Exam #6 Review Nur1410

Front 1

What type of pain is characterized by rapid onset?

Back 1

Acute

Front 2

What type of pain is characterized by varying in intensity?

Back 2

acute

Front 3

What type of pain serves as a warning?

Back 3

acute

Front 4

What type of pain disappears after resolution?

Back 4

acute

Front 5

What type of pain increases your pulse?

Back 5

acute

Front 6

What type of pain increases your blood pressure?

Back 6

acute

Front 7

What type of pain increases your respiratory rate?

Back 7

acute

Front 8

What type of pain dilates your pupils?

Back 8

acute

Front 9

What type of pain results in diaphoresis?

Back 9

acute

Front 10

What type of pain is limited?

Back 10

chronic

Front 11

What type of pain is described as intermittent or persistent?

Back 11

chronic

Front 12

What type of pain is characterized by lasting beyond the normal healing period?

Back 12

chronic

Front 13

What type of pain has remissions or exacerbations?

Back 13

chronic

Front 14

What type of pain doesn't necessarily change a person's vital signs?

Back 14

chronic

Front 15

What type of pain doesn't necessarily change a person's pupils?

Back 15

chronic

Front 16

What type of pain doesn't cause a change in a person's skin?

Back 16

chronic

Front 17

What type of pain is characterized by coming from nerve stimulus?

Back 17

Nociceptive Pain

Front 18

What are the types of nociceptive pain?

Back 18

Visceral pain and Somatic Pain (somatic is further divided into superficial and deep)

Front 19

What are the types of somatic pain?

Back 19

superficial and deep

Front 20

Superficial pain is located where?

Back 20

Skin, mucuous membranes

Front 21

Deep pain originates where?

Back 21

in the joints, tendons, ligaments, bones, vessels and nerves

Front 22

True or false: deep pain is diffused.

Back 22

True

Front 23

True or false: deep pain is characterized as being poorly localized.

Back 23

false. Visceral pain is the one that is characterized as being poorly localized.

Front 24

True or false: visceral pain is poorly localized.

Back 24

true

Front 25

Visceral pain originates where?

Back 25

in body organs

Front 26

What happens to a person's organs when they are under visceral pain?

Back 26

visceral pain originates in body organs and they become distended, ischemic or inflamed

Front 27

What type of pain is caused by nerve damage?

Back 27

Neuropathic

Front 28

What type of pain is characterized by CNS damage?

Back 28

Neuropathic

Front 29

Describe what neuropathic pain feels like.

Back 29

numb, tingling, burning, shooting, electrical, stabbing, etc

Front 30

What are the common causes of neuropathic pain?

Back 30

trauma, inflammation, metabolic disease, alcoholism, infections of nerves, tumors, toxins, neurologic diseases.

Front 31

What is referred pain?

Back 31

pain felt in a distant area from its origin

Front 32

What is intractable pain?

Back 32

Pain that persists regardless of treatment

Front 33

What is phantom pain?

Back 33

nerve stimulation after limb amputation

Front 34

What are the steps involved in the pain process?

Back 34

transduction, transmission, perception, modulation

Front 35

What is another term for transduction?

Back 35

activation

Front 36

What is another term for transmission?

Back 36

conduction

Front 37

What is another term for perception?

Back 37

interpretation

Front 38

What is another term for modulation?

Back 38

conversion

Front 39

The Gate Control Theory of Pain is associated with which step of the pain process?

Back 39

transmission, which is the same thing as conduction

Front 40

Describe the Gate Control Theory of Pain

Back 40

NEED TO LOOK THIS UP!!!!

Front 41

What is psychogenic pain?

Back 41

pain with an unidentified physical cause

Front 42

True or false: when in pain, it is a normal human reaction to move toward the stimulus.

Back 42

false! It is a normal human reaction to move away from the stimulus.

Front 43

What happens to your BP when in pain?

Back 43

it increases

Front 44

True or false: your heart rate decreases when in pain.

Back 44

false. Your heart rate increases.

Front 45

True or false: your respiratory rate decreases when in pain.

Back 45

false. Your respiratory rate increases when in pain.

Front 46

True or false: your pupils dilate when in pain.

Back 46

true

Front 47

True or false: your muscles relax when in pain.

Back 47

false. Your muscles tense up.

Front 48

True or false: your skin becomes pallor when in pain.

Back 48

true

Front 49

What are some signs that a non-verbal patient is in pain?

Back 49

grimacing, moaning, crying, restlessness

Front 50

True or false: a person may become withdrawn when in pain.

