Fundamentals of Nursing Q 390
Which client is most likely to receive opioids for extended periods of time?
A. A client with fibromyalgia
B. A client with phantom limb pain
C. A client with progressive pancreatic cancer
D. A client with trigeminal neuralgia
Correct Answer: C. A client with progressive pancreatic cancer
Cancer pain generally worsens with disease progression and the use of opioids is more generous. Opioids (narcotics) are used with or without non-opioids to treat moderate to severe pain. They are often a necessary part of a pain relief plan for cancer patients. These medicines are much like natural substances (called endorphins) made by the body to control pain. They were once made from the opium poppy, but today many are man-made in a lab.
Option A: Fibromyalgia is more likely to be treated with non-opioid and adjuvant medications. It is recommended to continue nonpharmacologic measures along with the use of medications for most patients with fibromyalgia. Some patients may, however, respond adequately to nonpharmacologic measures alone. The medications that have been well studied and consistently effective are certain antidepressants and anticonvulsants.
Option B: Phantom limb pain usually subsides after ambulation begins. Treatment, unfortunately, for PLP has not proven to be very effective. While treatment for RLP tends to focus on an organic cause for the pain, PLP focuses on symptomatic control.
Option D: Trigeminal neuralgia is treated with anti-seizure medications such as carbamazepine (Tegretol). The first-line treatment for patients with classic TN and idiopathic TN is pharmacologic therapy. The most commonly used medication is the anticonvulsant drug, carbamazepine. It is usually started at a low dose, and the dose is gradually increased until it controls the pain. It controls pain for most people in the early stages of the disease.