Exam 1 Study Guide with Complete Solutions

Advanced Med-Surg Principles Jersey College Exam 1 Study Guide with Complete Solutions What during labor increases the risk of neonate aquiring acute encephalitis? - Correct Answer active herpes simplex virus-2 How do you administer meds? - Correct Answer starting with the lowest dose and titrating up slowly What is pain is associated with? - Correct Answer actual or potential tissue damage When pain stimulates the sympathetic nervous system, what does it result in? - Correct Answer - increase in BP

• increase in HR
• increase in RR

Where are catecholamines released from? - Correct Answer adrenal medulla Where are steroid hormones (cortisol & aldosterone) released from? - Correct Answer adrenal cortex What does unrelieved pain lead to? - Correct Answer - increases glucagon production

• decreases insulin secretion
• depress immune function
• can lead to addictive behaviors

What initiates inflammation, contributes to tissue sweeling, and pain? - Correct Answer Prostaglandins What can nerve root injury lead to? - Correct Answer allodynia (pain that is associated with non- noxious stimuli) What is needed for renal blood flow? - Correct Answer Prostaglandin Pain is? - Correct Answer whatever the patient says it is 1 / 4

What is the single most reliable indicator of pain? - Correct Answer the patient's self-report How do NSAID's preimarily produce pain relief? - Correct Answer by preventing prostaglandin formation What does acetaminphen not have? - Correct Answer any inflammatory properties What do you manage nociceptive pain with? - Correct Answer - local anesthetics

• non-opioids
• opioids

What does 0 on the 0 - 10 numeric pain rating scale indicate? - Correct Answer no pain What does the Wong-Baker FACES pain scale consist of? - Correct Answer cartoon faces that the patient (ages 3 and up) selects to report thier pain level What does the visual analog 10cm scale represent? - Correct Answer no pain to the worst pain, the patient marks a spot somewhere in between indicating their pain level What pain scale helps indiviuals describe the intensity of pain? - Correct Answer verbal descriptor scale What does a comprehensive pain assessment consist of? - Correct Answer - duration (when it started/lasted)

• type (intensity/assoc factors/influencing fators)
• location

What patients do we avoid the rectal route for med administration? - Correct Answer thrombocytopenic What type of effect do topical agents produce? - Correct Answer local 2 / 4

What type of effect do transdermal agents produce? - Correct Answer drug absorption into the systemic circulation What would help reduce complications related to pain for patients? - Correct Answer provide a PCA How do we administer around the clock pain relief for post-op and chronic pain? - Correct Answer provide analgesics, never wait for chronic pain to reoccur What is provided for mild to moderate pain? - Correct Answer aspirin or acetaminaphen What is provided for moderate pain? - Correct Answer NSAID's What is provided for severe pain? - Correct Answer morphine Why would you wake patients who have chronic pain or who have moderate to severe pain folowing surgery? - Correct Answer to administer prescribed analgcsics What can excessive use of acetaminophen cause? - Correct Answer hepatoxicity What does of acetaminophen could lead to hepatoxicity? - Correct Answer 4,000 mg/day What can NSAID's meds result in? - Correct Answer - gastric ulcers

• contribute to CV events (MI or stroke)

What can the use of NSAID's lead to in patients with volume depletion or who take it for chronic pain? - Correct Answer acute renal failure What undesirable effects do opioids produce? - Correct Answer - constipation

• nausea
• pupil constriction
• respiratory distress 3 / 4

Physical dependence and tolerance are not the same as what? - Correct Answer addiction Why do you never apply heat over a transdermal patch? - Correct Answer it could increase absorption and result in lethal complications How should you manage neuropathic pain? - Correct Answer with adjuvant meds such as antidepressants or anticonvulsants What should not be used in a clincial practice that it would violate the nurse-patient relationship? - Correct Answer placebos What are some non-pharmacologic pain management strategies? - Correct Answer - physical modalities

• mind-body methods
• biologic and energy-based therapies

What are the clinical manifestations of hyponatremia? - Correct Answer - headaches

• seizures
• lethargy
• tachycardia
• decreased BP
• thready pulse
• hyperactive bowel sounds
• abdominal cramps

What are signs of hypoxia? - Correct Answer - restlessness

• confusion
• pallor
• tachycardia
• tachypnea

What can vagal stimulation be caused by? - Correct Answer - vomiting

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