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 patient with end-stage renal disease requires opioid therapy. Which opioid is SAFEST to use in this population due to its metabolite profile?
Answer: Fentanyl
Fentanyl is the preferred opioid in renal failure because it has inactive metabolites that do not accumulate, unlike morphine or hydromorphone.
A palliative nurse is preparing to titrate opioids in an opioid-naive patient with severe cancer pain. What is the standard starting oral morphine dose for adults?
Answer: 5 mg every 4 hours
The standard starting dose of oral immediate-release morphine in opioid-naive adults is 5 mg every 4 hours, titrated based on response.
Which statement best describes the principle of 'opioid rotation' in palliative care?
Answer: Switching to a different opioid when analgesia is inadequate or side effects are intolerable
Opioid rotation involves switching to a different opioid to improve the balance between analgesia and side effects, often using incomplete cross-tolerance to achieve better control.
A nurse is managing a patient's pain with a transdermal fentanyl patch. The patient's pain acutely worsens after 60 hours. What is the most appropriate first action?
Answer: Administer an oral immediate-release opioid for breakthrough pain
When transdermal fentanyl does not control breakthrough or acute pain, an immediate-release opioid should be used for rescue while patch delivery continues.
A patient receiving intrathecal opioid therapy for refractory pain reports sudden severe headache. What serious complication should the nurse suspect first?
Answer: Post-dural puncture headache or catheter migration
Sudden severe headache in an intrathecal catheter patient suggests post-dural puncture headache or catheter migration, requiring immediate assessment.
A palliative care nurse educates a family about the difference between physical dependence and addiction. Which statement is correct?
Answer: Physical dependence is a normal physiologic response to opioids and does not indicate addiction
Physical dependence (withdrawal if opioid is abruptly stopped) is a predictable pharmacologic response and is distinct from addiction, which involves compulsive use despite harm.
A hospice patient with liver failure requires analgesic management. Which opioid dose adjustment is most appropriate?
Answer: Reduce the dose and extend the dosing interval
Hepatic failure impairs opioid metabolism, increasing drug exposure and risk of toxicity; dose reduction and extended intervals are required.