UNCG - NUR 210 - EXAM #3
QUESTIONS WITH VERIFIED
ANSWERS
Patient's pain is treated or they are referred for treatment - Answer-Referrals may be
required for patients who present with complex pain management needs, such as
the opioid-addicted patient, the patient who is at high risk for adverse events but
requires treatment with opioids, or a patient whose pain management needs exceed
the expertise of the patient's provider.
Nonpharmacologic pain treatment modalities are promoted - Answer-
Nonpharmacologic modalities should be promoted by ensuring that patient
preferences are discussed and some nonpharmacologic treatment options provided.
Nonpharmacologic strategies include, but are not limited to, physical modalities (e.g.,
acupuncture therapy, chiropractic therapy, osteopathic manipulative treatment,
massage therapy, and physical therapy), relaxation therapy, and cognitive behavioral
therapy.
Patients identified as being high risk for adverse outcomes related to opioid
treatment are monitored - Answer-The most dangerous adverse effect of opioid
analgesics is respiratory depression. Equipment must be available to monitor
patients deemed highest risk (e.g., patients with sleep apnea, those receiving
continuous intravenous opioids, or those on supplemental oxygen).
Patients experiencing opioid substance abuse are referred to opioid treatment
programs - Answer-When clinicians encounter patients who are addicted to opioids,
the patients should be referred for treatment. The U.S. Substance Abuse and Mental
Health Services Administration provides a directory of opioid treatment programs.
The hospital facilitates access to the Prescription Drug Monitoring Program
databases - Answer-Prescription Drug Monitoring Programs (PDMP) aggregate
prescribing and dispensing data submitted by pharmacies and health care providers.
They are an effective tool for reducing prescription drug abuse and diversion. Read
more about PDMP in the "Legal/Ethical" chapter of the Open RN Nursing
Pharmacology textbook.
Patient's pain is reassessed and responded to through the evaluation and
documentation of - Answer-Response to pain intervention, Progress toward pain
management goals including the functional ability (for example, the ability to take a
deep breath, turn in bed, and walk with improved pain control), Side effects of
treatment.
Patients and their family members are educated on discharge plans related to pain
management including the following - Answer-Pain management plan of care, Side
effects of pain management treatment, activities of daily living, including the home
environment that might exacerbate pain or reduce the effectiveness of the pain
,management plan of care, as well as strategies to address these issues, Safe use,
storage, and disposal of opioids when prescribed
OLDCARTES pain assessment - Answer-onset, location, duration, characteristics,
aggravating, radiation, treatment, effect, severity
COLDSPA pain assessment - Answer-characteristics, onset, location, duration,
severity, pattern, associated factors
Wong-baker FACES scale - Answer-a visual tool for assessing pain with children
and other who cannot quantify the severity of their pain on a scale of 0 to 10
FLACC scale - Answer-a measurement used to assess pain for children between the
ages of 2 months and 7 years or individuals who are unable to verbally communicate
their pain
FLACC - Answer-Face, legs, activity, cry, consolability
PAINAD - Answer-Pain assessment in advanced dementia
COMFORT Behavioral Scale - Answer-a behavioral-observation tool validated for
use in children of all ages who are receiving mechanical ventilation
Comfort-function goals - Answer-encourages the patient to establish their level of
comfort needed to achieve functional goals based on their current health status
If a patient's pain score exceeds their comfort-function goal - Answer-nurses must
implement an intervention and follow up within 1 hour to ensure that the intervention
was successful.
Analgesics - Answer-Medications used to relieve pain.
Analgesic classifications - Answer-nonopioids, opioids, adjuvants
Adjuvants - Answer-Medication that is not classified as an analgesic but has been
found in clinical practice to have either an independent analgesic effect or additive
analgesic properties when administered with opioids.
