Pathophysiology VERIFIED SOLUTIONS 2023//2024

Pathophysiology VERIFIED SOLUTIONS 2023//2024 A client is experiencing a cluster headache. The client would most likely manifest: - ANSWER Severe pain behind the eye Explanation: Symptoms of cluster headache include severe, unrelenting unilateral pain located in the orbital area. The pain radiates behind the eye to the ipsilateral trigeminal nerve. The client may also experience symptoms such as restlessness or agitation, conjunctival redness, lacrimation, nasal congestion, rhinorrhea, forehead and facial sweating, miosis, ptosis, and eyelid edema. The other options are all associated with migraine headache. Page 874 A client with a history of migraine headaches tells the physician that he or she usually experiences an aura before the onset of the headache. The client is most likely experiencing: - ANSWER Visual disturbances Explanation: Migraine aura is associated with visual symptoms, including flickering lights, spots, or loss of vision; sensory symptoms, including feeling of pins or needles, or numbness; and speech disturbances or other neurologic symptoms. Page 873 The nurse knows that chronic pain lacks which of the characteristic pain-related reactions? - ANSWER Increased heart rate Explanation: Characteristics of chronic pain do not include autonomic responses like increased heart and respiratory rate. Loss of appetite, disturbed sleep patterns and depression are common among people dealing with chronic pain. Page 866 When conducting a health assessment that focuses on the pain experienced by an older client diagnosed with early dementia, the nurse will pay particular attention to which of the following? - ANSWER Behavioral signs of pain demonstrated by the client Explanation: The assessment of pain in older adults can range from relatively simple in a well-informed, alert, cognitively intact person with pain from a single source and no comorbidities to extraordinarily difficult in a confused person. When possible, a person's report of pain is the gold standard, but behavioral signs of pain should also be considered. This is especially true when the client's cognitive function is impaired. While the other options should be considered, the client's non verbal behaviors should be of particular interest to the nurse. Page 876 A mother is placing her child into the bathtub. The child immediately jumps out of the tub and begins to cry, stating their feet are 'burning'. The nurse in the emergency department knows that the child's response is based on which of the following pathophysiological principles listed below? - ANSWER The tactile sensation occurs well in advance of the burning sensation. The local withdrawal reflex reacts first. Explanation: If a person places a foot in a tub of hot water, the tactile sensation occurs well in advance of the burning sensation. The foot has been removed from the hot water by the local withdrawal reflex well before the excessive heat is perceived by the forebrain. All other responses are incorrect. Page 858 A 58-year-old woman comes to the clinic for evaluation of a sharp, intermittent, severe, stabbing facial pain that she describes as, "like an electric shock." The pain occurs only on one side of her face; it seems to be triggered when she chews, brushes her teeth, or sometimes when she merely touches her face. There is no numbness associated with the pain. What is most likely causing her pain? - ANSWER Trigeminal neuralgia Explanation: Her symptoms are characteristic of trigeminal neuralgia, caused by damage to the fifth cranial nerve, which carries impulses of touch, pain, pressure, and temperature to the brain from the face and jaw. Page 870 A 7 year old child had an emergency appendectomy during the night. When trying to assess their pain, the nurse should: - ANSWER Show them a scale with faces of actual children and have them point to the picture that best describes how they are feeling. Explanation: Children do feel pain and have been shown to reliably and accurately report pain...With children 3-8 years of age, scales with faces of actual children or cartoon faces can be used to obtain a report of pain. Physiologic measures, such as heart rate, are convenient to measure but they are nonspecific. They may be a sign of anxiety and not pain. Distraction methods are good but medications should be used on an individual basis to match the analgesic agent with the level of pain. Page 875 Which is considered the most accurate method of assessing pain in children ages 8 years and older? - ANSWER Using a numeric 1-10 scale Explanation: Children between ages 3 and 8 years can accurately point to a scale of faces that ranges from very tearful to very happy to indicate their pain level. Children older than 8 are accurately able to report pain on a numeric scale, or using words ranging from "none" to "the most I have ever had." The older child may consider the faces scale juvenile. Physiologic responses to pain, such as tachycardia and guarding, are not very accurate because they are nonspecific and may not occur with chronic pain. A parent may say that their child is acting differently, but the child is the best person to describe his or her pain. Page 876 A client is admitted to the acute care facility with severe pain in the abdomen related to inflammatory bowel disease. What type of pain will the nurse be administering medication to relieve? - ANSWER Visceral pain Visceral pain has its origin in the visceral organs and is one of the most common pains produced by disease. While similar to somatic pain in many ways, both the neurologic mechanisms and the perception of visceral pain differ from somatic pain. One of the most important differences between surface pain and visceral pain is the type of damage that causes pain. Strong contractions, distention, or ischemia affecting the walls of the viscera can induce severe pain.