Back 50

true

Front 51

True or false: a person may become more stoic when in pain.

Back 51

true

Front 52

True or false: patient's in pain often feel fear, powerlessness and hopelessness.

Back 52

true

Front 53

True or false: ethnic/cultural values impact a person's perception of pain.

Back 53

true

Front 54

True or false: it does not matter what developmental stage a person is in when relating to pain.

Back 54

false; developmental stage does affect a person's perception of pain

Front 55

True or false: a person's environment and their surrounding support people influences their perception of pain.

Back 55

true

Front 56

True or false: a person's past pain experiences impacts their perception of pain

Back 56

true

Front 57

True or false: pain means the same thing for everyone.

Back 57

False: each person has their own meaning of what pain is.

Front 58

True or false: a person's anxiety/stress level does not impact their pain perception.

Back 58

False; a person's anxiety/stress level does impact their perception of pain

Front 59

True or false: all people have the same coping abilities.

Back 59

False. Each person has their own ability to cope and it does impact their pain perception.

Front 60

True or false: pain is a vital sign.

Back 60

True

Front 61

True or false: visual analogues are used when assessing a patient's pain.

Back 61

True

Front 62

Relate the acronym COLAID to pain assessment.

Back 62

C- characeristics
O- onset
L- location
A-aggregating and alleviating aspects
I-intensity
D- duration

Front 63

Relate the acronym DLCSM to pain assessment

Back 63

D- duration
L- location
C- characteristics
S - surgical
M - medical

Front 64

True or false: a person's description/verbalization of their pain is considered accurate.

Back 64

True!

Front 65

As a nurse you would assess a patient's pain and it's impact on what?

Back 65

A person's quality of life and their ability to complete ADLS.

Front 66

What are the NANDAs associated with Pain?

Back 66

ACIRF : A = Anxiety r/t pain anticipation and inadequate pain management. C = constipation related to chronic use of narcotic analgesics. I = ineffective coping related to failure of chronic pain management. R = risk for injury related to decreased pain sensation. F = fatigue related to lack of pain relief.

Front 67

True or false: it is important to be realistic of a patient's pain goals.

Back 67

True

Front 68

True or False: As a nurse, your goal is always to eliminate pain.

Back 68

False. You want to eliminate pain if it is possible, but in certain situations all you can do is lessen pain.

Front 69

True or false: As a nurse, you want to address the physiological, psychological, spiritual, social and economic needs related to pain.

Back 69

True

Front 70

True or false: as a nurse, pain management is your independent responsibility.

Back 70

False. pain management is a collaborative effort, and you should collaborate with multi-healthcare team members.

Front 71

What are the NOC indicators relating to pain?

Back 71

Comfort Level, Pain Control, Pain Level, Pain: Disruptive Effects

Front 72

True or false: A good therapeutic relationship is a barrier to pain management.

Back 72

False. A lack of a therapeutic relationship is a barrier to pain management.

Front 73

True or false: varying pain tolerance is a barrier to pain management.

Back 73

true

Front 74

True or false: fatigue is a barrier to pain management.

Back 74

true

Front 75

True or false: lack of knowledge is a barrier to pain management.

Back 75

true

Front 76

True or false: fear of addiction is a barrier to pain management.

Back 76

true

Front 77

True or false: Many patient's are in pain but will not verbalize it out of a desire to be "strong or good."

Back 77

true

Front 78

True or false: patient's having a desire to be "strong or good" is a barrier to pain management.

Back 78

true

Front 79

True or false: accompanying disease process is a barrier to pain management.

Back 79

true

Front 80

True or false: tolerance is a barrier to pain management.

Back 80

true

Front 81

True or false: Dependence is a barrier to pain management

Back 81

true

Front 82

True or false: withdrawal is a barrier to pain management

Back 82

true

Front 83

True or false: addiction is a barrier to pain management

Back 83

true

Front 84

True or false: nonpharmacological interventions to pain are useless

Back 84

false

Front 85

What are some examples of nonpharmacological therapies?

Back 85

distraction, positioning, humor, music, imagery, meditation, yoga, relxation, prayer, cutaneous stimluation, acupuncture, hypnosis, biofeedback, therapeutic touch, chiropractic medicine, dietary supplements/herbs, magnetic therapy

Front 86

True or false: magic therapy is a nonpharmacological therapy.

Back 86

FALSE, there is no such thing as magic therapy

Front 87

True or false: magnetic therapy is a nonpharmacological therapy.

