Med-Surg - Chapter 10: Pain (Lewis)
A client who is receiving sustained-launch morphine sulphate every 12 hours for persistent ache
experiences degree 9 breakthrough ache and anxiety. Which of these prescribed medicinal
drugs ought to the nurse anticipate administering?
A. Lorazepam 1 mg orally
B. Amitriptyline 10 mg orally
C. Ibuprofen four hundred-800 mg daily
D. Immediate-launch morphine 30 mg orally - ANS-ANS: D
The intense step forward pain suggests that the initial therapy must be a rapidly appearing
opioid, consisting of the instantaneous-release morphine. The ibuprofen and amitriptyline can
be suitable to use as adjuvant therapy, but they are now not likely to dam excessive step
forward pain. Use of antianxiety agents for pain manage is inappropriate because this
customer's tension is due to the pain.
A purchaser who uses a fentanyl patch for continual most cancers pain complains to the nurse
of the speedy onset of ache at a stage nine (0-10 scale) and requests "some thing for ache so
as to paintings quickly". Which of the subsequent styles of ache is the most appropriate for the
nurse to record for this customer?
A. Somatic pain
B. Referred pain
C. Neuropathic pain
D. Breakthrough pain - ANS-ANS: D
Pain that occurs beyond the continual pain already being treated by way of appropriate
analgesics is named breakthrough pain. Neuropathic pain is caused by harm to peripheral
nerves or the crucial anxious device (CNS). Somatic ache is localized and arises from bone,
joint, muscle, skin, or connective tissue. Referred pain is pain that is localized in unhurt tissue.
A consumer with cancer-related pain and a records of opioid abuse complains of leap forward
ache 2 hours earlier than the following dose of morphine sulphate extended-launch is due.
Which of the following moves is precedence for the nurse to put in force?
A. Administer the prescribed PRN instant-release morphine.
B. Suggest the use of alternative treatments which include warmness or cold.
C. Utilize distraction by using speaking approximately things the purchaser enjoys.
D. Consult with the physician about increasing the morphine sulphate prolonged-launch dose. -
ANS-ANS: A
The purchaser's ache calls for rapid remedy and the nurse ought to administer the
immediate-release morphine. Increasing the morphine sulphate prolonged-launch dose and use
of alternative treatments additionally can be needed, but the preliminary movement ought to be
to apply the prescribed analgesic medicines.
A consumer with persistent abdominal pain has learned to manipulate the ache with the use of
imagery and hypnosis. A member of the family asks the nurse how these techniques work.
Which of the following motives offer the idea for the nurse's response when it comes to the
effectiveness of those techniques?
, A. Impact the cognitive and affective components of ache
B. Increase the modulating effect of the efferent pathways
C. Prevent transmission of nociceptive stimuli to the cortex
D. Slow the release of transmitter chemical substances inside the dorsal horn - ANS-ANS: A
Cognitive therapies impact the notion of pain by the brain as opposed to affecting efferent or
afferent pathways or influencing the release of chemical transmitters inside the dorsal horn.
A client with 2nd-degree burns has acquired morphine via affected person-managed analgesia
(PCA) for every week. The client wakes up frequently for the duration of the night time
complaining of ache. Which of the following movements ought to the nurse implement?
A. Administer a dose of morphine each 1-2 hours from the PCA machine while the customer is
napping.
B. Consult with the fitness care company about the usage of a different treatment protocol to
manipulate the consumer's pain
C. Request that the health care company order a bolus dose of morphine to take delivery of
while the purchaser awakens with pain
D. Teach the client to push the button each 10 mins for an hour before going to sleep, even if
the ache is minimum - ANS-ANS: B
PCAs are first-class for controlling acute ache; this patron's records shows persistent ache and
a want for a pain control plan so as to offer ok analgesia while the client is slumbering.
Administering a dose of morphine whilst the patron already has excessive pain will not deal with
the trouble. Teaching the purchaser to manage unneeded remedy earlier than going to sleep
can bring about over sedation and respiration despair. It is illegal for the nurse to manage the
morphine for a client via PCA.
A postoperative purchaser asks the nurse how the prescribed ibuprofen will manipulate the
incisional pain. The nurse will educate the client that ibuprofen interferes with the ache process
through decreasing which of the subsequent physiological responses?
A. Modulating effect of descending nerves
B. Sensitivity of the brain to painful stimuli
C. Production of pain-sensitizing chemical substances
D. Spinal cord transmission of ache impulses - ANS-ANS: C
Nonsteroidal anti inflammatory tablets (NSAIDs) provide analgesic consequences via lowering
the manufacturing of pain-sensitizing chemical compounds which includes prostaglandins at the
web page of injury. Transmission of impulses through the spinal wire, mind sensitivity to pain,
and the descending nerve pathways aren't laid low with the NSAIDs.
The health care company plans to titrate a affected person-managed analgesia (PCA) machine
to offer pain comfort for a customer with acute surgical ache who has never received opioids in
the past. Which of the following nursing movements regarding opioid management are suitable
at this time?
A. Assessing for symptoms that the purchaser is becoming addicted to the opioid
B. Monitoring for therapeutic and detrimental effects of opioid administration
C. Emphasizing that the threat of some opioid detrimental effects increases over the years
D. Teaching about the want to lower opioid doses by way of the second one postoperative day -
ANS-ANS: B
A client who is receiving sustained-launch morphine sulphate every 12 hours for persistent ache
experiences degree 9 breakthrough ache and anxiety. Which of these prescribed medicinal
drugs ought to the nurse anticipate administering?
