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Management of pain in patients on hemodialysis.

1. Rates of hemodialysis patients experiencing pain has been reported to be as high as:

a) 25%

b) 50%

c) 58%

d) 84%

2. A recent American study reported almost two-thirds of study patients received opioid prescriptions at least:

a) once annually

b) twice annually

c) monthly

d) quarterly each year

3. Common causes of pain in hemodialysis patients include the following except:

a) polycystic kidney disease

b) recurrent needle insertion

c) renal osteodystrophy

d) hypertension

4. Barriers to adequate pain management in hemodialysis patients include all of the following except:

a) altered pharmacokinetics of drug and type of dialysis

b) language

c) prescriber expertise with pain assessment

d) patients' being generally unforthcoming with pain

5. Pain is associated with all of the following except:

a) decreased quality of life

b) increased hospitalization

c) inability to cope with stress

d) decreased cost to healthcare system

6. Which of the following assessment tools has not been validated in studies with hemodialysis patients?

a) Modified Edmonton Symptom Assessment Score

b) McGill Pain Questionnaire

c) Palliative Care Outcome Scale-Renal

d) Dialysis Symptom Index

7. Which of the following questions is not generally included during pain assessment:

a) quality

b) radiation

c) stinging

d) timing

8. NS is a 50-year-old male on hemodialysis. He is currently taking the maximum dose of acetaminophen, but is still experiencing moderate-severe pain, described as a burning sensation. After deciding to discontinue acetaminophen due to its ineffectiveness, which of the following is the most appropriate analgesic to initiate?

a) codeine

b) hydromorphone

c) pregabalin

d) fentanyl

9. AT is a 28-year-old female on hemodialysis. She was recently started on oxycodone for her pain. What adverse effect(s) would you monitor for?

a) constipation, nausea, respiratory depression

b) sedation, seizures, dizziness

c) all of the above

d) none, this medication is generally well tolerated

10. PR is a 70-year-old female on hemodialysis. She is currently experiencing some muscle pain on her right shoulder. She finds acetaminophen to be ineffective, and the team is hesitant to prescribe ibuprofen. Which of the following would be a reasonable option to recommend?

a) diclofenac 1.16% gel

b) lidocaine 5% cream

c) menthol cream

d) capsaicin 0.050% cream

By Rachel Liu and Marisa Battistella

Copyright [c] 2018 Canadian Association of Nephrology Nurses and Technologists

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Author:Liu, Rachel; Battistella, Marisa
Publication:CANNT Journal
Article Type:Report
Date:Apr 1, 2018
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