Types of adjuvants - Answer-Amitriptyline (antidepressant), Gabapentin
(anticonvulsant)
Acetaminophen - Answer-Tylenol
Acetaminophen - Answer-used to treat mild pain and fever but does not have anti-
inflammatory properties, safe for all ages, can be taken PO, PR, IV, can head to
hepatotoxicity
hepatotoxicity - Answer-severe liver damage
daily limit of Acetaminophen - Answer-4,000 mg/day
,daily limit of acetaminophen in older adults - Answer-3,200 mg/day
daily limit of acetaminophen in chronic alcoholic - Answer-2,000 mg/day
Nonsteroidal anti-inflammatories (NSAIDS) - Answer-provide mild to moderate pain
relief and also reduce fever and inflammation by inhibiting the production of
prostaglandins
How do Nonsteroidal anti-inflammatories (NSAIDS) work - Answer-Inhibits the
production of prostaglandins
Examples of Nonsteroidal anti-inflammatories (NSAIDS) - Answer-ibuprofen,
naproxen, ketorolac
Risks of Nonsteroidal anti-inflammatories (NSAIDS) - Answer-heart attack, heart
failure, and stroke
Side effects of Nonsteroidal anti-inflammatories (NSAIDS) - Answer-dyspepsia,
nausea, vomiting
When should Nonsteroidal anti-inflammatories (NSAIDS) be taken - Answer-with
food
Nonsteroidal anti-inflammatories (NSAIDS) use can lead to - Answer-kidney failure
Result of taking Nonsteroidal anti-inflammatories (NSAIDS) with warfarin or
corticosteroids - Answer-GI bleed
Opioids - Answer-used to treat moderate to severe pain and work by blocking the
release of neurotransmitters involved in the process of pain
Morphine - Answer-a drug that has no ceiling effect, meaning the higher the dose the
higher the level of analgesia
Codeine with acetaminophen - Answer-Tylenol #3
Codeine with acetaminophen route - Answer-PO
Codeine with acetaminophen adult dosage - Answer-30 mg/300 mg
Hydrocodone with acetaminophen - Answer-Lortab, Norco, Vicodin
Hydrocodone with acetaminophen route - Answer-PO
Hydrocodone with acetaminophen adult dosage - Answer-5 mg/300 mg or 325 mg,
10 mg/320 mg or 325 mg, 5mg/500 mg
Oxycodone - Answer-Oxycodone IR & OxyContin (ER), Percocet & Roxicet
, Oxycodone route - Answer-PO
Oxycodone adult dosage - Answer-5 mg - 10 mg, 5 mg/325 mg
Physical dependence - Answer-Withdrawal symptoms that occur when chronic pain
medication is suddenly reduced or stopped because of physiological adaptations that
occur from chronic exposure to the medication.
Misuse - Answer-Taking prescription pain medications in a manner or dose other
than prescribed; taking someone else's prescription, even if for a medical complaint
such as pain; or taking a medication to feel euphoria (i.e., to get high).
What in the 5th vital sign - Answer-pain
What did treatment of the 5th vital sign lead to - Answer-led to an associated rise in
the number of deaths from overdose. Organizations began to urge caution about the
use of opioids for pain, including guidelines published in 2016 by the Centers for
Disease Control (CDC) on prescribing opioids for pain
Substance abuse disorder - Answer-Significant impairment or distress from a pattern
of substance use (i.e., alcohol, drugs, or misuse of prescription medications).
Symptoms of substance abuse - Answer-Use of more of a substance than planned
or using a substance for a longer interval than desired
Symptoms of substance abuse - Answer-Inability to cut down despite desire to do so
Symptoms of substance abuse - Answer-Spending a substantial amount of the day
obtaining, using, or recovering from substance use
Symptoms of substance abuse - Answer-Cravings or intense urge to use a
substance
Symptoms of substance abuse - Answer-Repeated usage causing an inability to
meet important social or professional obligations
Symptoms of substance abuse - Answer-Persistent usage despite user's knowledge
that it is causing frequent problems at work, school, or home
Symptoms of substance abuse - Answer-Giving up or cutting back on important
social, professional, or leisure activities because of use
Symptoms of substance abuse - Answer-Usage in physically hazardous situations,
such as driving, or usage despite it causing physical or mental harm
Symptoms of substance abuse - Answer-Persistent use despite the user's
awareness that the substance is causing, or at least worsening, a physical or mental
problem
QUESTIONS WITH VERIFIED
ANSWERS
Patient's pain is treated or they are referred for treatment - Answer-Referrals may be
required for patients who present with complex pain management needs, such as
the opioid-addicted patient, the patient who is at high risk for adverse events but
requires treatment with opioids, or a patient whose pain management needs exceed
the expertise of the patient's provider.
