Nokea
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.
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Which of the following information would be included in a pain assessment?
- A. Characteristics of the pain
- B. Level of the pain
- C. Whether the patient has a low pain tolerance
- D. What the patient wants done for the pain
Correct Answer: A,B,D
Rationale: A pain assessment includes the characteristics (A), level (B), and patient's desired interventions (D). Pain tolerance (C) is subjective and not a standard part of the assessment.
Which of the following statements is(are) thought to accurately describe the gate control theory?
- A. Transmission of pain impulses to the central nervous system is controlled by a gate that is opened and closed by sensory stimulus.
- B. Stimulation of the broad nerve fibers by heat, cold, massage, and exercise is thought to open the gate, allowing pain impulses to be transmitted.
- C. Stimulation of the smaller, narrow nerve fibers by injury and damage to the tissues is thought to open the gate, allowing pain impulses to be transmitted.
- D. It is thought that the thalamus can open the gate when stress and anxiety increase and close the gate when stress and anxiety decrease.
Correct Answer: A,C
Rationale: The gate control theory posits that pain transmission is modulated by a 'gate' in the spinal cord. Stimulation of smaller nerve fibers (e.g., by injury) opens the gate, allowing pain signals to pass (C). Sensory stimuli like massage close the gate, blocking pain (A is correct, but B is incorrect as broad nerve fiber stimulation closes, not opens, the gate). The thalamus is not directly involved in gate control (D is incorrect).
Fill in the blank. The medical term for pain medications is
- A. analgesics
- B. antibiotics
- C. antidepressants
- D. anesthetics
Correct Answer: A
Rationale: Analgesics is the medical term for medications specifically used to relieve 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.
Fill in the blank. The second chemical that stimulates the pain receptors in Question 13 is
- A. substance P
- B. histamine
- C. dopamine
- D. norepinephrine
Correct Answer: A
Rationale: Substance P is another chemical released during tissue damage that activates nociceptors, enhancing pain perception.