A client in an outpatient pain management clinic reports that their leg pain began 1 year ago after an injury that affected the spinal nerves. The pain has an intense sharp quality "like an electric shock". The client rates the pain level 9 on (0-10) scale after taking opioids & non-steroidal anti-inflammatory agents and receiving acupuncture. What are appropriate descriptors of the pain for the nurse to document? (SELECT ALL THAT APPLY)

chronic

visceral

intractable

neuropathic

cutaneous

Answer and Explanation

Correct Answer : A,C,D

A. Chronic:

Chronic pain is characterized by pain that persists beyond the expected time for tissue healing, typically lasting for more than 3 to 6 months.

In this scenario, the client's pain has been present for 1 year, indicating a prolonged duration consistent with chronic pain.

Documenting the pain as chronic provides important information about the nature and duration of the client's pain experience.

C. Intractable:

Intractable pain refers to pain that is difficult to manage or control despite various treatment modalities.

The client's report of intense, sharp pain persisting at a high level (rated 9 out of 10) despite opioid analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), and acupuncture suggests that the pain is intractable.

Documenting the pain as intractable highlights the challenges associated with managing the client's pain and the need for additional interventions or referral to specialized pain management services.

D. Neuropathic:

Neuropathic pain arises from damage or dysfunction of the nervous system and is often described as sharp, shooting, burning, or like an electric shock.

The client's description of their leg pain as "an intense sharp quality 'like an electric shock'" is consistent with neuropathic pain.

Documenting the pain as neuropathic helps identify the underlying pathophysiology of the pain and guides appropriate treatment strategies targeting neuropathic pain mechanisms.

B. Visceral:

Visceral pain originates from internal organs and is typically described as deep, dull, or cramping.

While the pain in this scenario is associated with spinal nerve injury, which can involve visceral pain pathways, the client's description of the pain as sharp and electric shock-like is more indicative of neuropathic pain rather than visceral pain.

Therefore, visceral pain may not be an appropriate descriptor for the client's pain experience in this case.

E. Cutaneous:

Cutaneous pain arises from the skin or subcutaneous tissues and is often described as superficial, sharp, or burning.

While the client's leg pain may involve cutaneous innervation, the description provided ("like an electric shock") suggests involvement of deeper structures and neuropathic pain mechanisms rather than purely cutaneous pain.

Therefore, cutaneous pain may not fully capture the nature of the client's pain experience in this scenario.

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Correct Answer is A

Explanation

A. Isotonic: Isotonic fluids have a similar osmolarity to extracellular fluid and are often used for volume replacement in clients with fluid volume deficits, such as those with gastroenteritis. Isotonic fluids help to expand intravascular volume without causing significant shifts in fluid and electrolyte balance.

B. Hypotonic: Hypotonic fluids have a lower osmolarity than extracellular fluid and are typically used to rehydrate cells in cases of cellular dehydration. While hypotonic fluids can replenish intracellular volume, they are not typically used as initial replacement fluids for clients with fluid volume deficits, especially if there is risk of exacerbating extracellular fluid deficit.

C. Hypertonic: Hypertonic fluids have a higher osmolarity than extracellular fluid and are often used to expand intravascular volume in specific situations, such as severe hyponatremia or hypovolemic shock. However, they are not typically used as initial replacement fluids for clients with gastroenteritis and fluid volume deficits.

D. Colloid: Colloids are solutions containing large molecules, such as albumin or starches, which remain within the vascular space and exert oncotic pressure to draw fluid into the intravascular compartment. While colloids may be used in some cases of severe volume deficit, they are not typically used as initial replacement fluids for clients with gastroenteritis.

A. "I can take this medication along with mineral oil." B. "I should drink 4 ounces of water when I take the medication." C. "It might take up to 3 days for the medication to work." D. "I will take the medication for diarrhea."

Correct Answer is C

Explanation

Docusate sodium is a stool softener commonly prescribed to alleviate constipation, particularly in patients taking opioid pain medications, which often cause constipation as a side effect. When educating a client about docusate sodium, it's essential to provide accurate information about its onset of action and expected effects.

A. "I can take this medication along with mineral oil."

This statement indicates a misunderstanding of the teaching. Combining docusate sodium with mineral oil is not recommended because mineral oil can interfere with the absorption of fat-soluble vitamins and may diminish the effectiveness of docusate sodium.

B. "I should drink 4 ounces of water when I take the medication."

Although it's important to stay hydrated when taking docusate sodium, there isn't typically a specific volume of water recommended for each dose. While hydration can aid in the effectiveness of the medication, this statement doesn't directly address the expected action of docusate sodium.

C. "It might take up to 3 days for the medication to work."

This statement demonstrates an understanding of the teaching. Docusate sodium may take a few days to produce a noticeable effect on bowel movements. Understanding this timeline helps manage the client's expectations and prevents premature discontinuation of the medication due to perceived lack of efficacy.

D. "I will take the medication for diarrhea."

Docusate sodium is not indicated for the treatment of diarrhea. It is specifically used as a stool softener to alleviate constipation by promoting easier passage of stool. This statement indicates a misunderstanding of the intended use of the medication.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The physician has ordered replacement fluids for a client who has a fluid volume deficit with a diagnosis of gastroenteritis. The nurse would expect the use of which type of fluids initially upon admission?

Correct Answer is A

Explanation

A nurse is providing teaching to a client who takes opioid pain medication and has a new prescription for docusate sodium. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is C

Explanation

Which position would be appropriate for the nurse to perform an abdominal assessment?

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The nurse caring for a client diagnosed with dehydration recognizes that which of the following are appropriate nursing interventions? (SELECT ALL THAT APPLY)

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