TYPES OF PAIN
A client describes their pain as "sharp" and "burning" after getting a paper cut. The nurse documents this as which type of somatic pain?
What is Cutaneous (Superficial) Pain?
When caring for an older adult, the nurse anticipates the initial opioid dose will be reduced to this specific fraction of the usual adult dose
What is one-half to two-thirds?
According to the "Golden Rule" of nursing, pain is defined as this.
What is "whatever the patient says it is"?
A nurse assesses a respiratory rate of 10 breaths/min in a client receiving morphine. The priority action is to do this.
What is hold the medication (and assess/notify provider)
This evidence-based non-pharmacologic therapy is specifically recommended in the Exemplar for clients with Osteoarthritis.
What is Massage Therapy?
A client having a heart attack complains of pain in their left shoulder. This phenomenon, where discomfort is perceived away from the actual site of injury, is known as this.
What is Referred Pain?
A client is prescribed an opioid analgesic. To prevent a common complication, the nurse ensures a bowel regimen is started at this time.
What is immediately (or when the medication is prescribed)?
Pain is considered the "Fifth Vital Sign" and must be assessed at these times.
What is regularly (or with every check of vital signs)?
n an older adult, this sudden mental change is often a sign of infection or drug toxicity, rather than just "old age."
What is Confusion (or Change in Mental Status)?
In Traditional Chinese Medicine, health is viewed as the balance of Yin and Yang to maintain this life energy.
What is Qi (or Chi)?
A client presents with nausea, vomiting, hypotension, and "squeezing" abdominal pain. These systemic symptoms are characteristic of which type of pain classification?
What is Visceral Pain?
The nurse avoids administering pain medication via the Intramuscular (IM) route in older adults primarily due to this physiological change.
What is diminished muscle mass?
A client with dementia is grimacing and pacing but denies pain. The nurse understands that distraction (like TV) does not indicate this.
What is that the patient is pain-free?
Applying a heating pad over a fentanyl patch can cause death because it leads to this.
What is increased absorption (or overdose/toxicity)?
A Native American "Shaman" is a spiritual healer who enters a trance to journey to this place to acquire healing knowledge.
What is the spirit world?
A client with diabetic neuropathy complains of burning and itching. The nurse understands that this pain is caused by the neurotransmitter Glutamate activating these specific receptors.
What are NMDA Receptors?
Older adults taking NSAIDs (like Ibuprofen) are at highest risk for these two specific serious adverse effects.
What are Gastric Ulceration (GI Bleeding) and Renal Toxicity?
A client is prescribed a fentanyl patch. The client reports the pain is still an 8/10. Before calling the provider, the nurse must assess this.
What is the client's technique (or understanding/application of the patch)?
If a client on opioids becomes difficult to arouse, the nurse suspects this medical emergency.
What is Opioid Toxicity?
Integrative Health (IH) principles state that while science is valued, these types of interventions should be used first whenever possible.
What are natural and less invasive interventions?
Which of the following conditions are examples of Neuropathic Pain? (Select All That Apply)
1. osteoarthritis
2. Phantom limb pain
3. Shingles (Herpes Zoster)
4. Diabetic neuropathy
5. Kidney stones
2, 3, and 4. (Osteoarthritis is deep somatic; kidney stones are visceral)
A nurse is preparing to administer an opioid to an 82-year-old client. Which factors increase the client’s risk for opioid toxicity? (Select All That Apply)
1. Hyperactive metabolism
2. Higher peak effect of the drug
3. Longer duration of pain relief
4. Decreased muscle mass
5. History of drug accumulation
2, 3, and 5. (Older adults experience a higher peak and longer duration, leading to accumulation).
Which nonverbal behaviors in a cognitively impaired client should the nurse interpret as potential signs of pain? (Select All That Apply)
1. Agitation
2. Aggression
3. Withdrawal from social interaction
4. Changes in sleep patterns
5. Normal vital signs
1, 2, 3, and 4. (Vital signs may remain normal in chronic pain or older adults, so they are not a reliable exclusion criteria).
Which of the following are Joint Commission requirements for safe pain management? (Select All That Apply)
1. Screening for pain in the ER and upon admission.
2. Mandatory use of opioids for all surgical patients.
3. Monitoring high-risk patients for respiratory depression.
4. Accessing Prescription Drug Monitoring databases.
5. Discharge education on safe storage and disposal of opioids
1, 3, 4, and 5. (Hospitals must provide non-pharmacologic options; opioids are not mandatory for everyone).
In Ayurvedic medicine, treatments like yoga and meditation are used to restore the flow of this life force.
What is Prana?