Nonpharmacologic pain treatment modalities are promoted - Answer-
Nonpharmacologic modalities should be promoted by ensuring that patient
preferences are discussed and some nonpharmacologic treatment options provided.
Nonpharmacologic strategies include, but are not limited to, physical modalities (e.g.,
acupuncture therapy, chiropractic therapy, osteopathic manipulative treatment,
massage therapy, and physical therapy), relaxation therapy, and cognitive behavioral
therapy.
Patients identified as being high risk for adverse outcomes related to opioid
treatment are monitored - Answer-The most dangerous adverse effect of opioid
analgesics is respiratory depression. Equipment must be available to monitor
patients deemed highest risk (e.g., patients with sleep apnea, those receiving
continuous intravenous opioids, or those on supplemental oxygen).
Patients experiencing opioid substance abuse are referred to opioid treatment
programs - Answer-When clinicians encounter patients who are addicted to opioids,
the patients should be referred for treatment. The U.S. Substance Abuse and Mental
Health Services Administration provides a directory of opioid treatment programs.
The hospital facilitates access to the Prescription Drug Monitoring Program
databases - Answer-Prescription Drug Monitoring Programs (PDMP) aggregate
prescribing and dispensing data submitted by pharmacies and health care providers.
They are an effective tool for reducing prescription drug abuse and diversion. Read
more about PDMP in the "Legal/Ethical" chapter of the Open RN Nursing
Pharmacology textbook.
Patient's pain is reassessed and responded to through the evaluation and
documentation of - Answer-Response to pain intervention, Progress toward pain
management goals including the functional ability (for example, the ability to take a
deep breath, turn in bed, and walk with improved pain control), Side effects of
treatment.
Patients and their family members are educated on discharge plans related to pain
management including the following - Answer-Pain management plan of care, Side
effects of pain management treatment, activities of daily living, including the home
environment that might exacerbate pain or reduce the effectiveness of the pain
,management plan of care, as well as strategies to address these issues, Safe use,
storage, and disposal of opioids when prescribed
OLDCARTES pain assessment - Answer-onset, location, duration, characteristics,
aggravating, radiation, treatment, effect, severity
COLDSPA pain assessment - Answer-characteristics, onset, location, duration,
severity, pattern, associated factors
Wong-baker FACES scale - Answer-a visual tool for assessing pain with children
and other who cannot quantify the severity of their pain on a scale of 0 to 10
FLACC scale - Answer-a measurement used to assess pain for children between the
ages of 2 months and 7 years or individuals who are unable to verbally communicate
their pain
FLACC - Answer-Face, legs, activity, cry, consolability
PAINAD - Answer-Pain assessment in advanced dementia
COMFORT Behavioral Scale - Answer-a behavioral-observation tool validated for
use in children of all ages who are receiving mechanical ventilation
Comfort-function goals - Answer-encourages the patient to establish their level of
comfort needed to achieve functional goals based on their current health status
If a patient's pain score exceeds their comfort-function goal - Answer-nurses must
implement an intervention and follow up within 1 hour to ensure that the intervention
was successful.
Analgesics - Answer-Medications used to relieve pain.
Analgesic classifications - Answer-nonopioids, opioids, adjuvants
Adjuvants - Answer-Medication that is not classified as an analgesic but has been
found in clinical practice to have either an independent analgesic effect or additive
analgesic properties when administered with opioids.
