Pain Management Strategies Flashcards
7 cards from real CHPN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Pain Management Strategies flashcards as text
A palliative nurse recognizes that a patient's pain report is inconsistent with their behavioral cues. What is the gold standard for pain assessment in cognitively intact patients?
Answer: Patient self-report
Patient self-report is always the gold standard for pain assessment in patients who can communicate, regardless of discrepant behavioral cues.
When transitioning a patient from IV morphine to oral morphine, what is the correct conversion ratio (IV to oral)?
Answer: 1:3
IV morphine is approximately 3 times more potent than oral morphine, so the IV-to-oral conversion ratio is 1:3.
A dying patient is unable to swallow and has moderate pain. The family refuses an IV line. Which route is most appropriate for opioid delivery?
Answer: Sublingual or buccal administration
Sublingual or buccal opioid administration is a noninvasive, effective alternative when the patient cannot swallow and IV access is unavailable.
Which tool is most appropriate for assessing pain in a hospice patient with advanced dementia who cannot verbalize?
Answer: PAINAD (Pain Assessment in Advanced Dementia)
The PAINAD scale uses behavioral observation (breathing, vocalization, facial expression, body language, consolability) to assess pain in nonverbal dementia patients.
Corticosteroids such as dexamethasone are used as adjuvant analgesics in palliative care primarily for which type of pain?
Answer: Pain from cord compression and bone metastases with inflammatory component
Dexamethasone reduces peritumoral edema and inflammation, making it effective for pain from spinal cord compression and bone metastases.
A patient on opioid therapy develops severe constipation unresponsive to stimulant laxatives. Which agent specifically targets opioid-induced constipation?
Answer: Methylnaltrexone (Relistor)
Methylnaltrexone is a peripherally acting mu-opioid receptor antagonist that relieves opioid-induced constipation without reversing central analgesia.
A hospice nurse notes a patient is using breakthrough opioids every 2 hours around the clock for 3 days. What does this pattern indicate?
Answer: Undertreated pain requiring baseline dose adjustment
Consistent, frequent use of breakthrough opioids indicates the baseline (scheduled) dose is inadequate and the around-the-clock regimen needs titration upward.