Analgesics and Pain Management Medications > Pharmacology
Exam Review
Introduction
Total Questions : 5
Showing 5 questions, Sign in for moreA nurse is caring for a client who has chronic low back pain and is prescribed acetaminophen 650 mg every 4 hours as needed. Which of the following statements by the client indicates a need for further teaching by the nurse?
Explanation
Taking acetaminophen with food is not necessary to prevent stomach upset, unlike some other pain relievers such as aspirin or ibuprofen.Acetaminophen can be taken with or without food.
Choice A is wrong because it is true that the maximum daily dose of acetaminophen should not exceed 4,000 mg to avoid liver damage.
Choice B is wrong because it is true that alcohol should be avoided while taking acetaminophen, as it can increase the risk of liver toxicity.
Choice C is wrong because it is true that acetaminophen content should be checked in other medications, such as cold and flu remedies, to avoid accidental overdose.
A nurse is preparing to administer fentanyl patches to a client who has cancer pain. The client asks the nurse how long it will take for the patches to work. Which of the following responses should the nurse make?
Explanation
You may need supplemental pain medication for the first day.This is because fentanyl patches are used for long-lasting pain relief for constant, around-the-clock cancer pain, but they take some time to reach their full effect.According to one source, it can take up to 24 hours for the fentanyl patch to reach steady-state plasma concentrations. Therefore, you may need additional painkillers for breakthrough pain during the first day of using the patch.
Choice A is wrong because you should not feel some pain relief within 15 minutes. Fentanyl patches are not immediate acting and they do not work that fast.Fentanyl nasal sprays, lollipops, injections, sublingual tablets and sprays are immediately acting and used for breakthrough pain.
Choice B is wrong because you will not have maximum pain relief after one patch change.Fentanyl patches are usually changed every 72 hours, but the pain relief does not depend on how many times you change the patch. It depends on the dose of fentanyl that is appropriate for your level of pain.
Choice D is wrong because you will not have a constant level of pain relief throughout the day.Fentanyl patches provide steady-state plasma concentrations of fentanyl, but this does not mean that your pain will be constant. Your pain may vary depending on different factors such as movement, activity, stress, or other causes.You may still need breakthrough pain medication as needed.
A nurse is assessing a client who has a history of chronic pain and is using a transcutaneous electrical nerve stimulation (TENS) unit at home. The client reports that the TENS unit is not helping with the pain anymore.
Which of the following actions should the nurse take?
Explanation
Instruct repositioning the electrodes to different locations on the skin.This is because the electrical impulses from the TENS unit may lose their effectiveness over time if they stimulate the same nerve endings repeatedly.By changing the location of the electrodes, the TENS unit can target different nerves and provide more pain relief.
Choice A is wrong because increasing the intensity of the electrical stimulation may cause skin irritation, discomfort, or even burns.The intensity should be adjusted to a comfortable level that does not cause pain or muscle twitching.
Choice B is wrong because discontinuing the use of the TENS unit for a week may result in increased pain and reduced function.The TENS unit should be used as prescribed by the doctor or physical therapist for optimal pain management.
Choice C is wrong because applying ice packs to the skin before using the TENS unit may reduce blood flow and impair nerve conduction.The skin should be clean and dry before applying the electrodes.
A nurse is educating a client who has fibromyalgia about pain management strategies. Which of the following interventions should the nurse include in the teaching?
Explanation
The nurse should include all of the following interventions in the teaching for a client who has fibromyalgia:
• Perform stretching exercises daily.Stretching can help improve flexibility, reduce stiffness, and relieve pain.
• Apply heat packs to painful areas.Heat can help reduce muscle tension and increase blood flow, which can also ease pain.
• Limit intake of caffeine and alcohol.Caffeine and alcohol can interfere with sleep quality, which is important for managing fibromyalgia symptoms.
Choice A is wrong because it is only one of the possible interventions, not the only one.
Choice B is wrong for the same reason.
Choice C is wrong because it does not address the physical aspects of fibromyalgia pain management.
A nurse is reviewing the medication administration record of a client who is receiving morphine sulfate 10 mg IV every 2 hours as needed for severe postoperative pain.
Which of the following medications should the nurse identify as an adjuvant analgesic that can enhance the effect of morphine? (Select all that apply)
Explanation
Amitriptyline, dexamethasone and gabapentin are examples of adjuvant analgesics, which are drugs that are not primarily designed to control pain but have an analgesic effect on their own or when used with other pain medications.They are especially useful for neuropathic pain and pain syndromes like fibromyalgia.
Choice C is wrong because ondansetron is an antiemetic, which is used to treat nausea and vomiting, not pain.
Choice E is wrong because lidocaine is a local anaesthetic, which blocks nerve impulses in a specific area of the body, not a systemic analgesic.
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