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A postoperative patient asks the nurse about pain management following surgery. What teaching will the nurse provide?
- A. Avoid asking for pain medication often, as it can be addictive.
- B. It is better to wait until the pain is severe before asking for pain medication.
- C. It's natural to have pain after surgery; it will lessen in intensity in a few days.
- D. You will be more comfortable if you take the medication at regular intervals.
Correct Answer: D
Rationale: Patients should take pain medication at regular intervals to prevent severe pain (D). Waiting until pain is severe (B) makes it harder to control, and addiction is rare with short-term use (A). Pain should be managed, not accepted as natural (C).
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A nurse is caring for patients who are nonverbal. What are examples of behavioral responses to pain? Select all that apply.
- A. Cradling a wrist that was injured in a car accident
- B. Moaning and crying from abdominal pain
- C. Increasing pulse following a myocardial infarction
- D. Striking out at a nurse who attempts to provide a bath
- E. Acting depressed and withdrawn while experiencing chronic cancer pain
- F. Pulling away from a nurse trying to give an injection
Correct Answer: A,B,D,F
Rationale: Behavioral responses include cradling an injured area (A), moaning and crying (B), striking out (D), and pulling away (F). Increased pulse (C) is a physiologic response, and depression/withdrawal (E) is an affective response.
Based on the objective and subjective assessment of this patient, where should the nurse focus the initial efforts of the interprofessional team?
- A. Collaborating with the endocrinologist to manage the patient's blood glucose and A1c
- B. Consulting psychiatry to set up a medication regimen to treat the patient's anxiety and depression
- C. Working with the provider, the patient, and the patient's wife to address functional pain goals
- D. Providing detailed information on the microvascular and macrovascular complications of type 2 diabetes
Correct Answer: C
Rationale: The priority is addressing Carla's functional pain goals (C) to improve her quality of life, as her pain impacts her daily functioning and stress affects her diabetes management. While glucose control (A) and psychiatric consultation (B) are relevant, pain management is the immediate focus. Education on complications (D) is secondary to addressing current pain.
A nurse on an adult surgical floor enters a patient room and observes a family member pressing the button to administer a dose of PCA via the infusion pump. What response by the nurse is most appropriate?
- A. That dose will sure be helpful after their type of surgery.
- B. Having only the patient use the pump prevents respiratory complications.
- C. If the patient asked you to press the button, then it's OK.
- D. Since the pump has built in safeguards, you can help with pain management.
Correct Answer: B
Rationale: PCA by proxy (family administering doses) risks overdose, oversedation, and respiratory depression (B). Only the patient should press the PCA button, regardless of safeguards (D) or patient requests (C), and option A ignores the safety issue.
How will the nurse and Carla know that the treatment plan has been effective?
- A. Carla is completely pain free but is taking large doses of OTC acetaminophen.
- B. Carla reports some pain but states she was able to engage in the full walking tour with occasional rest periods.
- C. Carla admits that she is not taking the medication because she has just learned to live with the pain.
- D. Carla tried a few nonpharmacologic recommendations but has opted to simply double the prescribed dose.
Correct Answer: B
Rationale: The treatment plan is effective if Carla achieves her functional goal of completing a walking tour with minimal pain and occasional rest (B), aligning with her stated goals of 1/10 pain at rest and 3/10 with activity. Complete pain relief with high acetaminophen doses (A) risks toxicity, ignoring medications (C) indicates nonadherence, and doubling doses (D) is unsafe.
During postconference, nursing students are exploring definitions of pain and its nature. Which statements should be included in this discussion? Select all that apply.
- A. It is whatever the health care provider treating the pain says it is.
- B. Pain exists whenever the person experiencing it says it is present.
- C. It is an emotional and sensory reaction to tissue damage.
- D. Pain is a simple, universal, and easy-to-describe phenomenon.
- E. When a cause cannot be identified, pain is psychological in nature.
- F. It is classified by duration, location, source, transmission, and etiology.
Correct Answer: B,C,F
Rationale: Pain is defined as whatever the patient says it is (B), an emotional and sensory reaction to tissue damage (C), and classified by duration, location, source, transmission, and etiology (F). It is not defined by the provider (A), nor is it simple or universal (D). Pain without an identifiable cause is not necessarily psychological (E).