Ch 29: Pain Management in Cancer Patients – Flashcards
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The nurse is conducting a pain assessment for a patient with cancer. Which data will be the most helpful in assessing the patient's current level of pain?
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Patients description of pain
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Which prescription would be the most appropriate for treating persistent cancer pain?
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Morphine (Duramorph) 30 mg every 3 to 4 hours
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Which side effect of morphine (Duramorph) does not subside over time?
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Constipation
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Which condition should the nurse anticipate when the patient has received an intraspinal opioid medication to control cancer pain?
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Potential for delayed respiratory depression and catheter-related infections
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A patient with end-stage breast cancer is experiencing ineffective pain management. Which statement represents the most likely cause of this problem? (Select all that apply.)
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B. Many cancer patients are reluctant to take pain medication C. Healthcare professionals often fear patient addiction to pain medication E. The healthcare system often places a low priority on pain management
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Burning, numb, cold: injury to peripheral nerve
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Neuropathic
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Opioids most effective; injury to tissue ..2 forms somatic and visceral
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Nociceptive
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adjunctive drugs most effective; pain results from injury to bone, joint
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Somatic
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Opioids most effective; organ origin of pain; diffuse, aching pain
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Visceral
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What is the most reliable indicator of the need for pain relief in the oncology patient?
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patients report of a need for pain relief
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When developing a plan car for a pain management for the cancer patient, achievement of what is the priority outcome?
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Pain relief that is acceptable to the patient
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A cancer patient whose history includes type 2 DM informs the nurse that she is experiencing constant burning pain in her feet. Based on the type of foot pain commonly experienced by diabetics, the nurse would consult the prescriber regarding possibly ordering which drug?
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A neurologic-acting adjunct drug, such as gabapentin (Neurontin)
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Which os these lab test results would be priority to report to the prescriber when a cancer patient treated with chemo is taking a pain reliever that contains ibuprofen?
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Platelet count 60,000/m^3
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A postoperative cancer patient was receiving morphine sulfate IV 10mg every 4 hrs for pain. The prescriber has discontinued the IV morphine and ordered morphine sulfate 20-mg tab every 4 hrs. How does the oral dose compare with the IV dose?
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The oral dose is LESS potent than IV dose
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The nurse know that respiratory depression is most likely to occur with which pain regimen?
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A loading dose of 10mg of morphine before starting PCA
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A patient has been taking oral opioids for moderate pain associated with prostate cancer that has metastasized to the spine. Suregry is performed, and the patient is experiencing moderate to severe postoperative pain. Which analgesic is most appropriate in this case?
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Morphine sulfate via PCA pump
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What is of most concern to the nurse when a patient is prescribed an NSAID analgesic on a regular basis?
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Rigid abdomen
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NSAIDs and acetaminophen are initial drugs for
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pt with mild pain
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Acetaminophen is about equal to the NSAIDs in analgesic efficacy but lacks
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anti-inflammatory actions
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NSAIDs increase the risk of thrombotic events EXCEPT
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aspirin
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produce their effects by inhibiting cyclooxygenase (COX)
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NASIDs
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Celecoxib 200mg twice a day is prescribed for a patient with cancer that has metastasized to the bone. Which adverse effect is more likely to occur with celecoxib than other NSAIDs?
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Cerebrovascular accident
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Which lab test result would be greatest priority to report to the prescriber of an NSAID drug to a cancer patient?
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Platelets 40,000/mm^3
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What is of greatest priority when naloxone is administered to combat the respiratory depression associated with opioid use for cancer patients?
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Return of pain
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The nurse is preparing to administer metoclopramide (Reglan) to a cancer patient who is experiencing nausea associated with opioid use. How should the nurse respond when the patient asks how this drug works?
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"The drug counteracts gastric slowing caused by opioid use"
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What is the priority concern when a patient combines prescribed opioids with alcohol?
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Respiratory depression
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Multiple factors contribute to the under treatment of patients with pain caused by cancer
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1. inadequate prescriber training in pain management 2. unfounded fears of addiction 3. health care system that focuses more on treating disease than reliving suffering
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certain anti seizure drugs, such as carbamazepine and gabapentin, can help relieve which type of pain?
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neuropathic
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2 beneficial effects of the use of CNS stimulants in the treatment of cancer pain
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1. enhance opioid induced analgesic 2. counteract opioid-induced sedation also be used for rapid elevation of the mood
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Drug sensitivity occurs in the neonate for 2 reasons
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1. blood-brain barrier is incompletely formed, giving drugs ready access to the CNS 2. Kidneys and liver are poorly developed causing drug elimination to be slow
