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Linton: Introduction to Medical-Surgical Nursing, 6th Edition

Chapter 15: Pain Management

Open-Book Quiz
1. According to The Joint Commission, what are the standards for the management of pain for
all patients?
A. recognizing the right of patients to appropriate assessment and management of pain
B. screening patients for pain during initial assessment and when clinically required,
during ongoing, periodic reassessments
C. teaching patients and families about effective pain management.
2. What are endorphins and enkephalins?
They are the body natural opioid-like substances that block the transmission of painful
impulses to the brain.
3. Explain Melzack and Walls gate-control theory.
Painful transmitted to the spinal cord small diameter nerve afferent pathways, these fiber
stimulates the gating mechanism that permits the transmission of impulses from the
spinal cord to the brain. Painful impulses factors are fear of pain, monotonous
environment, tissue damage, these stimulate the gate to open. And in the end of spinal
cord is the large diameter that interfere with the impulses and transmission between
spinal cord and brain.
4. Compare and contrast pain threshold and pain tolerance.
Pain threshold the point which the stimulus causes the sensation of pain.
Pain tolerance refers to the intensity of pain that a person will endure
5. List the psychological factors that can influence the response to pain.
1. Culture, ethnicity and Gender
2. Religious Beliefs
3. Past experiences and anxiety
4. Situational factors
6. What is neuropathic pain, and when does it occur?
Pain is caused by nerve damage resulting from wide variety of anatomic and physiologic
conditions and underlying deseases. Ex. Burning, shooting pain
Copyright 2016 by Saunders, an imprint of Elsevier Inc.

Open-Book Quiz


7. Name the six steps in pain assessment.

Accept the patients report
Determine the status of the pain
Describe the pain
Examine the site of the pain
Identify coping methods
Document assessment
8. Explain transcutaneous electric nerve stimulation (TENS) as a physical intervention to
relieve pain.
Less widely used and requires physicians order. The therapy involves external electrical
stimulation of the skin and underlying tissues through electrodes attached to small unit
that the patient can carry around. The electrodes are palced over, above or below painful
sites and attached to a battery operated devie that delivers low voltage electrical currents
to block the pain signals.
9. What are the uses of nonopioid analgesics?
Nonopoid generally used to mild pain. Act mostly on the peripheral nervous system such
as arthritis, backache, headache, dysmenorrhea, postoperative pain, cancer pain, and bone
10. Explain why you should be cautious when using meperidine.
Because the side effect of the drugs especially in older patients. They should be
monitored in increased bleeding time, gastrointestinal irritation , confusion, constipation
and headache.

Copyright 2016 by Saunders, an imprint of Elsevier Inc.