Chapter 23 Pharmacologic Pain Management

Chapter 23   Pharmacologic Pain Management

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1) Which of the following is a common barbiturate used in labor?

1. Seconal
2. Valium
3. Phenergan
4. Vistaril

Answer:  1

Explanation:  1. The most common barbiturates used in labor are secobarbital (Seconal) and zolpidem tartrate (Ambien).

Page Ref: 544

Cognitive Level:  Understanding

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards:  QSEN Competencies: I. A. 1. Integrate understanding of multiple dimensions of patient centered care. | AACN Essentials Competencies: IX. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings. | NLN Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome:  2 Describe the use of systemic analgesics to promote pain relief during labor.

MNL LO:  3.3.3 Examine the use, advantages, and disadvantages of anesthesia and analgesia for pain relief.

 

 

2) The nurse is assessing a client before administering an analgesic. What are some of the factors the nurse should consider?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. The client is willing to receive medication after being advised about it.
2. The client’s vital signs are stable.
3. The partner agrees to use of the medication.
4. The client has no known allergies to the medication.
5. The client is aware of the contraindications of the medication.

Answer:  1, 2, 4, 5

Explanation:  1. Medication should be explained to the client before it is administered.

2. Vital signs need to be stable before any analgesic medication is administered.
3. Ask the client about allergies before administering any medications.
4. Clients should always be aware of the contraindications of the medication.

Page Ref: 543

Cognitive Level:  Evaluating

Client Need/Sub:  Safe and Effective Care Environment: Management of Care

Standards:  QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome:  1 Discuss the nurse’s role in supporting pharmaceutical pain relief measures in labor.

MNL LO:  3.3.3 Examine the use, advantages, and disadvantages of anesthesia and analgesia for pain relief.

 

3) A client in labor is requesting pain medication. The nurse assesses her labor status first, focusing on which of the following?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Contraction pattern
2. Amount of cervical dilatation
3. When the labor began
4. Whether the membranes are intact or ruptured
5. Fetal presenting part

Answer:  1, 2, 5

Explanation:  1. The client should have a good contraction pattern before receiving an analgesic.

2. The nurse should evaluate the amount of cervical dilatation before analgesic medication is administered.
3. If normal parameters are absent or if nonreassuring maternal or fetal factors are present, the nurse may need to complete further assessments with the physician/CNM.

Page Ref: 543

Cognitive Level:  Analyzing

Client Need/Sub:  Safe and Effective Care Environment: Management of Care

Standards:  QSEN Competencies: I. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome:  1 Discuss the nurse’s role in supporting pharmaceutical pain relief measures in labor.

MNL LO:  3.3.3 Examine the use, advantages, and disadvantages of anesthesia and analgesia for pain relief.

 

 

4) A woman in active labor is given nalbuphine hydrochloride (Nubain) 14 mg IV for pain relief. Half an hour later, her respirations are at 8 per minute. The physician would likely order which medication for this client?

1. Narcan
2. Reglan
3. Benadryl
4. Vistaril

Answer:  1

Explanation:  1. Narcan is useful for respiratory depression caused by nalbuphine (Nubain).

Page Ref: 547

Cognitive Level:  Analyzing

Client Need/Sub:  Safe and Effective Care Environment: Management of Care

Standards:  QSEN Competencies: V. B. 2. Demonstrate effective use of strategies to reduce risk of harm to self or others. | AACN Essentials Competencies: IX. 8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan. | NLN Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome:  2 Describe the use of systemic analgesics to promote pain relief during labor.

MNL LO:  3.3.3 Examine the use, advantages, and disadvantages of anesthesia and analgesia for pain relief.

5) An analgesic medication has been administered intramuscularly to a client in labor. How would the nurse evaluate if the medication was effective?

1. The client dozes between contractions.
2. The client is moaning during contractions.
3. The contractions decrease in intensity.
4. The contractions decrease in frequency.

Answer:  1

Explanation:  1. If the client dozes between contractions, the analgesic is effective. Analgesics decrease discomfort and increase relaxation.

Page Ref: 542

Cognitive Level:  Analyzing

Client Need/Sub:  Physiological Integrity: Physiological Adaptation

Standards:  QSEN Competencies: I. B. 7. Initiate effective treatments to relieve pain and suffering in light of patient values, preferences, and expressed needs. | AACN Essentials Competencies: IX. 8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan. | NLN Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome:  2 Describe the use of systemic analgesics to promote pain relief during labor.

MNL LO:  3.3.3 Examine the use, advantages, and disadvantages of anesthesia and analgesia for pain relief.