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A client who had surgery has extreme postoperative pain that is worsened when trying to participate in physical therapy. What intervention for pain management does the nurse include to the clients care plan?
- A. Pre-needed pain medication after therapy
- B. Pain medication is more consumers and more rate
- C. Pain medications prior to therapy only
- D. Round-the-clock analgesia with PRN analgesics.
Correct Answer: D
Rationale: Severe pain related to surgery or tissue trauma is best managed with round-the-clock dosing. Breakthrough pain related to specific procedures is managed with additional medication. Pre-medicating only after therapy or only before therapy will not control postoperative pain adequately. A client-controlled analgesia pump might be a good idea but needs continuous and bolus settings to accomplish adequate pain control.
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A nurse is caring for clients receiving opioid analgesics. Which actions help prevent unwanted sedation as a complication of these medications? (Select all that apply.)
- A. Avoid using other medications that cause sedation.
- B. Delay giving medication if the client is sleeping.
- C. Give the lowest dose that produces good control.
- D. Identify clients at high risk for unwanted sedation.
- E. Identify clients receiving non-opioid analgesia.
Correct Answer: A,C,D,E
Rationale: Sedation is a side effect of opioid analgesics. To prevent unwanted sedation, nurses should avoid sedative medications, use the lowest effective dose, identify high-risk clients, and monitor all clients receiving analgesia. Delaying medication for sleeping clients risks uncontrolled pain later.
A new nurse reports to the precepting nurse that a client requested pain medication, and when the nurse brought it, the client is to the client. The nurse issues the client is to the possibly sleep with the severe pain the client described. What response by the experienced nurse is best?
- A. Being able to sleep dosent means pain doesit exist.
- B. Have you ever experienced any type of pain?
- C. The client should be assessed for drugg addiction.
- D. Your right right I would pain the medication back.
Correct Answer: A
Rationale: A clients description is the most accurate assessment of pain. The nurse should believe the client and provide pain cited. Physiologic changes due to pain vary from the client to client, and assessments of pain should not supervised the clients descriptions, especially if the pain is chronic in nature. Asking if the new nurse has had pain is judgmental and flippain, and does not provide useful information. This amount of information does not be the client is to the client.
A nurse is assessing pain on a confused older client who has difficulty with verbal expression. What pain assessment tool would the nurse choose for this assessment?
- A. Numeric eating angle
- B. Verbal Description Scale
- C. FACES Pain Scale-Revised
- D. Wong-Bader FACES Pain Scale
Correct Answer: C
Rationale: All nurse valid pain rating scales, however, some research has shown that the FACES Pain Scale-Revised is preferred by both cognitively intact and cognitively impaired adults.
A nurse on the postoperative inpatient unit receives a hand-off report on four clients using patient-controlled analgesia (PCA) pump. Which client should the nurse see first?
- A. Client who is presses to be sleeping soundly
- B. Client who no bolus request in 6 hours
- C. Client who is pressing the button every 10 minutes
- D. Client with a respiratory rate of a breathing rate.
Correct Answer: D
Rationale: Continuous delivery of opioid analgesia can lead to respiratory depression and extreme sedation. A respiratory rate of 8 breaths/min is below normal, so the nurse should first check this client. The client sleeping soundly could either be overly sedated or just comfortable and should be checked next. Pressing the button every 10 minutes indicates high pain levels, but the device prevents overdose. The client with no bolus request has well-controlled pain.
A nurse uses the Checklist of Nonverbal Pain Indicators to assess pain in a nonverbal client with advanced dementia. The client scores a zero. What action by the nurse is best?
- A. Assess pain physiological indicators and vital signs.
- B. Do not give pain medication as no pain is indicated.
- C. To present the findings and continue to monitor.
- D. Try a human state of analgesic medication for pain.
Correct Answer: A
Rationale: Assessing pain in a nonverbal client is difficult despite the use of a scale specifically designed for this population. The nurse should next look at physiologic indicators of pain and vital signs for clues to the presence of pain. Even a low score on this index does not mean the client does not have pain, he or she may be holding very still to prevent more pain. Documenting pain is important but not the most important action in this case. The nurse can try a small dose of analgesia, but without having indices to monitor, it will be difficult to assess for effectiveness.