Answer to Question 1
B
With complex pain management that has been unsuccessful in the past, it is important to collaborate with other members of the team to consider alternative approaches. A pain journal is a useful assessment tool for collection of patient subjective and objective pain experiences, which would aid the healthcare team in developing a collaborative pain management plan with the patient. Taking a prescribed analgesic is important for keeping the pain threshold at a tolerable level. Once the patient gets behind on managing pain, it is more difficult to achieve control. The goal of pain management is that chronic pain does not prevent the patient from performing activities of daily living. Although massage has been shown to be effective in reducing pain by providing cutaneous stimulation and relaxing the muscles, the priority is to develop an effective, comprehensive pain management plan that might also include nonpharmacological interventions, such as massage. However, in the case of chronic back pain, the patient should consult the provider before seeking deep massage therapy. Effleurage, or the use of slow, long guiding strokes, is used for obstetrical patients during labor.
Answer to Question 2
C
Ibuprofen is a nonsedating analgesic. This would be the best choice but the nurse should instruct the patient to call if the pain is not tolerable because a stronger analgesic may be needed. If the patient desires to be alert, an opioid analgesic would not be the best choice because it produces drowsiness. Hydrocodone and fentanyl are opioid agonists and, based on the patient's request to be alert, would not be the best choice.
The grey nurse shark is critically endangered on the Australian east coast.
Patient with a cerebrovascular accident.
A physical therapist helping the patient on parallel bars.
Pneumonia patient’s chest x-ray. Note the irregular areas of density.
Head of a patient with tertiary syphilis.
Patient Physical Status Classification