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You have medicated a female patient for severe pain and are waiting for the medication to take effect. In an effort to relieve her discomfort, you decide to try an additional nonpharmacological intervention. After explaining what you are about to do, you begin to verbally direct the patient to focus her conscious mind on the sequential tightening and relaxing of her muscles, beginning at her head and working toward her feet. What is the medical term for this intervention? How does it work?
- A. Progressive muscle relaxation; it reduces muscle tension and promotes relaxation, which can decrease pain perception.
- B. Guided imagery; it distracts the mind from pain by focusing on calming images.
- C. Effleurage; it involves gentle stroking to soothe the skin and reduce pain.
- D. Biofeedback; it uses monitoring to control physiological responses.
Correct Answer: A
Rationale: Progressive muscle relaxation involves sequentially tensing and relaxing muscles to reduce tension and pain perception by promoting physical and mental relaxation.
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An individual's thoughts and emotions are also believed to affect the opening and closing of the gate by stimulating production of
- A. Prostaglandins
- B. Endorphins
- C. Substance P
- D. Opioids
Correct Answer: B
Rationale: Endorphins, produced in response to positive thoughts and emotions, can close the pain gate, reducing pain perception, per the gate control theory.
Fill in the blank. That rest that allows an individual to awaken feeling rested, refreshed, rejuvenated, energized, and ready to meet new challenges is
- A. restorative sleep
- B. non-REM sleep
- C. REM sleep
- D. light sleep
Correct Answer: A
Rationale: Restorative sleep is the type of rest that leaves an individual feeling refreshed, rejuvenated, and energized upon waking.
Fill in the blank. The pain receptors referred to in Question 13 can be stimulated by two chemicals that are released during injury and damage to tissue. One of those chemicals is
- A. prostaglandins
- B. endorphins
- C. opioids
- D. serotonin
Correct Answer: A
Rationale: Prostaglandins are chemicals released during tissue injury that stimulate nociceptors, contributing to pain sensation.
Your patient seems to be having a lot more postoperative pain today than he did yesterday, whichsurprises you because he has been progressing so well since his surgery 4 days ago. As you are critically thinking about factors that can increase pain, you identify data that could explain why he is having an increase in pain today. Which of the following pieces of data might provide you with this understanding?
- A. His wife, who is a strong part of his support system, was here to visit this morning for several hours.
- B. In the report, the night nurse noted that he slept only a couple of hours last night.
- C. His medical chart indicates that he is from a culture in which some with traditional views feel that pain should be suffered in silence.
- D. Earlier this morning, the patient's wife mentioned that the patient is really missing their oldest daughter, who was unable to come for the surgery because she lives in Europe.
Correct Answer: B,D
Rationale: Lack of sleep (B) can lower pain tolerance, increasing perceived pain. Emotional distress, such as missing a loved one (D), can also heighten pain perception. A supportive visit (A) and cultural beliefs (C) are less likely to directly cause an increase in pain.
Fill in the blank. Classes of medication that either produce pain relief from a mechanism different from traditional analgesics or by potentiating or increasing the effects of opiates, opioids, and nonopioid drugs are known as
- A. adjuvant drugs
- B. antipyretics
- C. anti-inflammatories
- D. antihistamines
Correct Answer: A
Rationale: Adjuvant drugs enhance pain relief by mechanisms different from traditional analgesics or by potentiating the effects of opiates, opioids, and nonopioids.