Philadelphia University
Second Term – 2012/2013
Critical Care Nursing _ Theory
1 st short exam
ID Number:------------------------------- Student’s Name:-----------------------------------------
1.
List three physiological cardiovascular consequences (or manifestations) of the unrelieved pain among surgical patients.
I.
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II.
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III.
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(Increased heart rate, increased blood pressure, unstable angina, myocardial ischemia, deep vein thrombosis).
2.
Discuss a mechanism by which the unrelieved pain may suppress (inhibit) the immunity of patients.
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(Increased cortisol levels suppress inflammatory and immune response, decreasing number of circulating leukocytes and inhibiting their ability to migrates by decreasing capillary permeability.
Cortisol also inhibits release of histamine and prostaglandins, which depresses phagocyte activity.
High cortisol levels inhibit production of cytokines essential for mounting an immune response (Interleukin-1)
3.
List three common myths that might be heard in clinical settings regarding pain and its management.
A.
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B.
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C.
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 (Physical and behavioral symptoms are more reliable than self-report for assessing the presence of pain and its intensity.
 Pain rating scales are not reliable measures of pain in children, elderly, or those with any cognitive impairment
 Complaints of pain that occur ion the absence of tissue damage are probably psychosomatic or psychogenic in origin.
 Pain intensity is directly related to the size of the wound or amount of tissue damage, suggesting a uniform pain threshold.
 The more frequent and severe pain the pain, the more tolerant patients become.
 Analgesics should be withheld until a definitive diagnosis is made, to prevent the masking of important symptoms.
 Cancer pain is more severe than non-cancer pain.
 Opioid abuse and addiction are common complications associated with the use of Opioid analgesics to manage acute and chronic pain.
 Response to placebo analgesic is a proof of malingering (lying).
 Infants do not require analgesics, as their neurologic system is too immature to recognize and transmit impulses.)
1.
What is/are health problems that should be ruled out before administering anit-diarrhial agnets to patients with diarrheia?
4.
Failure of the vomiting to relieve the nausea means that the nausea is caused by: a.
Pancereatitis b.
Gall bladder stone c.
Urinary tract infection d.
Gastric ulcer.