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NSG 533 Advanced Pathophysiology ACTUAL 3 with actual quiz and solutions

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NSG 533 Advanced Pathophysiology ACTUAL 3 with actual quiz and solutions

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NSG 533 Advanced Pharmacology ASSESSMENT 2 WITH
CORRECT QUESTIONS AND ANSWERS.

,pain - correct Xans:the most common symptom prompting patients to visit
primary care providers.

More than 80% of patients who visit physicians report pain. Often remains
under treated.

nociceptive pain - correct ans:pain from a normal process that results in
noxious stimuli being perceived as painful. Explained by ongoing tissue
injury.

thermal, mechanical and chemical nociceptors that engage "withdrawal"
reflex followed by inflammatory response to protect injured tissue



functional pain - correct ans:pain sensitivity due to an abnormal processing
or function of the central nervous system in response to normal stimuli



neruopathic pain - correct ans:Pain caused by lesions or other damage to the
nervous system.



Diabetic peripheral neuropathy - correct ans:progressive deterioration of
nerve function that results in loss of sensory perception



acute pain - correct ans:is pain that occurs as a result of injury or surgery,
under 3 months. Poorly treated acute pain can cause psychological stress
and compromise the immune system. Somatic acute pain is an injury to skin,
bone, joint, muscle and connective tissue. Visceral pain involves injury to
nerves on internal organs. Treat aggressively. Examples: cut hand, menstrual
cramps.



chronic pain - correct ans:can be intermittent or persistent, more than 3
months. Main affects include a) effects on physical function b) psychological
changes c) social consequences and d) societal consequences. Usually
involving life threatening diseases such as cancers, aids, progressive
neurological diseases, end stage organ failure, dementia. Management
should be multimodal with cognitive interventions, physical manipulations,

, pharmacological agents, surgical interventions, and regional or spinal
anesthesia.



chronic malignant pain - correct ans:Painn is associated with a progressive
life-threatening disease like cancer, aids, neurologic diseases, end stage
organ failure, and dementia. Goal is pain alleviation and prevention.
Dependence or addiction is not a concern. Pain not associated with life
threatening disease and lasting more than 6 months beyond the healing
period is referred to as "chronic nonmalignant pain."



What are some non-pharmacological approaches to pain? - correct
ans:imagery, distraction, relaxation, psychotherapy, biofeedback, cognitive
behavioral therapy, support groups, and spiritual counseling. Physical
therapy, heat, cold, water, ultrasound, TENS, massage and therapeutic
exercise.



WHO 3 step analgesic ladder - correct ans:* 1- nonopioid

* 2 - opioid for mild to moderate pain

* 3 - opioid for moderate to severe pain



WHO first step pain ladder - correct ans:mild pain/nonopioid analgesics such
as NSAIDS or acetaminophen w/ or w/out adjuvants (such as pregablin) ..
"soreness." Med examples: apap 1000mg q 6hrs, ibu600mg q6 hrs



NSAIDs - correct ans:Non-steroidal anti-inflammatory drugs. associated with
several clinically significant contraindications and drug interactions. NSAIDS
are equally effective in analgesia, antipyretic and anti-inflammatory effects.
Choice should include STEPS (simplicity, tolerability, evidence, price, safety).
If patient fails therapy with an agent from one class of NSAIDs, use of an
agent from another class is reasonable.



COX2 inhibitors - correct ans:Celecoxib (Celebrex) selective agents
(celecoxib) have ideal indication in patients with high risk for GI bleed, high

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