Pain
Before giving pain medication the nurse should first do this
What is assess the patient's pain?
Bonus points: what is the acronym to help remember pain assessment steps
When a nurse asks the patient to report pain on a scale of 0-10 they are measuring this aspect of the PQRST mnemonic
What is S for severity?
A patient is in the grieving process. This is the first step of the nurse
What is assess to determine if the patient's grief is healthy or complicated
Bonus: what is the difference between healthy and complicated grieving?
Why do nurses need to know if patients are taking herbal supplements?
Because often herbs have unwanted interactions with prescribed medications
This is the first step to take when finding an open vial of any controlled substance in a patient's room
What is report it immediately?
True or false: Using analgesics for pain management will eventually lead to addiction
False: while poorly managed analgesic opioid administration can cause dependency, this is not an guaranteed eventuality
Phantom limb pain falls under this category
What is neuropathic pain?
A person who says they'll be a better husband if they can be cured of cancer is in this stage of grieving
What is bargaining?
True or False: Spirituality can increase the quality of life and a patient's willingness to accept death
True
This is required when wasting medication
What is a witness from a second nurse?
Name three vital sign changes when a patient is experiencing increased pain
What are increased HR, RR, BP?
Name three non-pharmacological methods to manage pain
A patient who does not want to return to the hospital because they feel they don't need treatment is in this stage of the grieving process
What is denial?
This therapy method has been proven to decrease anxiety
What is cognitive behavioral therapy
This is an essential step in post-mortem care
What is wash the patient's body and clean their bed
For a patient who is sedated, these are non verbal signs of pain
What are restlessness, grimacing, and clenching?
This is a common barrier to effective pain management when treating hospice patients
What is the fear that opioid narcotics will lead to addiction?
Give an example of maladaptive grieving
Isolation, picking up bad habits like drinking or smoking, PTSD, ignoring their own emotional, social, and physical needs, not taking medications, self-harm etc
A young child may display this behavior towards outside care givers after experiencing death at home
What is cling to their caregiver
The final stage of healthy grieving is this stage
What is acceptance?
While Noah strongly disagrees with this, nursing school, med school, NCLEX, and hospital policy states that this is the most effective way to determine levels of pain (Because they've been lobbied by big Pharma, the biggest lobby in the US by almost double)
What is the patient's self-report?
Bonus points: explain why this is a lie
Name two side effects of morphine administration
What is decreased respiratory rate and orthostatic hypotension?
This type of nurse will help manage comfort for a patient who is expected to die within 6 months at home from an incurable disease
What is a hospice nurse?
Name three side effects of acetaminophen
Jaundice due to hepatotoxicity, abdominal pain, clay colored stools, fever
This type of breathing pattern is visible when a patient is near death
What is Cheyne-Stokes breathing?
Bonus points: describe it
Name one do and one don't of PCA (patient-controlled analgesia) management
Don't let family use it for the patient
Do push it before you sense pain becoming too severe
Do push the button as often as you like
Don't request pain medication from the nurse
Don't worry about overdosing