A. Lorazepam 1 mg orally
B. Amitriptyline 10 mg orally
C. Ibuprofen four hundred-800 mg daily
D. Immediate-launch morphine 30 mg orally - ANS-ANS: D
The intense step forward pain suggests that the initial therapy must be a rapidly appearing
opioid, consisting of the instantaneous-release morphine. The ibuprofen and amitriptyline can
be suitable to use as adjuvant therapy, but they are now not likely to dam excessive step
forward pain. Use of antianxiety agents for pain manage is inappropriate because this
customer's tension is due to the pain.
A purchaser who uses a fentanyl patch for continual most cancers pain complains to the nurse
of the speedy onset of ache at a stage nine (0-10 scale) and requests "some thing for ache so
as to paintings quickly". Which of the subsequent styles of ache is the most appropriate for the
nurse to record for this customer?
A. Somatic pain
B. Referred pain
C. Neuropathic pain
D. Breakthrough pain - ANS-ANS: D
Pain that occurs beyond the continual pain already being treated by way of appropriate
analgesics is named breakthrough pain. Neuropathic pain is caused by harm to peripheral
nerves or the crucial anxious device (CNS). Somatic ache is localized and arises from bone,
joint, muscle, skin, or connective tissue. Referred pain is pain that is localized in unhurt tissue.
A consumer with cancer-related pain and a records of opioid abuse complains of leap forward
ache 2 hours earlier than the following dose of morphine sulphate extended-launch is due.
Which of the following moves is precedence for the nurse to put in force?
A. Administer the prescribed PRN instant-release morphine.
B. Suggest the use of alternative treatments which include warmness or cold.
C. Utilize distraction by using speaking approximately things the purchaser enjoys.
D. Consult with the physician about increasing the morphine sulphate prolonged-launch dose. -
ANS-ANS: A
The purchaser's ache calls for rapid remedy and the nurse ought to administer the
immediate-release morphine. Increasing the morphine sulphate prolonged-launch dose and use
of alternative treatments additionally can be needed, but the preliminary movement ought to be
to apply the prescribed analgesic medicines.
A consumer with persistent abdominal pain has learned to manipulate the ache with the use of
imagery and hypnosis. A member of the family asks the nurse how these techniques work.
Which of the following motives offer the idea for the nurse's response when it comes to the
effectiveness of those techniques?
, A. Impact the cognitive and affective components of ache
B. Increase the modulating effect of the efferent pathways
C. Prevent transmission of nociceptive stimuli to the cortex
D. Slow the release of transmitter chemical substances inside the dorsal horn - ANS-ANS: A
Cognitive therapies impact the notion of pain by the brain as opposed to affecting efferent or
afferent pathways or influencing the release of chemical transmitters inside the dorsal horn.
A client with 2nd-degree burns has acquired morphine via affected person-managed analgesia
(PCA) for every week. The client wakes up frequently for the duration of the night time
complaining of ache. Which of the following movements ought to the nurse implement?
A. Administer a dose of morphine each 1-2 hours from the PCA machine while the customer is
napping.
B. Consult with the fitness care company about the usage of a different treatment protocol to
manipulate the consumer's pain
C. Request that the health care company order a bolus dose of morphine to take delivery of
while the purchaser awakens with pain
D. Teach the client to push the button each 10 mins for an hour before going to sleep, even if
the ache is minimum - ANS-ANS: B
PCAs are first-class for controlling acute ache; this patron's records shows persistent ache and
a want for a pain control plan so as to offer ok analgesia while the client is slumbering.
Administering a dose of morphine whilst the patron already has excessive pain will not deal with
the trouble. Teaching the purchaser to manage unneeded remedy earlier than going to sleep
can bring about over sedation and respiration despair. It is illegal for the nurse to manage the
morphine for a client via PCA.
A postoperative purchaser asks the nurse how the prescribed ibuprofen will manipulate the
incisional pain. The nurse will educate the client that ibuprofen interferes with the ache process
through decreasing which of the subsequent physiological responses?
A. Modulating effect of descending nerves
B. Sensitivity of the brain to painful stimuli
C. Production of pain-sensitizing chemical substances
D. Spinal cord transmission of ache impulses - ANS-ANS: C
Nonsteroidal anti inflammatory tablets (NSAIDs) provide analgesic consequences via lowering
the manufacturing of pain-sensitizing chemical compounds which includes prostaglandins at the
web page of injury. Transmission of impulses through the spinal wire, mind sensitivity to pain,
and the descending nerve pathways aren't laid low with the NSAIDs.
The health care company plans to titrate a affected person-managed analgesia (PCA) machine
to offer pain comfort for a customer with acute surgical ache who has never received opioids in
the past. Which of the following nursing movements regarding opioid management are suitable
at this time?
A. Assessing for symptoms that the purchaser is becoming addicted to the opioid
B. Monitoring for therapeutic and detrimental effects of opioid administration
C. Emphasizing that the threat of some opioid detrimental effects increases over the years
D. Teaching about the want to lower opioid doses by way of the second one postoperative day -
ANS-ANS: B
