A neurotransmitter known for its involvement in pain modulation is
A.
Which of the following words is most likely to be used to describe neuropathic pain?
B.
Unrelieved pain is
B.
A cancer patient who reports ongoing, constant moderate pain with short periods of severe pain during dressing changes
C.
An example of distraction to provide pain relief is
A.
An appropriate nonopioid analgesic for mild pain is
D.
An important nursing responsibility related to is to
B.
Providing opioids to a dying patient who is experiencing moderate to severe pain
A.
A nurse believes that patients with the same type of tissue injury should have the same amount of pain. This statement reflects
A.
Pain has been defined as "whatever the person experiencing the pain says it is, existing whenever the patient says it does." The definition is problematic when caring for a patient who has
C.
On the first day following a bowel resection, the patient complains of abdominal and incisional pain rated 7 on a scale of 10. Postoperative orders include morphine, 4 to 10 mg IV q2-4hr. The nurse determine that it has been 3.5 hours since the last dose and plans to administer 4 mg of morphine. Routine administration of the smallest prescribed dose of a opioid analgesic when a range of doses is prescribed,
D.
List the five dimensions of pain.
1.
2.
3.
4.
5.
1. Physiologic
2. Affective
3. Cognitive
4. Behavioral
5. Sociocultural
During transmission of an action potential along a peripheral nerve fiber to the dorsal root of the spinal cord,
D.
While caring for an unconcious patient, the nurse discovers a stage 2 pressure ulcer on the patient's heel. During care of the ulcer the nurse
A.
A patient comes to the clinic with a complain of a dull pain in the anterior and posterior neck. On examination, the nurse notes that the patient has full ROM of the neck and no throat redness or enlarged head or neck lymph nodes. The next appropriate assessment indicated by the patient's findings is
A.
Amitriptyline (Elavil) is prescribed for a patient with chronic pain from fibromyalgia. When the nurse explains that this drugs is an antidepressant, the patient states that she is in pain, not depressed. The nurse's best response to the patient is that
C.
When teaching a patient with rheumatoid arthritis to avoid repetitive motions such as knitting, the nurse is addressing the
C.
A patient with trigeminal neuralgia has moderate to severe burning, shooting pain. In helping the patient manage the pain, the nurse recognizes that this type of pain
A.
A patient with bowel cancer has continous, poorly localized abdominal pain at an intensity of 5 on a scale of 1 to 10. The nurse teaches the patient to use pain medications
B.
A patient who has been taking ketoprofen (Orudis) and imipramine (Tofranil) for control of cancer pain is having increased pain. The nurse recommends that an appropriate change in the medication plan would be to
D.
A patient with chronic cancer-related pain has started using MS Contin for pain control and has developed common side effects of the drug. The nurse reassures the patient that tolerance will develop to most of these effects but that continued treatment will most likely be required for the
B.
The use of a continuous infusion of an analgesic with patient-controlled-analgesia (PCA) prevents what disadvantage of PCA?
Patient-controlled analgesia (PCA) use is decreased at night when the patient sleeps, and without a continuous infusion of an analgesic, the patient is a likely to awaken in pain that will require substantial time to bring under control.
A patient with multiple injuries resulting from an automobile accident tells that nurse that he has "bad" pain but that he can "tough it out" and does not require pain medication. To gain the patient's participation in pain management, the nurse explains that
A.
Arises from bone, join, muscle, skin, or connective tissue; usually aching or throbbing in quality and is well localized.
Somatic pain
Arises from visceral organs, such as the GI tract and bladder.
Visceral pain
Normal processing of stimulus that damamges normal tissue or has the potential to do so if prolonged. Usually responsive to nonopioid and/or opioid drugs.
Nociceptive pain
Abnormal preocessing of sensory input by the peripheral or central nervous system. Treatment usually includes adjuvant analgesics.
Neuropathic pain
Is the conversion of a mechanical, thermal, or chemical stimulus into a neuronal action potential.
D.
Movement of pain impulses from the site of transduction to the brain.
D.
Occurs when pain is recognized, defined, and responded to by the individual experiencing the pain.
B.
Involves the activation of descending pathways that exert inhibitory or facilitatory effects on the transmission of pain.
C.
Pain known to radiate from the chest to the jaw or down the left arm.
Angine pectoris
Most common opioid side effect
Constipation
Increasing the dose beyond an upper limit provides no greater analgesia.
Analgesic ceiling
These medications, sometimes referred to as co-analgesics, are drugs used in conjunction with opioid and nonopioid analgesics.
Adjuvant analgesic therapy
Enhance the descending inhibitory system by preventing the cullular reuptake of serotonin and norepinephrine; sodium channel modulation, weak NMDA receptor modulation.
Tricyclic antidepressants
Sodium channel modulation, central calcium channel modulation, and changes in excitatory amino acids and other receptors. Effective for neuropathic pain and prophylactic treatment of migrain headaches.
Antiseizure drugs or antiepileptic drugs (AEDs)
Dose adjustment based on assessment of the adequacy of analgesic effect versus the side effects produced.
Analgesic titration
The physiologic process by which information about tissue damage is communicated to the central nervous system (CNS).
