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 terminally ill patient develops opioid-induced respiratory depression. Which medication reverses this effect and what is the priority nursing concern?
Answer: Naloxone; administer in small titrated doses to avoid precipitating severe pain and withdrawal
Naloxone reverses opioid-induced respiratory depression, but in opioid-tolerant palliative patients it must be titrated in small doses to restore breathing without precipitating acute pain crisis or withdrawal.
A patient rates their pain 3/10 and states they are comfortable. The nurse observes mild grimacing. What is the most appropriate action?
Answer: Document the self-report of 3/10 as the pain score and reassess per protocol
Self-report remains the gold standard; a patient who states they are comfortable at 3/10 should be believed and documented accordingly, with ongoing reassessment.
Which description best defines 'total pain' as conceptualized in palliative care?
Answer: The multidimensional experience encompassing physical, psychological, social, and spiritual suffering
Dame Cicely Saunders' concept of 'total pain' recognizes that suffering in dying patients is multidimensional, requiring holistic assessment and intervention across all domains.
A palliative nurse notes a patient's pain worsens significantly at night. Which factor should be assessed first?
Answer: Reduced distraction, increased anxiety, and circadian variation in pain thresholds
Nocturnal pain worsening is often multifactorial: fewer distractions amplify pain perception, anxiety peaks at night, and some pain types have circadian patterns.
A patient on long-term opioid therapy reports that the same dose no longer provides adequate relief. This phenomenon is best described as:
Answer: Opioid tolerance
Opioid tolerance is the pharmacologic phenomenon in which a given dose produces less effect over time, requiring dose escalation — it is distinct from addiction.
A patient reports their pain as burning, shooting, and electric-shock-like in quality. Which assessment finding most supports a neuropathic pain diagnosis?
Answer: Allodynia — pain from a stimulus that does not normally cause pain
Allodynia (pain from non-painful stimuli such as light touch) is a hallmark feature of neuropathic pain, along with dysesthesias and hyperalgesia.
A family member asks whether giving pain medication to a dying patient will hasten death. What is the most accurate and ethical response by the hospice nurse?
Answer: Appropriately titrated opioids to relieve pain do not hasten death and are ethically supported by the principle of double effect
Research consistently shows appropriately titrated opioids do not hasten death; the principle of double effect supports their use when the intent is comfort, even if some risk exists.