Back 87

true

Front 88

What is involved with analgesic administration?

Back 88

the administration of nonopioids, opioids and adjuvant drugs as well as side effect management and management of the physical dependence, tolerance and addiction of drugs.

Front 89

What is involved with analgesic administration in terms of nursing responsibilites AFTER the drug has been administered?

Back 89

side effect management and management of the physical dependence, tolerance and addiction of drugs

Front 90

Describe step one of the WHO analgesic pain relief ladder.

Back 90

Step one involves mild to moderate pain and involves the use of non-opiods and NSAIDS

Front 91

mild to moderate pain involves the use of what drugs?

Back 91

non-opiods and non-steroidal anti-inflammatory drugs

Front 92

Describe step two of the WHO analgesic pain relief ladder

Back 92

involves moderate to severe pain and mil-opioids with or without non-opioids

Front 93

Describe step three of the WHO analgesic pain relief aldder

Back 93

involves sever pain and strong opioids with or without non- opioids

Front 94

Morphine is classified as a ______ opioid.

Back 94

strong

Front 95

Codeine is classified as a _______ opioid

Back 95

mild

Front 96

true or false: many nonopioid analgesics are OTC.

Back 96

true

Front 97

What are the sie effects of nonopioid analgesics?

Back 97

gastric irriation and GI bleeds

Front 98

cox-2 inhibitors are an example of what?

Back 98

non-opioid analgesics

Front 99

What do cox-2 inhibitors lower?

Back 99

cox-2 inhibitors lower the risk of a GI bleed

Front 100

What do cox-2 inhibitors increase?

Back 100

cox-2 inhibitors increase the risk of cardiovascular incidence

Front 101

True or false: opioids are useful for cardiovascular pain only.

Back 101

false. opioids are useful for many types of pain

Front 102

Opioids act on _____ receptors.

Back 102

opioids act on brain receptors.

Front 103

True or false: opioids are available in a specific dosage only.

Back 103

False. opioids are available in multiple dosage forms.

Front 104

True or false: opioids have a predictable action.

Back 104

true

Front 105

True or false: opioids are very expensive.

Back 105

false. opioids are inexpensive.

Front 106

What are the most common side effects of opioids?

Back 106

SEDATION, CONSTIPATION, nausea/vomiting, pruritis and urinary retention

Front 107

True or false: diarrhea is a common side effect of opioids.

Back 107

false. constipation is a common side effect of opioids.

Front 108

True or false: non-opioids have a ceiling or a saturation point of dosage to effectivness.

Back 108

true

Front 109

True or false: opioids have a ceiling or a saturation point of dosage to effectiveness.

Back 109

false. opioids do not have a ceiling.

Front 110

What are the myths surrounding opioids?

Back 110

LOOK THIS UP.

Front 111

What do adjuvant drugs do?

Back 111

they can enhance or reduce the side effects of opioids and lessen the anxiety of pain experiences

Front 112

What are the commonly used adjuvant drugs?

Back 112

corticosteroids, anti-convulsants, anti-depresants

Front 113

Administering a pain medication with an anti-emetic drug is an example of the use of what?

Back 113

An adjuvant drug (the anti-emetic)

Front 114

Administering a pain medication with a sleep aid is an example of the use of what?

Back 114

An adjuvant drug (the sleep aid)

Front 115

Administering a pain medication with zanax is an example of the use of what?

Back 115

An adjuvant drug (the zanax)

Front 116

When a patient is doing well and all of a sudden there is an episode of pain, it is known as what?

Back 116

Breakthrough pain

Front 117

True or false: breakthrough pain typically occurs at the beginning of a medication dose

Back 117

false. breakthrough pain typcically occurs at the end of a dose.

Front 118

True or false: breakthrough pain is typically incidental.

Back 118

true

Front 119

What medications are used to help a patient with breakthrough pain?

Back 119

supplemental opioids

Front 120

True or false: breakthrough pain is managed on a PRN basis.

Back 120

true

Front 121

If a patient is frequently using PRN medications to manage pain, what should you do?

Back 121

Recalculate the around the clock medication dosage and call the physician if necessary

Front 122

When you treat breakthrough pain with a supplemental opioid, that is often called a _____ dose.

Back 122

rescue

Front 123

For children, you would give medications around the clock or how?

Back 123

with continuous IV

Front 124

For children, you would give medications with continuous IV or how?

Back 124

around he clock

Front 125

What is the drug of choice with children?

