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1 CE Test Hour

Managing Postoperative Pain

Contrada, Emily

AJN The American Journal of Nursing: January 2018 - Volume 118 - Issue 1 - p 35,47
doi: 10.1097/01.NAJ.0000529712.62848.79
Feature Articles
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Managing Postoperative Pain


To help nurses translate the recommendations of the American Pain Society's postoperative pain management guideline into clinical practice.

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After completing this educational activity, you should be able to

  • outline the context in which the new guideline emerged.
  • list several recommendations made by the guideline panel.
  1. Evidence suggests that what proportion of patients undergoing surgery will report adequate postoperative pain relief?
  2. fewer than half
    about two-thirds
    nearly three-quarters
  3. How many surgical patients will report moderate to severe postoperative pain?
  4. nearly 40%
    about 60%
    more than 80%
  5. Strong recommendations are those that
  6. apply to most patients in most circumstances.
    have some benefits that outweigh potential harms.
    contain an action that always relieves pain.
  7. Of the 32 recommendations in the 2016 postoperative pain management guideline from the American Pain Society (APS), how many were based on high-quality evidence?
  8. 4
  9. One of the recommendations for which the guideline panel found insufficient evidence to support or discourage was
  10. heat therapy.
    ice application.
    transcutaneous electrical nerve stimulation.
  11. An area that members of the guideline panel identified as providing insufficient evidence to inform clinical practice was
  12. use of patient-controlled analgesia.
    management of circumcision pain.
    delivery of organizational care.
  13. The Centers for Disease Control and Prevention (CDC) guideline for prescribing opioids for chronic pain makes no recommendation for
  14. postoperative use of opioids.
    the duration of opioid use.
    effective dosing of opioids.
  15. The CDC guideline's recommendation for limiting opioid prescriptions for acute pain is based on
  16. scientific evidence.
    clinical experience.
    gray literature.
  17. The Federal Pain Research Strategy planning committee devised a protocol with 5 key areas that help identify research priorities, one of which is
  18. recommendations specifically for neuropathic pain.
    the transition from acute to chronic pain.
    complementary and alternative approaches.
  19. The Joint Commission's revised pain standards stress the need to focus on
  20. professional collaboration.
    quality improvement.
    evidence-based care.
  21. According to the article, as an adjunct to other pain treatments, transcutaneous electrical nerve stimulation is
  22. supported by moderate-quality evidence.
    widely used in the clinical practice setting.
    not supported by the evidence at hand.
  23. The most recent version of the U.S. Food and Drug Administration “Blueprint for Prescriber Education for Extended-Release and Long-Acting Opioid Analgesics” represents a shift from a previous focus on
  24. risks.
    pain assessment.
    nonopioid analgesics.
  25. Which of the following recommendations from the APS postoperative pain management guideline is strong and is supported by high-quality evidence?
  26. Use a validated pain assessment tool to track postoperative pain treatment response and adjust the treatment plan.
    Offer multimodal analgesia for the treatment of perioperative pain in children and adults.
    Consider IV ketamine as a component of multimodal analgesia in adults.
  27. Choosing oral over IV administration of opioids for postoperative analgesia in patients who can use the oral route is a
  28. strong recommendation with moderate-quality evidence.
    strong recommendation with low-quality evidence.
    weak recommendation with moderate-quality evidence.
  29. Considering surgical site–specific local anesthetic infiltration for procedures with evidence indicating efficacy is a
  30. strong recommendation with moderate-quality evidence.
    strong recommendation with low-quality evidence.
    weak recommendation with moderate-quality evidence.
  31. Providing appropriate monitoring of patients receiving systemic opioids for postoperative analgesia is a
  32. strong recommendation with moderate-quality evidence.
    strong recommendation with low-quality evidence.
    weak recommendation with moderate-quality evidence.
  33. Which of these is not recommended according to the APS guideline?
  34. intrapleural analgesia with local anesthetics for pain control after thoracic surgery
    IV ketamine as a component of multimodal analgesia in adults
    anesthetics in combination with nerve blocks prior to circumcision
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