Nokea
What is a significant common side effect that occurs with opioid administration?
- A. Euphoria
- B. Diuresis
- C. Constipation
- D. Allergic reactions
Correct Answer: C
Rationale: Constipation is one of the most common side effects of opioid administration. Preventive strategies should be implemented to minimize this problem. Sedation is a more common result than euphoria. Urinary retention, not diuresis, may occur with opiates. Rarely, some individuals may have pruritus.
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A child is in the intensive care unit after a motor vehicle collision. The child has numerous fractures and is in pain that is rated 9 or 10 on a 10-point scale. In planning care, the nurse recognizes that the indicated action is which?
- A. Give only an opioid analgesic at this time.
- B. Increase dosage of analgesic until the child is adequately sedated.
- C. Plan a preventive schedule of pain medication around the clock.
- D. Give the child a clock and explain when she or he can have pain medications.
Correct Answer: C
Rationale: For severe postoperative pain, a preventive around the clock (ATC) schedule is necessary to prevent decreased plasma levels of medications. The opioid analgesic will help for the present, but it is not an effective strategy. Increasing the dosage requires an order. The nurse should give the drug on a regular schedule and evaluate the effectiveness. Using a clock is counterproductive because it focuses the childs attention on how long he or she will need to wait for pain relief.
Which is the most consistent and commonly used data for assessment of pain in infants?
- A. Self-report
- B. Behavioral
- C. Physiologic
- D. Parental report
Correct Answer: B
Rationale: Behavioral assessment is useful for measuring pain in young children and preverbal children who do not have the language skills to communicate that they are in pain. Infants are not able to self-report. Physiologic measures are not able to distinguish between physical responses to pain and other forms of stress. Parental report without a structured tool may not accurately reflect the degree of discomfort.
Which is a complication that can occur after abdominal surgery if pain is not managed?
- A. Atelectasis
- B. Hypoglycemia
- C. Decrease in heart rate
- D. Increase in cardiac output
Correct Answer: A
Rationale: Pain associated with surgery in the abdominal region (e.g., appendectomy, cholecystectomy, splenectomy) may result in pulmonary complications. Pain leads to decreased muscle movement in the thorax and abdominal area and leads to decreased tidal volume, vital capacity, functional residual capacity, and alveolar ventilation. The patient is unable to cough and clear secretions, and the risk for complications such as pneumonia and atelectasis is high. Severe postoperative pain also results in sympathetic overactivity, which leads to increases in heart rate, peripheral resistance, blood pressure, and cardiac output. Hypoglycemia, decreases in heart rate, and increases in cardiac output are not complications of poor pain management.
What is an important consideration when using the FACES pain rating scale with children?
- A. Children color the face with the color they choose to best describe their pain.
- B. The scale can be used with most children as young as 3 years.
- C. The scale is not appropriate for use with adolescents.
- D. The FACES scale is useful in pain assessment but is not as accurate as physiologic responses.
Correct Answer: B
Rationale: The FACES scale is validated for use with children ages 3 years and older. Children point to the face that best describes their level of pain. The scale can be used through adulthood. The childs estimate of the pain should be used. The physiologic measures may not reflect more long-term pain.
What describes nonpharmacologic techniques for pain management?
- A. They may reduce pain perception.
- B. They usually take too long to implement.
- C. They make pharmacologic strategies unnecessary.
- D. They trick children into believing they do not have pain.
Correct Answer: A
Rationale: Nonpharmacologic techniques provide coping strategies that may help reduce pain perception, make the pain more tolerable, decrease anxiety, and enhance the effectiveness of analgesics. The nonpharmacologic strategy should be matched with the childs pain severity and be taught to the child before the onset of the painful experience. Tricking children into believing they do not have pain may mitigate the childs experience with mild pain, but the child will still know the discomfort was present.