Back 125

opioids

Front 126

True or false: With children, you would pre-medicate for pain.

Back 126

true

Front 127

Why would you pre-medicate for pain with children?

Back 127

to remove fear of the experiences

Front 128

True or false: good assessment and good communication are crucial when dealing with children.

Back 128

true

Front 129

When dealing with children it is very important to know your ______ when dealing with pain medications.

Back 129

dosages

Front 130

With older adults, what medications do you want to avoid?

Back 130

demeral, darvon, tawin and indocin.

Front 131

With older adults, you want to avoid what type of injections?

Back 131

im

Front 132

true or false: with older adults, their pain medications are PRN only.

Back 132

false. you want to avoid PRN only pain medications and medicate around the clock.

Front 133

Are opioids safe to use with older adults?

Back 133

yes, it is safe to use opioids with older adults as long as you use precautions.

Front 134

What is a PCA?

Back 134

patient-controlled analgesia that is effective, consistent and an individualized system of self-medicating via portable drug delivery system

Front 135

What routes are options with PCA's?

Back 135

intravenous or epidural

Front 136

What are some common medications given to patients with PCA's?

Back 136

morphine, fentanyl and hydromorphone

Front 137

With PCA's, patients can be given them continuous and ______.

Back 137

bolus

Front 138

With PCA's, patients can be given them bolus and ________.

Back 138

continuous

Front 139

True or false: patient satisfaction is low with PCA's.

Back 139

false. patient satisfaction is high.

Front 140

True or false: demeral is often given via PCA's.

Back 140

False, you want to avoid giving demeral via a PCA's.

Front 141

True or false: PCA's have lock-out intervals.

Back 141

true

Front 142

True or false: lock-out intervals with PCA's are a disadvatage to using PCA's for the patient.

Back 142

true

Front 143

True or false: cogntively impaired patients can be given PCA's.

Back 143

false. The patient must be alert and awake.

Front 144

True or false: intense patient teaching is required with PCA.

Back 144

true

Front 145

True or false: documentation is not required with a PCA because the patient is in control of the situation.

Back 145

false. Documentation is still required with a PCA.

Front 146

What is described:

" Direct opioid delivery through the spinal inserted cathether."

Back 146

epidural analgesia

Front 147

What is an epidural analgesia?

Back 147

Direct opioid delivery through the spinal inserted cathether.

Front 148

True or false: epidural analgesia's are given with sedation.

Back 148

false. an advantage of epidural analgesia's is that they are an effective pain control method without sedation

Front 149

True or false: It is important for nurses to monitor cathether placement when dealing with epidural analgesias.

Back 149

true

Front 150

True or false: infection is not at high risk for epidural analgesias.

Back 150

False. it is important that the nurse monitor for infections

Front 151

True or false: a nurse should monitor for numbness/tingling when dealing with patient's who have epidural analgesias.

Back 151

true

Front 152

Analgesic administration is _______ with epidural analgesias.

Hint: think location

Back 152

intraspinal

Front 153

True or false: medication management is a nursing responsibility with epidural analgesias and PCA's.

Back 153

true

Front 154

True or false: pain management is a nursing responsibility with epidural analgesias and PCA's.

Back 154

True

Front 155

True or false: with PCA's, assistance is needed by the nurse.

Back 155

true

Front 156

True or false: massage is a nursing intervention for PCA's and epidural analgesic patients.

Back 156

false, massage is not listed.

Front 157

True or false: acupuncture is a nursing intervention for PCA and epidural analgesic patients.

Back 157

true

Front 158

True or false: head/cold application is a nursing intervention for PCA and epidural analgesic patients.

Back 158

true

Front 159

True or false: Relaxation therapy is a nursing intervention for PCA and epidural analgesic patients.

Back 159

true

Front 160

True or false: dying care is a nursing intervention for PCA and epidural analgesic patients.

Back 160

true

Front 161

Using Placebos is a standard practce of nursing care.

Back 161

FALSE. Using placebos raises serious ethical questions and can ruin a nurse's therapeutic relationship with a patient.

Front 162

What is a placebo?

Back 162

An inactive substance that may give satisfaction

Front 163

What is the ABCDE for Pain management and Assessment?

Back 163

- Ask about pain regularly
- Assess pain systematically
- Believe the patient and family in their report of pain and what relieves it
- Choose pain control options appropriate for the patient, family and setting
- Deliver intervention in timely, logical and coordinated fashion
- Empower patients and their family
- Enable them to control their course to the greatest extent possible.