Pain Management and Palliative Care Flashcards

A patient rates their post-operative pain as 8/10 and reports their current analgesic regimen is ineffective. The nurse's first action is:

Answer: Assess the pain fully using location, quality, onset, and aggravating factors, then contact the provider for orders if needed

Comprehensive pain reassessment is necessary before escalating treatment to ensure the appropriate analgesic approach is selected for the type of pain.

A patient receiving IV patient-controlled analgesia (PCA) morphine is found with a respiratory rate of 7 breaths/min and is difficult to arouse. The nurse's priority action is:

Answer: Stop the PCA, administer naloxone (Narcan), and call for emergency assistance

Respiratory depression from opioid overdose is life-threatening and requires immediate PCA cessation, naloxone administration, and emergency response.

A patient with chronic cancer pain is on scheduled long-acting opioids. The nurse's understanding of equianalgesic dosing is important when:

Answer: Converting between opioid formulations or routes to maintain equivalent pain control

Equianalgesic dosing tables allow safe conversion between different opioids or routes (oral to IV) while maintaining equivalent pain control without under- or over-dosing.

A palliative care patient with advanced cancer has uncontrolled pain despite scheduled opioids. The nurse should advocate for the addition of:

Answer: A breakthrough (rescue) dose of a short-acting opioid for episodic pain

Breakthrough (rescue) doses of short-acting opioids are prescribed for episodic or incident pain that exceeds the relief provided by scheduled long-acting medications.

A patient with chronic neuropathic pain is prescribed gabapentin (Neurontin). The nurse should teach the patient that this medication:

Answer: Is an anticonvulsant that treats neuropathic pain by stabilizing nerve membranes; causes dizziness and somnolence

Gabapentin is an anticonvulsant used for neuropathic pain that works via calcium channel modulation; it requires gradual dose titration and causes dizziness and sedation.

In the WHO analgesic ladder, which step represents the use of strong opioids for severe pain?

Answer: Step 3 — strong opioids such as morphine or oxycodone

WHO Step 3 recommends strong opioids (morphine, oxycodone, hydromorphone) for severe pain (NRS 7–10) when Step 1 and Step 2 analgesics are inadequate.