DONEskills- skills 1/2/3 Flashcards
underteeament when
older patients
older patients also
pain management
undertreament of pain may occur in critically ill patients due inability yo verbalize pain
older patients may be unable to verbalize pain
older pateints may also take other pain meds that can interfere with drug interactions
opioids
commonly
deaths
start w
follow
very commonly misused
over half of opiod death is related to legally acquired opioids
start with lowest effective dosage and no more then needed
follow up and discosntue if needed
physical dependence
state of
produced by
A state of adaptation that is manifested by a drug class–specific withdrawal syndrome
produced by abrupt cessation, rapid dose reduction, decreasing blood level of an opioid, and/or administration of a drug that can act as an antagonist.
Addictive behaviors include one or more of the following:
impaired
_ use
use despite
diminished
c
impaired control over drug use,
compulsive use,
continued use despite harm,
diminished recognition of problems related to one’s behavior,
and craving.
Drug tolerance:
A state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the effects of the drug over time.
Addiction
primary
dysfunction
A primary, chronic disease of brain reward, motivation, memory, and related neurocircuitry
Dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations.
administering pain meds
check
perform
patient
reassess
do what
prepare
provide
help
check MAR
perform hand hygiene
patient identifiers
reassess pain
hand hygiene and gloves
prepare analgesic
provide basic non pharm comfort
help in comfortable position and place call light in reach
purpose of iv therapy
provides
transfuses
administers
provides nutrition
transfuses blood products
adminster medications
The Pasero Opioid Sedation Scale (POSS)*
s
1
2
3
4
S = Sleep, easy to arouse
1 = Awake and alert
2 = Slightly drowsy, easily aroused
3 = Frequently drowsy, arousable, drifts off to sleep during conversation
4 = Somnolent, minimal-or-no response to physical stimulation
Remember—sedation precedes respiratory depression.
How to Administer Naloxone in an Emergency Setting:
When you find an individual who is suspected of overdosing:
attempt to
check for
V_ patient
give
if no
if no change
Attempt to waken patient. If no response, common signs of opioid overdose are constricted pupils, slow or no breathing, snoring sound, and blue, gray, or pale skin color.
- Check for pulse and respirations. Call 911.
- Ventilate patient (following CPR guidelines) for a few quick breaths (if the person is not breathing).
give them naloxone
If there is no breathing or breathing continues to be shallow, continue to perform ventilation while waiting for the naloxone to take effect.
- If there is no change in 3–5 minutes, administer another dose of naloxone and continue to ventilate the patient and initiate CPR if needed.
ways to adminster naloxone
affix
tilt
inject
Affix a nasal atomizer to the needleless syringe and then assemble the cartridge of naloxone (according to package directions).
- Tilt the individual’s head back and spray half of the naloxone into one naris (1 mL) and half into the other naris (1 mL).
- Inject 1 mL (100 units) of naloxone intramuscularly.
vascular access devices
to adminster
when selecting
to adminster iv solutions- vascular access devices is inserted into vein
when selecting appropriate vad- consider length of treatment and duration of device
Patient controlled analgesic
check
perform
check
explain
put
insert
wipe
secure
program
check mar
perform hand hygiene
check pt identifiers
explain to pt
put on gloves
insert drug into infusion device
wipe injection port
secure connection
program PCA pump
administer IV fluids carefully-isotonic
increased risk for fluid overload in renal or cardiac disease
administer IV fluids carefully-hypotonic
hypotonic can exacerbate a hypotensive state
