NUR./144./MIDTERM
1. Sources./of./pain:./cutaneous,./deep./somatic,./visceral,./referred,./phantom
2. Cutaneous./pain:./superficial./pain./usually./involving./the./skin./or./subcutaneous./tissue
3. Somatic./pain-./deep:./originating./from./muscle,./bone,./joints,./tendons,./or./blood./vessels
4. Visceral. / pain:. / diflcult./to./localize-./originates./in./organs./in./abdomen,./thorax,./and./brain(disease)
5. Referred. / pain:. / felt./at./a./particular./site./but./originates./from./another./location
6. Phantom./pain:./pain./or./discomfort./felt./in./an./amputated./limb
7. Responses./to./pain:./physiologic(involuntary),./behavioral(voluntary),./attective(psychological)
8. Nursing. / goals. / for. / pain:. / reduce./pain./and./improve./QOL
9. Steps. / for. / pain. / management:. / 1../Non-opioid./with./or./without./adjuvant.
2. Taking./Opioid
3. Opioid./with./or./without./non-opioid./and./adjuvant.
10. Agonist:./ binds./to./receptor./and./causes./a./response-./produces./analgesia,./sedation,./and./sense./of./well./being.
11. Agonist-
Antagonist./Opioids:./react./with./some./opioid./receptor./sites./to./stimulate./activity./while./block-
ing./other./opioid./receptor./sites../use./on./pregnant./women./and./used./to./detox./people./without./sedation
12. antagonist./ opioids:./ block./receptors./to./reverse./adverse./ettects./(narcan)
13. What./are./ opioids./ used./for?:./ moderate./to./severe./pain./and./drug./detox
14. Non-opioid. / analgesics:. / Acetaminophen
NSAIDs
15. 3./types./of./NSAIDs:./Selective,./Non-selective,./Salicylate./(aspirin)
16. Acetaminophen:./mild./to./moderate./pain,./fever.
NO. / anti-inflammatory. / ettects.
17. Acetaminophen. / Contraindications:. / Hypersensitivity,./liver./disease,./G6PD./deficiency.
18. What./is./daily./dose./of./acetaminophen?:./3-4,000./mg../or./2,000mg/day./if./liver./dysfunction
19. Adverse. / effects. / of. / acetaminophen:. / hepatotoxicity,./potential./for./drug./overdose
20. What./are./non-steroidal./anti-inflammatory./drugs./used./for?./(NSAIDS):./analgesic,
anti-inflammatory,./anti-pyretic,./anti./platelet(aspirin./only)
21. What./can./cause./bleeding./in./a./patient./taking./NSAIDs?:./vitamin./K./deficiency./or./peptic
./ulcer./disease
22. Mechanism. / of. / action. / of. / NSAIDs:. / inhibit./prostaglandin./or./leukotriene./pathways
23. What. / do. / non-selective. / NSAIDs. / block?:. / block./COX./1./and./2
24. What. / do. / selective. / NSAIDS. / block?:. / COX-2
./ .
/
, NUR./144./MIDTERM
25. Adverse./effects./of./NSAIDs:./GI:./heartburn./to./severe./GI./bleedin
g./Increased./risk./of./MI./and./stroke
Tinnitus,./hearing./loss
26. Salicylates:./ relieve./mild./to./moderate./pain./and./reduce./inflammation../anti-platelet./(ASPIRIN)
27. What./should./a./nurse./instruct./patients./to./report./when./taking./ibuprofen?:./-
Bleeding./and./heart./burn
28. For./best./results./when./treating./severe./pain./associated./with./pathologic./spinal.
/fractures./related./to./metastatic./bone./cancer,./the./nurse./should./remember./that
./the./best./type./of./dosage./schedule./is./to./administer./the./pain ./medication
a) as./needed.
b) around./the./clock.
c) on./schedule./during./waking./hours./only.
d) around./the./clock,./with./additional./doses./as./needed./for./breakthrough./pain.-
:. / around./the./clock,./with./additional./doses./as./needed./for./breakthrough./pain.
29. A./patient./with./bone./pain./caused./by./metastatic./cancer./will./be./receiving./tra
nsdermal./fentanyl./patches../The./patient./asks./the./nurse./what./benefits./these./pa
tches./have../The./nurse's./best./response./includes./which./of./these./features?
a) More./constant./drug./levels./for./analgesia
b) Less./constipation./and./minimal./dry./mouth
c) Less./drowsiness./than./with./oral./opioids
d) Lower./ dependency./ potential./ and./ no./ major./ adverse./ effects:./ More./constant./drug
levels./for./analgesia.
30. A./nurse./is./assessing./a./client./who./has./salicylism../Which./findings./should./th
e./nurse./expect?:./dizziness,./tinnitus,./headache.
31. Pain./process:./transduction,./transmission,./perception,./modulation
32. A./patient./with./a./history./of./heavy./alcohol./use./needs./a./medication./for./pain..
/The./recommended./maximum./daily./dose./of./acetaminophen./for./this./patient
./would./be?:./2,000mg/daily
33. A./hospitalized./patient./has./an./order./for./ketorolac../The./nurse./notes./that./the.
/order./is./only./for./5./days../What./is./the./reason./for./this?:./The./drug./can./cause./severe./renal./a
nd
GI./ettects.
