mild electrical current to the skin via electrodes that are attached to a stimulator by flexible wires? | TENS or transcutaneous electric nerve stimulation |
| What has harmful physical effects, such as increased oxygen demand, respiratory dysfunction, decreased gastrointestinal motility, confusion, and depressed immune response? | Unrelieved pain |
| What are the administrative routes for analgesics? | IV administration, IM injection and the oral route |
| What 2 types of data are collected when assessing a patient's pain? | Objective and Subjective |
| What are acetylsalicylic acid (aspirin), acetaminophen (Tylenol), ibuprofen (Motrin), naproxen (Naprosyn), and ketorolac tromethamine (Toradol) in relation to pain management? | These are the most common peripheral analgesics and work primarily as peripheral receptors to diminish reception of pain stimuli. |
| What are NSAIDs? | nonsteroidal antiinflammatory drugs |
| What type of pain creates an autonomic response that originates within the sympathetic nervous system, flooding the body with epinephrine and commonly referred to as the fight-or-flight response. | Acute |
| What administrative route is usually necessary when a quick onset of analgesia is desired or when the patient is unable to take oral medication. | IV |
| What type of pain management are nerve blocks, epidural analgesics, neurosurgical procedures, and acupuncture? | Invasive pain management |
| Who is responsible for the insertion and maintenance of the epidural catheter for the infusion? | These are the responsibility of the anesthetist or anesthesiologist. |
| Which organization requires accredited facilities and organizations to develop policies and procedures that formalize this obligation? | JCAHO |
| What is the standard agent for opioid therapy? | Morphine |
| What is rest? | A patient at rest feels mentally relaxed, free from worry, and physically calm. A patient at rest is free from physical or mental exertion. |
| In guided imagery the patient is encouraged to concentrate on an image that helps relieve pain or discomfort. What type of pain measure would this be? | Noninvasive pain relief |
| What are the three methods of administering epidural analgesia? | Bolus dosing, continuous infusion, and patient-controlled epidural analgesia (PCEA). |
| What is the difference between prn and PCA? | With PCA the patient rather than a nurse administers the analgesic, so the delay in waiting for a nurse's response to the request for analgesia is eliminated. |
| What type of pain is generally characterized as pain lasting longer than 6 months. The pain can be continuous or intermittent and can be intense? | Chronic |
| What is sleep? | Sleep is a state of rest that occurs for a sustained period. The reduced consciousness during sleep provides time for repair and recovery of body systems for the next period of wakefulness. |
| Are Acetaminophen and NSAIDs considered OPIOIDS or NONOPIOIDS? | Nonopioids |
| What protein found in foods such as milk, cheese, and meats, may help induce sleep? | L-tryptophan, |
| What responsibility do nurses have with the epidural catheter? | They are responsible for monitoring the patient's level of consciousness, pain intensity, respiratory rate, the infusion rate/volume on the pump and the dressing site is examined for signs of infection or leakage of medication around the catheter. |
| What does TENS stimulate? | Endorphins |
| Who developed the FACES pain rating scale? | Wong and Baker |
| Which adminstrative route for analgesics is the most optimal route, especially for chronic pain treatment, because of its convenience, its flexibility, and the relatively steady blood levels produced. | The oral route |
| Morphine, meperidine (Demerol), hydromorphone (Dilaudid), and fentanyl (Actig, Duragesic) act on higher centers of the brain to modify perception and reaction to pain and are called what? | OPIOIDS |
| What type of pain is felt at a site other than the injured or diseased organ or part of the body. | Referred |
| Can a patient with impairment of renal or hepatic function use PCA? | No |
| Pain is largely what type of an experience? | A subjective experience |
| Is the lightest level of sleep in REM or NREM? | NREM |
| How many stages of sleep does NREM have? | 4 |
| Chronic lack of what can alter the ability to perform daily functions | Chronic lack of sleep |
| Which stage of sleep is vivid, full-color dreaming (less vivid dreaming may occur in other stages) | REM |
| How does the nurse individualize pain therapy? | By working closely with the patient, using assessment findings, and trying a variety of therapies. |
| What are used to objectively evaluate pain intensity and the effectiveness of pain therapies? | Pain scales |
| True or False: Making pain the fifth vital sign ensures that pain is monitored on a regular basis. | True |
| True or False: Pain cannot be viewed as a protective mechanism that warns of tissue injury. | False |
| What is the only Opioid side effect for which the individual does not develop a tolerance? | Constipation |
| Fatigue, sleep disturbance, and depression act in what type of relationship that can markedly change one's perception of pain? | synergistic relationship |
| What is the 24-hour, day-night cycle known also as the diurnal rhythm? | The circadian rhythm |
| What are the 2 phases of sleep? | NREM and REM |
| What are some of the side effects of epidural opioids? | Urinary retention, postural hypotension, pruritus, nausea, vomiting, and respiratory depression. |
| True or False: When providing teaching on PCA's the nurse must explain the risks of overdose. | False, Explain that the pump PREVENTS risks of overdose. |
| Which method of administration of opioids is associated with wide fluctuations in absorption, including delayed absorption in postoperative patients, making it an ineffective and potentially dangerous method of managing pain. | IM or intramuscular |
| What is the pain mechanism for NSAIDS? | Their actions are peripheral (at the site of injury), where they may exert analgesic effects through the inhibition of prostaglandin production. |
| What is the pain mechanism for OPIOIDS? | They relieve pain mainly by action in the CNS, binding to opioid receptor sites in the brain and spinal cord. |
| What is the pain mechanism for adjuvent analgesics? | No one mechanism of action for pain relief can be identified for this analgesic group. This group is composed of diverse classes of drugs that relieve pain by a variety of mechanisms, many of which are not understood. |
| The risk for gastric and renal toxicity from NSAIDs is increased in older adults or in children? | In older adults |
Created by:
bsmymicareo
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