A patient with chronic neck pain is seen in the pain clinic for ...

[ericka1]

A patient with chronic neck pain is seen in the pain clinic for follow-up. In order to evaluate whether the pain management is effective, which question is best for the nurse to ask?
 
  a. Can you describe the quality of your pain?
  b. Has there been a change in the pain location?
  c. How would you rate your pain on a 0 to 10 scale?
  d. Does the pain keep you from doing things you enjoy?

Question 2

A patient who is receiving sustained-release morphine sulfate (MS Contin) every 12 hours for chronic pain experiences level 9 (0 to 10 scale) breakthrough pain and anxiety. Which action by the nurse is best?
 
  a. Provide amitriptyline (Elavil) 10 mg orally.
  b. Administer lorazepam (Ativan) 1 mg orally.
  c. Offer ibuprofen (Motrin) 400 to 800 mg orally.
  d. Give immediate-release morphine 30 mg orally.

[Sammyo]

Answer to Question 1

ANS: D
The goal for the treatment of chronic pain usually is to enhance function and quality of life. The other questions are also appropriate to ask, but information about patient function is more useful in evaluating effectiveness.

Answer to Question 2

ANS: D
The severe breakthrough pain indicates that the initial therapy should be a rapidly acting opioid, such as the immediate-release morphine. Lorazepam and amitriptyline may be appropriate to use as adjuvant therapy, but they are not likely to block severe breakthrough pain. Use of antianxiety agents for pain control is inappropriate because this patient's anxiety is caused by the pain.

[ericka1]

Excellent

[Dominic]

Gracias!