./ .
/
1. Sources./of./pain:./cutaneous,./deep./somatic,./visceral,./referred,./phantom
2. Cutaneous./pain:./superficial./pain./usually./involving./the./skin./or./subcutaneous./tissue
3. Somatic./pain-./deep:./originating./from./muscle,./bone,./joints,./tendons,./or./blood./vessels
4. Visceral. / pain:. / diflcult./to./localize-./originates./in./organs./in./abdomen,./thorax,./and./brain(disease)
5. Referred. / pain:. / felt./at./a./particular./site./but./originates./from./another./location
6. Phantom./pain:./pain./or./discomfort./felt./in./an./amputated./limb
7. Responses./to./pain:./physiologic(involuntary),./behavioral(voluntary),./attective(psychological)
8. Nursing. / goals. / for. / pain:. / reduce./pain./and./improve./QOL
9. Steps. / for. / pain. / management:. / 1../Non-opioid./with./or./without./adjuvant.
2. Taking./Opioid
3. Opioid./with./or./without./non-opioid./and./adjuvant.
10. Agonist:./ binds./to./receptor./and./causes./a./response-./produces./analgesia,./sedation,./and./sense./of./well./being.
11. Agonist-
Antagonist./Opioids:./react./with./some./opioid./receptor./sites./to./stimulate./activity./while./block-
ing./other./opioid./receptor./sites../use./on./pregnant./women./and./used./to./detox./people./without./sedation
12. antagonist./ opioids:./ block./receptors./to./reverse./adverse./ettects./(narcan)
13. What./are./ opioids./ used./for?:./ moderate./to./severe./pain./and./drug./detox
14. Non-opioid. / analgesics:. / Acetaminophen
NSAIDs
15. 3./types./of./NSAIDs:./Selective,./Non-selective,./Salicylate./(aspirin)
16. Acetaminophen:./mild./to./moderate./pain,./fever.
NO. / anti-inflammatory. / ettects.
17. Acetaminophen. / Contraindications:. / Hypersensitivity,./liver./disease,./G6PD./deficiency.
18. What./is./daily./dose./of./acetaminophen?:./3-4,000./mg../or./2,000mg/day./if./liver./dysfunction
19. Adverse. / effects. / of. / acetaminophen:. / hepatotoxicity,./potential./for./drug./overdose
20. What./are./non-steroidal./anti-inflammatory./drugs./used./for?./(NSAIDS):./analgesic,
anti-inflammatory,./anti-pyretic,./anti./platelet(aspirin./only)
21. What./can./cause./bleeding./in./a./patient./taking./NSAIDs?:./vitamin./K./deficiency./or./peptic
./ulcer./disease
22. Mechanism. / of. / action. / of. / NSAIDs:. / inhibit./prostaglandin./or./leukotriene./pathways
23. What. / do. / non-selective. / NSAIDs. / block?:. / block./COX./1./and./2
24. What. / do. / selective. / NSAIDS. / block?:. / COX-2
./ .
/
, NUR./144./MIDTERM
25. Adverse./effects./of./NSAIDs:./GI:./heartburn./to./severe./GI./bleedin
g./Increased./risk./of./MI./and./stroke
Tinnitus,./hearing./loss
26. Salicylates:./ relieve./mild./to./moderate./pain./and./reduce./inflammation../anti-platelet./(ASPIRIN)
27. What./should./a./nurse./instruct./patients./to./report./when./taking./ibuprofen?:./-
Bleeding./and./heart./burn
28. For./best./results./when./treating./severe./pain./associated./with./pathologic./spinal.
/fractures./related./to./metastatic./bone./cancer,./the./nurse./should./remember./that
./the./best./type./of./dosage./schedule./is./to./administer./the./pain ./medication
a) as./needed.
b) around./the./clock.
c) on./schedule./during./waking./hours./only.
d) around./the./clock,./with./additional./doses./as./needed./for./breakthrough./pain.-
:. / around./the./clock,./with./additional./doses./as./needed./for./breakthrough./pain.
29. A./patient./with./bone./pain./caused./by./metastatic./cancer./will./be./receiving./tra
nsdermal./fentanyl./patches../The./patient./asks./the./nurse./what./benefits./these./pa
tches./have../The./nurse's./best./response./includes./which./of./these./features?
a) More./constant./drug./levels./for./analgesia
b) Less./constipation./and./minimal./dry./mouth
c) Less./drowsiness./than./with./oral./opioids
d) Lower./ dependency./ potential./ and./ no./ major./ adverse./ effects:./ More./constant./drug
levels./for./analgesia.
30. A./nurse./is./assessing./a./client./who./has./salicylism../Which./findings./should./th
e./nurse./expect?:./dizziness,./tinnitus,./headache.
31. Pain./process:./transduction,./transmission,./perception,./modulation
32. A./patient./with./a./history./of./heavy./alcohol./use./needs./a./medication./for./pain..
/The./recommended./maximum./daily./dose./of./acetaminophen./for./this./patient
./would./be?:./2,000mg/daily
33. A./hospitalized./patient./has./an./order./for./ketorolac../The./nurse./notes./that./the.
/order./is./only./for./5./days../What./is./the./reason./for./this?:./The./drug./can./cause./severe./renal./a
nd
GI./ettects.
./ .
/
