What is the role of a postoperative nurse in managing pain without pharmacologic interventions?
Administer heating pads to the surgical site.
Elevating the head of the bed continuously.
Guided imagery and relaxation techniques.
Restricting movement to avoid pain.
The Correct Answer is C
A. Administer heating pads to the surgical site: Applying heat to an acute surgical wound can induce vasodilation and significantly increase the risk of postoperative hemorrhage or edema. While heat therapy is useful for chronic musculoskeletal pain, it is generally contraindicated in the immediate postoperative phase. Cold therapy is typically preferred to reduce inflammation and localized pain.
B. Elevating the head of the bed continuously: While Semi-Fowler's position can assist with respiratory excursion, keeping the head of the bed continuously elevated may not address specific nociceptive pathways. Excessive elevation can also increase pressure on the sacrum, potentially leading to skin breakdown. Positioning must be individualized to the specific surgical procedure and patient comfort.
C. Guided imagery and relaxation techniques: These cognitive-behavioral interventions modulate the gate-control mechanism of pain by engaging the central nervous system. They reduce the patient's sympathetic nervous system arousal, lowering heart rate and muscle tension. These techniques provide a safe, non-invasive adjunct to pharmacological therapy to enhance the patient's pain threshold.
D. Restricting movement to avoid pain: Prolonged immobility is a major risk factor for deep vein thrombosis, pulmonary embolism, and atelectasis. While movement may cause temporary discomfort, early ambulation is essential for systemic recovery and preventing secondary complications. Nurses should use pain management to facilitate movement rather than using pain as a reason for stasis.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Overproduction of surfactant:Surfactant is a lipoprotein that reduces surface tension in the alveoli to prevent their collapse. An overproduction would not lead to the musical whistling sound of wheezing. Asthma is a disease of the conducting airways, not a primary disorder of surfactant production or alveolar tension.
B. Airway narrowing due to bronchospasm:During an attack, inflammatory triggers lead to the contraction of bronchial smooth muscle and mucosal edema. This narrows the lumen of the bronchioles, creating high-velocity, turbulent airflow as air is forced through the constricted passages. This turbulence produces the characteristic high-pitched wheezing sound.
C. Accumulation of fluid in the alveoli:Fluid in the alveoli, such as in pulmonary edema, typically produces crackles or rales during auscultation. Wheezing is specifically associated with the narrowing of the airway pipes, not the filling of the air sacs. The pathology of asthma focuses on the bronchial tubes.
D. Thickening of alveolar walls:Thickening of the alveolar-capillary membrane is characteristic of restrictive lung diseases like interstitial fibrosis. While it impairs gas exchange, it does not mechanically cause the expiratory wheezing seen in obstructive diseases like asthma. Asthma's primary defect is reversible airway obstruction and inflammation.
Correct Answer is A
Explanation
A. Decreased alveolar surface area:Senescence involves the progressive loss of alveolar walls, leading to a reduction in the total surface area available for gas exchange. This anatomical change reduces the diffusion capacity for oxygen, particularly during periods of increased metabolic demand. It is a hallmark of the aging respiratory system.
B. Increased lung elasticity:Aging actually results in a loss of elastic recoil due to the degradation of elastin fibers within the lung parenchyma. This leads to premature airway closure during expiration and increased air trapping, rather than improved elastic function. Reduced elasticity makes the work of breathing more difficult for the elderly.
C. Thickening of capillary membranes:While some vascular changes occur, the primary age-related defect is the structural alteration of the alveoli and chest wall. Capillary membrane thickening is more characteristic of specific pathologies like pulmonary fibrosis rather than normal physiological aging. It is not the most likely contributing factor in healthy aging.
D. Enhanced mucociliary clearance:The aging process is associated with a decrease in the number and functional efficiency of cilia in the respiratory epithelium. This impaired clearance mechanism increases the risk of retained secretions and pulmonary infections. Enhanced clearance would be a protective factor rather than a cause of dyspnea.
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