In a post-surgical unit, the nurse cares for many patients experiencing pain. Which situation is likely to lower a patient’s pain threshold?
A patient who is awaiting biopsy results.
A patient who is anxious.
A patient who is having difficulty sleeping in the hospital setting.
It is the same for all patients who have had surgery.
The Correct Answer is B
Choice A rationale:
Awaiting biopsy results can certainly cause anxiety and stress, but it doesn't directly impact the physiological mechanisms that modulate pain perception.
While a patient awaiting biopsy results may be more attentive to their bodily sensations, including pain, the anxiety itself is not the primary driver of a lowered pain threshold.
It's important to address the patient's concerns and provide emotional support, but this alone may not be sufficient to manage pain effectively if anxiety is not the primary factor.
Choice B rationale:
Anxiety activates the sympathetic nervous system, which triggers the "fight-or-flight" response. This cascade of physiological changes includes:
Increased heart rate and blood pressure Muscle tension
Dilated pupils
Heightened awareness of bodily sensations
These physiological changes can amplify pain signals and lower the pain threshold, meaning that a person who is anxious may perceive pain more intensely than someone who is calm and relaxed.
This is because anxiety can reduce the effectiveness of the body's natural pain-inhibiting mechanisms, such as the release of endorphins and serotonin.
Choice C rationale:
Difficulty sleeping can also contribute to pain, but its effect on pain threshold is less direct than that of anxiety. Sleep deprivation can lead to:
Increased irritability Decreased pain tolerance Impaired cognitive function
These factors can make it more difficult to cope with pain, but they don't directly lower the threshold at which pain signals are perceived.
Choice D rationale:
Pain threshold varies among individuals due to a variety of factors, including: Genetics
Past experiences with pain Psychological factors Cultural beliefs
Coping mechanisms
It is incorrect to assume that all patients who have had surgery will have the same pain threshold.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E"]
Explanation
Choice A rationale:
Intravenous theophylline (aminophylline) is a bronchodilator that can be life-saving in cases of anaphylactic shock with bronchospasm. It works by relaxing the smooth muscles in the airways, allowing for increased airflow.
Anaphylactic shock can cause severe bronchospasm, which can lead to respiratory failure and death. Theophylline can help to reverse bronchospasm and improve oxygenation.
The dosage of theophylline should be individualized based on the patient's weight and severity of bronchospasm. It is important to monitor the patient's heart rate and blood pressure while administering theophylline, as it can cause tachycardia and arrhythmias.
Choice B rationale:
Culturing the site of the bee sting and administering antibiotics is not appropriate in the acute management of anaphylactic shock. Anaphylaxis is an allergic reaction, not an infection. Antibiotics will not address the underlying cause of the reaction.
Antibiotics may be necessary if the patient develops a secondary infection at the site of the bee sting. However, this is not a priority in the acute setting.
Choice C rationale:
Providing sips of water to moisten the mouth and throat is not a priority in the acute management of anaphylactic shock. The patient's primary concern is likely to be difficulty breathing.
If the patient is able to drink, it is important to ensure that they are able to do so safely without compromising their airway. However, this is not a life-saving intervention.
Choice D rationale:
Diphenhydramine (Benadryl) is an antihistamine that can help to block the effects of histamine, one of the chemicals released during an allergic reaction. This can help to reduce symptoms such as swelling, itching, and hives.
Diphenhydramine can also help to prevent further release of histamine, which can help to stop the progression of the allergic reaction.
Diphenhydramine is available over-the-counter, but it is important to consult a healthcare professional before administering it to a patient in anaphylactic shock.
Choice E rationale:
Surgical management of the airway may be necessary if the patient's airway becomes compromised due to swelling. This could include intubation or a tracheostomy.
It is important to be prepared for surgical airway management in case it is needed. Early preparation can help to prevent delays in treatment and improve the patient's chances of survival.
Correct Answer is B
Explanation
Choice A rationale:
The spinal cord plays a crucial role in pain transmission, but it does not initiate the afferent pathways. It receives pain signals from nociceptors and relays them to the brain for processing.
The spinal cord is also involved in pain modulation, as it can dampen or amplify pain signals depending on various factors. However, it is not the primary trigger for pain sensation. That role belongs to nociceptors.
Choice B rationale:
Nociceptors are specialized sensory receptors that detect potentially damaging stimuli, such as intense heat, pressure, or chemical irritants.
They are located throughout the body, including the skin, muscles, joints, and internal organs.
When nociceptors are activated, they generate electrical signals that travel along nerve fibers to the spinal cord and brain. This process initiates the afferent pathways, which ultimately lead to the conscious perception of pain.
Nociceptors are essential for protecting the body from harm. They alert us to potential dangers and trigger responses that help us avoid injury or further damage.
Choice C rationale:
Endorphins are natural pain-relieving substances produced by the body. They act on receptors in the brain and spinal cord to reduce pain perception.
However, endorphins do not trigger the afferent pathways. They work by modulating pain signals that have already been initiated by nociceptors.
Choice D rationale:
The cortex is the outer layer of the brain that is responsible for higher-level functions, such as thinking, feeling, and decision- making.
It plays a role in the conscious experience of pain, but it does not trigger the afferent pathways.
The cortex receives pain signals from the spinal cord and processes them, leading to the awareness of pain.
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