A client with trigeminal neuralgia reports moderate to severe burning and shooting pain. In assisting the client with pain management, the nurse recognizes which of the following?
Treatment includes the use of adjuvant analgesics.
The pain will be chronic and require long-term treatment.
The pain responds well to around-the-clock moderate doses of oral opioids.
Pain can be controlled effectively with salicylates or NSAIDs.
The Correct Answer is A
Trigeminal neuralgia is a chronic neuropathic pain disorder characterized by sudden, burning or shooting facial pain, often triggered by light touch or facial movement. This type of pain responds poorly to traditional analgesics like NSAIDs and opioids. Instead, it is most effectively managed with adjuvant analgesics such as anticonvulsants (e.g., carbamazepine, gabapentin) and sometimes tricyclic antidepressants, which modulate nerve conduction and reduce neuropathic pain.
Rationale for Correct Answer:
A. Treatment includes the use of adjuvant analgesics: First-line pharmacologic management for trigeminal neuralgia involves adjuvant drugs that stabilize nerve activity. Anticonvulsants are the mainstay of therapy and provide significant pain relief for many clients.
Rationale for Incorrect Answers:
B. The pain will be chronic and require long-term treatment: While this is often true, it is not the best answer because it does not directly address the nurse’s role in assisting with pain management or identify the specific treatment approach.
C. The pain responds well to around-the-clock moderate doses of oral opioids: Neuropathic pain from trigeminal neuralgia generally responds poorly to opioids, which are not considered first-line treatments.
D. Pain can be controlled effectively with salicylates or NSAIDs: These drugs are typically ineffective for neuropathic pain and do not target the underlying nerve dysfunction seen in trigeminal neuralgia.
Key Takeaways:
- Trigeminal neuralgia is a neuropathic pain disorder that responds best to adjuvant analgesics such as anticonvulsants.
- Opioids and NSAIDs are generally ineffective for this type of pain.
- Nursing care focuses on medication education, pain management support, and helping clients avoid triggers that worsen the pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The most appropriate initial action when assessing pain is to ask the client to rate the pain using a standardized scale, such as 0 to 10, where 0 means no pain and 10 means the worst pain imaginable. This helps the nurse quantify the client's subjective experience, determine the urgency of intervention, and evaluate response to treatment over time.
Rationale for Correct Answer:
A. Ask the client to rate the pain on a scale from 0 to 10: This method provides an objective measurement of the client’s subjective experience of pain, forming the basis for treatment planning and evaluation. It is a standard and validated assessment tool.
Rationale for Incorrect Answers:
B. Determine if the client can stop moving about: This may offer indirect information but does not provide a reliable or quantifiable assessment of pain intensity.
C. Administer the prescribed pain medication: Pain must be assessed and documented before administration, especially if it's the first dose or if the provider needs data to determine dosage.
D. Observe if the client is breathing heavily: While observing physiologic signs of distress is helpful, subjective reporting is the most accurate and essential component of pain assessment.
Key Takeaways:
- The 0–10 numeric pain rating scale is a reliable tool for assessing pain severity.
- Subjective reporting is the gold standard in pain assessment.
- Objective observations support but do not replace the client’s verbal pain report.
Correct Answer is C
Explanation
TENS therapy is a noninvasive method of pain control that uses low-voltage electrical currents delivered through electrodes placed on the skin. The most commonly reported sensation during TENS use is a pleasant tingling or buzzing feeling, which stimulates sensory nerves and helps block or reduce the perception of pain. The intensity can be adjusted to maintain comfort and effectiveness.
Rationale for Correct Answer:
C. A pleasant tingling sensation: This is the expected and desired sensation during TENS therapy. It should not be painful. The tingling distracts the nervous system from transmitting pain signals, providing relief for chronic or localized pain.
Rationale for Incorrect Answers:
A. A hard knocking feeling: This is not a typical or desired sensation with TENS. Such a sensation could indicate the intensity is too high or the electrode placement is inappropriate.
B. An intermittent burning reaction: A burning feeling is abnormal and may signal skin irritation, improper settings, or electrode malfunction. It should be reported and addressed immediately.
D. A small shock to the affected area: TENS does not deliver shocks. A shock-like feeling may indicate the intensity is set too high or the device is malfunctioning.
Key Takeaways:
- TENS therapy produces a pleasant tingling sensation, not pain or shocks.
- The goal of TENS is to modulate pain perception through gentle electrical stimulation.
- Any discomfort, burning, or shocking sensation should be evaluated and may require adjustment of settings or electrode placement.
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