exam 3 study guide Flashcards
Understand alterations in discomfort, sensory and cognitive impairment and expected developmental goals across the lifespan; be able to apply this knowledge in making decisions about nursing interventions
very young and older adults are less able to tolerate higher intensities of pain and experience a longer period of hyperalgesia
Alterations in sensory function include sensory impairment, sensory overload, and sensory deprivation dt less blood in brain
cognition with normal aging are declines in performance on cognitive tasks
Understand therapeutic communication as it relates to developmental stages, discomfort and cognitive impairment
talking up to people, always using mr mrs. don’t speak down to kids.
emphasizing balancing provider safety with patient comfort-use techniques to calm down/promote comfort
Speak directly to the person, Give the person time to respond,Ask what the person is still comfortable doing,Don’t exclude the person
Understand the use of different pain scales.
Numerical rating scales (NRS): Uses numbers to rate pain.
Visual analog scales (VAS): Asks you to select a picture that best matches your pain level.
Categorical scales: Primarily uses words, possibly along with numbers, colors, or location(s) on the body
Understand communication techniques for patients with a sensory impairment.
Turn your face towards the person and ensure your face is well-lit so your lip movements can be easily seen.
Don’t shout or over-exaggerate words or lip movements
Speak clearly and slightly slower, but keep the natural rhythms of your speech
Review the terminology associated with pain and the pathophysiology of pain.
Pain Threshold
Lowest intensity at which pain is experienced
Pain Tolerance
Point when a patient can no longer endure the pain
Medication Tolerance
Body becomes accustomed and needs a larger dose for pain relief
Breakthrough Pain
Pain that occurs in-spite of medical intervention / flare-up, often use PRN medications to treat
Dependence
Body becomes accustomed to opioid therapy and experiences withdrawal when stopped
Addiction
Inability to stop using a substance even though it causes physical harm – used for euphoric aspect in spite of pain resolving
Identify safety interventions for patients with sensory and cognitive alterations.
ncreased risk for falls and injury, so it is important to encourage basic safety features in the environment, including adequate lighting, availability of handrails and grab bars, hazard-free walkways, and appropriate settings on water heater controls.
Describe the nurse’s role in pain management.
effectively managing the patient’s pain through assessment, intervention and patient advocacy.
Identify nursing strategies for caring for patients with Alzheimer’s.
Obtain thorough history and physical exam.
Assess neurological and psychiatric status.
Assess mood.
Check behavior, nutrition ability to dress.
Ensure adequate nutrition.
Ensure patient is oriented.
Provide structure and maintain schedule.
Assist with daily living activities
Review the safe use of PCA and narcotics.
Set to administer scheduled and/or on-demand dosing
Patient must press the button
Assess who is appropriate!!!
Assess patient AT MINIMUM every 4 hours
Continuous pulse-ox d/t increased risk for respiratory depression
Two RNs must check the settings!!!
Level of Consciousness (LOC)
Sedation Scale
Respiratory Status (rate/quality)
Side effects (nausea/constipation)
Level of pain
Vital signs
Identify characteristics of acute and chronic pain. Identify what nursing interventions can be implemented to help patients control pain.
happens suddenly, starts out sharp or intense, and serves as a warning sign of disease or threat to the body
long standing pain that persists beyond the usual recovery period or occurs along with a chronic health condition, such as arthritis.
Review pharmacological and non-pharmacological pain interventions
Non-pharmacological Interventions
TENS unit
Heat/Ice
Toileting / Making Comfortable
Quiet Environment / Hypnosis
Guided Imagery
Massage / Acupuncture
Exercise or Repositioning
Distraction (laughter, music, TV)
Non-opioid Analgesics or NSAIDs
Opioid Analgesics
Adjuvant or Co-analgesics
