CHPN CHAPTER 4&5 QUESTIONS AND ANSWERS
With cancer, what is the prevalence of pain?1/3 of patients with cancer experience pain
at the time of diagnosis, well 2/3 with metastatic disease report pain. - Answers -With
cancer, what is the prevalence of pain?
Impaired quality of life, and in some cases, increased risk of hastened Death. - Answers
-Higher pain intensity and pain interference are associated with what?
Lack of basic education, assessment of pain using only simple screening tools such as
0 to 10 scale is insufficient, fears regarding addiction, tolerance, adverse effects related
to pain medications particularly opioids. - Answers -What are the barriers related to pain
assessment and treatment?
Stoicism, concerned about distracting healthcare providers from treatment, believe the
pain is an expected outcome of the disease, or pain may admit that the disease is
getting worse. Patients and family members may also for your addiction and tolerance
along with adverse effects. Other reasons it might include not wanting to complain, pain
is expected with aging, bearing the pain is better than bearing side effects from pain
medication, Strong pain medication should only be used for severe pain and lastly
morphine and other opioids Hasten death. - Answers -Why might a patient or family
member not report pain?
Pain is whatever the patient says it is. Never assume that someone should demonstrate
outward signs of pain. - Answers -What is the most important thing for a nurse to
remember about how the patient reports pain?
Misuse - Answers -Use of a medication other than as directed or as indicated.
Examples include use of pain medication for sleep rather than pain control.
Addiction - Answers -A primary, chronic, neurobiological disease with genetic,
psychosocial, and environmental factors influencing its development and
manifestations. Characterized by behavior that include one or more of the following
impaired control over drug use, impulsive use, and continued use despite harm and
craving.
Tolerance - Answers -A state of adaption in which exposure to a drug induces changes
that result in a diminution of one or more of the drugs affect overtime.
Physical dependence - Answers -A state of adaptation that is manifested by drug class
specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose
reduction, decreasing blood level of the drug.
, Anxiety, irritability, lacrimination, rhinorrhea, sweating, nausea, vomiting, diarrhea,
abdominal cramps, insomnia, tachycardia, hypertension - Answers -Signs and
symptoms of abstinence syndrome or withdrawl
Opioid pseudoaddiction - Answers -Patients develop certain behavioral characteristics
of psychological dependence as a consequence of in adequate pain treatment. These
patients are often described as difficult patient, chronic complainers, drug seekers.
Patient will often resort to Bizzarre a dramatic behavior in attempt to prove their pain is
real so pain medications are provided.
Double effect - Answers -And ethical principle that permits in action, intended to have a
good effect, when there is a risk of also causing harmful affects, only when the intention
was to produce the good effect. And example of this would be giving high does opioids
at end of life to control pain, but may cause sedation.
Character - Answers -explanation of pain using words such as tingling, burning, sharp,
shooting.
A change in the patient's behavior. - Answers -The gold standard for measuring
effectiveness of pain interventions and patient's discomfort level.
Furrowed brow - Answers -Number one indicator of pain for a patient who is
unresponsive.
Peripheral neuropathy that occurs from both the virus and the treatment. Late stage HIV
is often associated with headaches from acute and chronic meningitis and chest pain
from pneumonia - Answers -Most common pain syndrome seen in patients with HIV
disease?
Chest pain caused by angina pectoris, respiratory syndrome's, third, panic attacks. -
Answers -Most common pain seen with patients with cardiovascular disorders?
Somatic pain, visceral pain, referred pain - Answers -Types of nociceptive pain include
Corticosteroids - Answers -This class of medication is often used in metastatic bone
pain which can produce significant pain control along with increased energy, enhance
mood and improved appetite. Also useful to relieve pain associated with liver metastasis
and other visceral pain syndromes
Experts recommend reducing the dose by 25% to account for incomplete cross
tolerance. If converting from the oral to the intervenous route it is not clear that the
patient has reasonable absorption of this drug through the gastrointestinal system,
reduce the dose by 25% however if you are converting from one drug for another in the
patient is in severe pain, dose reduction is often not necessary. - Answers -Directions
for converting from one opioid to another when patient's pain is well-controlled