Using the WHO pain ladder, the nursing plan of care for a patient with chronic lower back pain should include which strategy?
A) Start with the first step and advance slowly up the ladder.
B) Treat breakthrough pain with a long-acting analgesic.
C) Administer an opioid and then slowly move back down the ladder.
D) Aim for complete pain control as the goal of therapy.
A) Start with the first step and advance slowly up the ladder.
Explanation: A) The WHO pain ladder is appropriate for the management of chronic pain. In contrast to acute pain, management of chronic pain starts at the first step and advances slowly up the ladder.
B) Breakthrough pain can occur randomly and suddenly; it needs to be treated with shorter-acting opioids while longer-acting medications continue to be used for the chronic pain.
C) The WHO pain ladder is appropriate for the management of chronic pain. In contrast to acute pain, management of chronic pain starts at the first step and advances slowly up the ladder.
D) The goal of chronic pain management is pain reduction, not pain elimination, and improved quality of life.
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