Types of adjuvants - Answer-Amitriptyline (antidepressant), Gabapentin
(anticonvulsant)
Acetaminophen - Answer-Tylenol
Acetaminophen - Answer-used to treat mild pain and fever but does not have anti-
inflammatory properties, safe for all ages, can be taken PO, PR, IV, can head to
hepatotoxicity
hepatotoxicity - Answer-severe liver damage
daily limit of Acetaminophen - Answer-4,000 mg/day
,daily limit of acetaminophen in older adults - Answer-3,200 mg/day
daily limit of acetaminophen in chronic alcoholic - Answer-2,000 mg/day
Nonsteroidal anti-inflammatories (NSAIDS) - Answer-provide mild to moderate pain
relief and also reduce fever and inflammation by inhibiting the production of
prostaglandins
How do Nonsteroidal anti-inflammatories (NSAIDS) work - Answer-Inhibits the
production of prostaglandins
Examples of Nonsteroidal anti-inflammatories (NSAIDS) - Answer-ibuprofen,
naproxen, ketorolac
Risks of Nonsteroidal anti-inflammatories (NSAIDS) - Answer-heart attack, heart
failure, and stroke
Side effects of Nonsteroidal anti-inflammatories (NSAIDS) - Answer-dyspepsia,
nausea, vomiting
When should Nonsteroidal anti-inflammatories (NSAIDS) be taken - Answer-with
food
Nonsteroidal anti-inflammatories (NSAIDS) use can lead to - Answer-kidney failure
Result of taking Nonsteroidal anti-inflammatories (NSAIDS) with warfarin or
corticosteroids - Answer-GI bleed
Opioids - Answer-used to treat moderate to severe pain and work by blocking the
release of neurotransmitters involved in the process of pain
Morphine - Answer-a drug that has no ceiling effect, meaning the higher the dose the
higher the level of analgesia
Codeine with acetaminophen - Answer-Tylenol #3
Codeine with acetaminophen route - Answer-PO
Codeine with acetaminophen adult dosage - Answer-30 mg/300 mg
Hydrocodone with acetaminophen - Answer-Lortab, Norco, Vicodin
Hydrocodone with acetaminophen route - Answer-PO
Hydrocodone with acetaminophen adult dosage - Answer-5 mg/300 mg or 325 mg,
10 mg/320 mg or 325 mg, 5mg/500 mg
Oxycodone - Answer-Oxycodone IR & OxyContin (ER), Percocet & Roxicet
, Oxycodone route - Answer-PO
Oxycodone adult dosage - Answer-5 mg - 10 mg, 5 mg/325 mg
Physical dependence - Answer-Withdrawal symptoms that occur when chronic pain
medication is suddenly reduced or stopped because of physiological adaptations that
occur from chronic exposure to the medication.
Misuse - Answer-Taking prescription pain medications in a manner or dose other
than prescribed; taking someone else's prescription, even if for a medical complaint
such as pain; or taking a medication to feel euphoria (i.e., to get high).
What in the 5th vital sign - Answer-pain
What did treatment of the 5th vital sign lead to - Answer-led to an associated rise in
the number of deaths from overdose. Organizations began to urge caution about the
use of opioids for pain, including guidelines published in 2016 by the Centers for
Disease Control (CDC) on prescribing opioids for pain
Substance abuse disorder - Answer-Significant impairment or distress from a pattern
of substance use (i.e., alcohol, drugs, or misuse of prescription medications).
Symptoms of substance abuse - Answer-Use of more of a substance than planned
or using a substance for a longer interval than desired
Symptoms of substance abuse - Answer-Inability to cut down despite desire to do so
Symptoms of substance abuse - Answer-Spending a substantial amount of the day
obtaining, using, or recovering from substance use
Symptoms of substance abuse - Answer-Cravings or intense urge to use a
substance
Symptoms of substance abuse - Answer-Repeated usage causing an inability to
meet important social or professional obligations
Symptoms of substance abuse - Answer-Persistent usage despite user's knowledge
that it is causing frequent problems at work, school, or home
Symptoms of substance abuse - Answer-Giving up or cutting back on important
social, professional, or leisure activities because of use
Symptoms of substance abuse - Answer-Usage in physically hazardous situations,
such as driving, or usage despite it causing physical or mental harm
Symptoms of substance abuse - Answer-Persistent use despite the user's
awareness that the substance is causing, or at least worsening, a physical or mental
problem
