Pain has been defined as "whatever the person experiencing the pain says it is, existing whenever the patient says it does."
This definition is problematic for the nurse when caring for which type of patient?
a. A patient placed on a ventilator
b. A patient with a history of opioid addiction
...
pain has been defined as whatever the person experiencing the pain says it is
existing whenever the patient says it does this definition is pr
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Medical Surgical Nursing Lewis Chapter
8 - Pain
Pain has been defined as "whatever the person experiencing the pain says it is, existing
whenever the patient says it does."
This definition is problematic for the nurse when caring for which type of patient?
a. A patient placed on a ventilator
b. A patient with a history of opioid addiction
c. A patient with decreased cognitive function
d. A patient with pain resulting from severe trauma - answersc. Because the patient's
self-report is the most valid means of pain assessment, patients who have decreased
cognitive function, such as those who are comatose, have dementia, or are mentally
disabled, might not be able to report pain. In these cases, nonverbal information and
behaviors are necessary considerations in pain assessment.
On the first postoperative day following a bowel resection, the patient complains of
abdominal and incisionalpain rated 9 on a scale of 0 to 10. Postoperative orders include
morphine, 4 mg IV q2 hr, for pain and may repeat morphine, 4 mg IV, for breakthrough
pain. The nurse determines that it has been only 2 hours since the last dose of
morphine and wants to wait a little longer. What effect does the nurse's action have on
the patient?
a. Protects the patient from addiction and toxic effects of the drug
b. Prevents hastening or causing a patient's death from respiratory dysfunction
c. Contributes to unnecessary suffering and physical and psychosocial dysfunction
d. Indicates that the nurse understands the adage of "start low and go slow" in
administering analgesics - answersc. Administering the smallest prescribed analgesic
dose when given a choice is not consistent with current pain management guidelines
and leads to undertreatment of pain and inadequate pain control. Without reassessing
the pain within 30 minutes of the IV analgesic the nurse is unsure how well the previous
dose of medication worked for the patient to determine the current dose needed.
Unnecessary suffering, impaired recovery from acute illness, increased morbidity as a
result of respiratory dysfunction, increased heart rate and cardiac workload, and other
physical dysfunction can occur.
List and briefly describe the five dimensions of pain. - answersa. Physiologic—the
anatomic and physical determinants of pain
b. Affective—the emotional response to pain
c. Cognitive—the beliefs, attitudes, and meanings
attributed to pain
d. Behavioral—observable actions that express or control pain
, e. Sociocultural—age and gender, family and caregiver influence, and culture that
influences the pain experience
Once generated, what may block the transmission of an action potential along a
peripheral nerve fiber to the dorsal root of the spinal cord?
a. The transmission may be interrupted by drugs such as local anesthetics.
b. Nothing can stop the action potential along an intact nerve until it reaches the spinal
cord.
c. The action potential must cross several synapses, points at which the impulse may
be blocked by drugs.
d. The nerve fiber produces neurotransmitters that may activate nearby nerve fibers to
transmit pain impulses. - answersa. Although a peripheral nerve is one cell that carries
an impulse directly from the periphery to the dorsal horn of the spinal cord with no
synapses, transmission of the impulse can be interrupted by drugs known as membrane
stabilizers or sodium-channel inhibitors, such as local anesthetics and some antiseizure
drugs. The nerve fiber produces neurotransmitters only at synapses, not during
transmission of the action potential.
A patient comes to the clinic with a complaint of a dull pain in the anterior and posterior
neck. On examination, the nurse notes that the patient has full range of motion (ROM)
of the neck and no throat redness or enlarged head or neck lymph nodes. What will be
the nurse's next appropriate assessment indicated by these findings?
a. Palpation of the liver
b. Auscultation of bowel sounds
c. Inspection of the patient's ears
d. Palpation for the presence of left flank pain - answersa. The right neck and flank are
common areas of referred pain from liver damage and examination of the liver should
be considered when pain occurs without other findings in these areas. Other common
referred areas are midscapular and left arm for cardiac pain, inner legs for bladder pain,
and shoulders for gallbladder pain.
While caring for an unconscious patient, the nurse discovers a stage 2 pressure ulcer
on the patient's heel. During care of the ulcer, what is the nurse's understanding of the
patient's perception of pain?
a. The patient will have a behavioral response if pain is perceived.
b. The area should be treated as a painful lesion, using gentle cleansing and dressing.
c. The area can be thoroughly scrubbed because the patient is not able to perceive
pain.
d. All nociceptive stimuli that are transmitted to the brain result in the perception of pain
- answersb. It is known that the brain is necessary for pain
perception but because it is not clearly understood where in the brain pain is perceived,
pain may be perceived even in a comatose patient who may not respond behaviorally to
noxious stimuli. Any noxious stimulus should be treated as potentially painful.
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