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    Potter: Fundamentals of Nursing, 9th Edition: Chapter 44: Pain Management Answer Key - Review Questions and Rationales

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    Potter: Fundamentals of Nursing, 9th Edition: Chapter 44: Pain Management Answer Key - Review Questions and Rationales

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    Fundamentals of Nursing

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    Fundamentals of Nursing

    Copyright:

    © All Rights Reserved
    Download as RTF, PDF, TXT or read online from Scribd
    Download as rtf, pdf, or txt
    20 views3 pages

    Potter: Fundamentals of Nursing, 9th Edition: Chapter 44: Pain Management Answer Key - Review Questions and Rationales

    Uploaded by

    Stacey
    Fundamentals of Nursing

    Copyright:

    © All Rights Reserved
    Download as RTF, PDF, TXT or read online from Scribd
    Download as rtf, pdf, or txt
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    Potter: Fundamentals of Nursing, 9th Edition

    Chapter 44: Pain Management

    Answer Key - Review Questions and Rationales

    1. Answer: 2.
    Sedation is a concern because it may indicate that the patient is experiencing opioid-related side
    effects. Advancing sedation may indicate that the patient may progress to respiratory depression.

    2. Answer: 1.
    The nurse needs to call the health care provider about the order because Fentanyl patches are not
    indicated for acute pain. They are indicated for patients with chronic pain who are opioid
    tolerant.

    3. Answer: 3.
    Constipation is a common opioid-related side effect, and patients do not become tolerant to it.

    4. Answer: 2.
    Long-acting or sustained-release opioids are dosed on a scheduled basis, not prn, to provide a
    base of continuous opioid analgesia.

    5. Answer: 3.
    The Food and Drug Administration (FDA) recommends a maximum daily dose of 4 g of
    acetaminophen, and many authorities believe that the maximum daily dose should be lower
    (3000 to 3200 mg/day) in the outpatient setting to reduce the risk of hepatotoxicity.

    6. Answer: 4.
    The common symptoms of opioid withdrawal that are associated with physical dependence may
    develop when an opioid is withdrawn rapidly. Symptoms include shaking chills, abdominal
    cramps, and joint pain.

    7. Answer: 1, 3, 4.
    Non-pharmacological therapies may provide comfort for the patient. It is much too early to
    consider possible addiction. Naloxone is not appropriate at this time because the patient does not
    show signs of over sedation or respiratory depression.

    Copyright © 2017, Elsevier Inc. All Rights Reserved.


    Answer Key - Review Questions and Rationales 2

    8. Answer: 1, 3, 5.
    The safety of PCA is based on the fact that it requires an awake patient to activate the button.
    The safety is compromised when someone else pushes the button for the patient. A limit on the
    number of doses per hour or 4-hour intervals may be set. Opioids (morphine PCA) are intended
    to provide analgesia; drowsiness is an undesirable potential side effect of opioids, and the PCA
    should only be used for analgesia.

    9. Answer: 2.
    The patient can be expected to have acute pain related to the G-tube insertion; in addition, she
    has a history of chronic pain. Her pain should be treated with ATC medication to match the
    timing of her pain.

    10. Answer: 2, 5, 1, 4, 6, 3.

    11. Answer: 1.
    Patient’s self-report of pain. Sleep is not an indicator of pain intensity. Unless a patient is
    stimulated, it is difficult to distinguish sleep from sedation, which may occur as a side effect of
    the opioid. Patients in pain sometimes sleep from exhaustion.

    12. Answer: 1, 2, 5.
    Apply the ice with firm pressure over the skin; then use a slow, steady circular massage. Apply
    ice for 5 minutes or until the patient feels numbness. It is acceptable to apply ice 2 to 5 times a
    day.

    13. Answer: 4.
    TENS units act on both the central and peripheral nervous systems. The peripheral effect occurs
    through activation of the neuroreceptors at or near the source of pain; therefore the electrodes
    should be placed near the site.

    14. Answer: 1, 5.
    Multimodal analgesia involves the use of a combination of drugs with at least two different
    mechanisms of action so pain control can be optimized. The use of acetaminophen, NSAIDs,
    gabapentin, and opioids represents a multimodal analgesic plan because each agent relies on a
    different mechanism of action to reduce pain, with the benefit of reducing the amount of opioid

    Copyright © 2017, Elsevier Inc. All Rights Reserved


    Answer Key - Review Questions and Rationales 3

    that is needed to control pain. This differs from polypharmacy because the combination of drugs
    is intentional and based on understanding of the action of each product on the pain pathway.

    15. Answer: 1.
    A pain assessment is still needed because sleep in a postoperative patient cannot be used as an
    assessment of a patient’s pain level. Sleep may result from sedating effects of medication, but
    analgesia may not be present. It is important to wake and assess the patient to ensure that the
    pain is controlled and the patient is not overly sedated from the medication (a sign of impending
    respiratory depression).

    Copyright © 2017, Elsevier Inc. All Rights Reserved

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