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Community And Wellness > Geriatrics: Pain, Perioperative Complications > Flashcards

Geriatrics: Pain, Perioperative Complications Flashcards

1
Q

What does immobility exacerbates?

A

Pain
*under diagnosed and undertreated
*fifth vital sign

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2
Q

What are acute and chronic types of pain?

A

Acute:
1. Sudden onset
2. Decreases or ceases as healing occurs
Goal: pain goes away with treatment
Chronic:
1. Insidious onset
2. Lasts more than 3-6 months
Goal: Maintain function and quality of life

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3
Q

What is nociceptive pain?

A
  1. Somatic pain
    *skin, bone, joint, connective tissue
  2. Visceral pain
    *Arises from internal organs
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4
Q

What is neuropathic pain?

A

Burning
Tingling
Shock-like

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5
Q

What are pain scale ratings?

A

Numeric rating scale
Verbal descriptor scale
Faces pain scale-revised

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6
Q

What are some physical therapies for pain?

A
  1. Heat or cold therapy
  2. Positioning
  3. Massage
  4. Acupuncture
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7
Q

What are some psychological therapies?

A
  1. Distraction
  2. Music
  3. Relaxation
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8
Q

If an elderly patient has mild pain how do you treat it?

A

With non-opioids
1. Acetaminophen
2. NSAIDs
3. Cox-2 inhibitors
4. Non-systemic therapies

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9
Q

What are some side effects of NSAIDs

A
  1. GI side effects
  2. HTN
  3. CHF
  4. Renal failure
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10
Q

If an elderly person has moderate pain how to treat it?

A

Mild opioids
1. Codeine
2. Hydrocodone
3. Oxycodone
4. Tramadol
*DO use if you have a history of seizures

*2 and 3 have Tylenol no extra Tylenol

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11
Q

What to use for severe pain?

A

Strong opioids
1. Morphine
2. Oxycodone
3. Hydro morphine
4. Fentanyl
5. Oxymorphone

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12
Q

What are drugs to avoid in elderly?

A

Meperidine
*Demerol

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13
Q

What are the safest drugs to use with renal failure?

A

Fentanyl
Methadone

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14
Q

What are drugs to avoid with renal failure?

A

Merperidine
Codeine
morphine

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15
Q

What are common opioid side effects?

A
  1. Constipation
  2. Dry mouth
  3. Nausea/vomiting
  4. Sedation
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16
Q

What opioid side effect can cause overdose?

A

Respiratory depression

17
Q

How to aid constipation?

A

Usually never resolves
*use stool softeners plus stimulants
*avoid bulking agents (Metamucil)

18
Q

How to treat nausea/vomiting?

A
  1. Metoclopramide
  2. Serotonergic blocking agents (Odansetron)
  3. Dopamminergic blocking agents (haloperidol, metoclopramide)
19
Q

What is the ASA score?

A

Subjective assessment of a patients overall health

20
Q

What is ASA I, ASA II, ASA III

A

ASA I: A normal healthy patient
ASA II: A patient with mild systemic disease
ASA III: A patient with severe systemic disease

21
Q

What is ASA IV, ASA V, ASA VI

A

IV: A patient with severe systemic disease that is a constant threat to life
V: A moribund patient who is not expected to survive without operation
VI: A patient who is already declared brain-dead

22
Q

When does neurological function return after a stroke?

A

First month

23
Q

What is acute phase of stroke rehbilitation?

A
  1. Change patient postilion every 2 hours
  2. Positioning to prevent contractures
  3. Positioning to prevent pneumonia
24
Q

What is later phase of stroke rehabilitation

A
  1. ADL training
  2. Ambulation training
    3, Muscle re-education
25
Q

What does occupational therapy focus on?

A

Functional abilities
*helps patients improve or adapt to their abilities to reform basic IADLs

26
Q

What does speech therapy help with?

A

Diagnoses and treats cognitive-communication and swallowing deficits

27
Q

What are pressure ulcers?

A

Damage caused to the skin and underlying soft tissue by unrelieved pressure
*compressed between bony prominence and external surface

28
Q

How to treat stages I and II pressure ulcers?

A
  1. Clean w/ warm saline or water
  2. Avoid pressure and moisture
  3. Cover open wounds with occlusive dressing
29
Q

How to treat stage III pressure ulcers?

A
  1. Debrief necrotic tissue
  2. Cleanse and dress
  3. Topical ATB
  4. Systemic ATB is cellulitis or sepsis
30
Q

How to treat stage IV pressure ulcer?

A
  1. Tissue biopsy for culture
  2. Systemic ATB
  3. May need surgical repair
31
Q

How to document pressure ulcers?

A
  1. Type, duration, setting
  2. Size
  3. color
  4. Exudate
  5. Odor
  6. Peri-wound tissues

Community And Wellness (39 decks)

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