IBD and Acute Pain - red Flashcards
Most important medications for Chron’s?
Immunomodulator/Biologics - Remicade and Humira
Chron’s:
- _____ _______ with medical or surgical intervention
not curable
Formation of numerous tiny pockets, or diverticular, in the lining of the bowel.
Diverticulosis
What is the difference between diverticulosis and diverticulitis?
Diverticulosis is the formation of diverticula, diverticulitis is the inflammation of the diverticula
What are the ideal characteristics for a stoma? Colour Shape Location of lumen Protrusion Abdominal placement
Colour - red, shiny, moist Shape, round, oval Location of lumen: center of stoma Protrusion - approximately 2.5cm Abdominal placement - smooth surface, below waist line
What is the most important sign/symptom of intestinal blockage?
Swollen stoma
Nurse’s role in effective pain relief:
- incorporates __-________ pain treatment measures in plan of care
- implements _________ interventions including ethnic/cultural practices that facilitate coping
- works with the interprofessional ___ to develop an individualized pain management plan
- ensures adequate ________ of dose and effects of pain medication/interventions
non-pharmacological
psychosocial
team
documentation
Nurse’s role in effective pain relief:
- ________ side effects of interventions
- Recognizes, and _________/_________ procedural or incident pain
- Monitoring _______ ___________ of pain management strategies
- Provides _________ to client/family about pain scales, medications, breakthrough dosing, AEs of medications, and use of non-pharmacological interventions
- Recognizes and ___________ off-label use of medications for pain management (e.g. antidepressants for neuropathic pain)
anticipates prevents/minimizes ongoing effectiveness education suggests
Pain is multidimensional and entirely ________.
Classified as ________ or _______, mixed or unknown origin.
Acute or persistent.
subjective
nociceptive
neuropathic
PAIN acronym assessment
- Pattern - e.g. onset and duration
- Area - helps determine cause and location
- Intensity - SEVERITY, pain scales helpful
- Nature - often the descriptions will dictate whether neuropathic (burning, cold, shooting, stabbing, itchy) or nociceptive (sharp, aching, cramping)
Pain treatment principles?
Every patient has the RIGHT to the best possible pain management
DOCUMENT pt and family teaching
A - Substituting one analgesic for another in the event that a particular drug is ineffective or producing side effects or when changing the administration route of opioids
B - Ongoing control, rather than providing analgesics after the patient’s pain has become moderate - severe
C - Dose adjustment based on drugs effects vs. AEs produced
A - equianalgesic dose
B - scheduling analgesic (i.e. around the clock rather than in response)
C - Titration
What are the rungs of the WHO analgesic ladder?
1 - non-opioid +/- adjuvant
2 - opioid for mild/moderate pain +/- non opioid +/-adjuvant
3 - Opioid for moderate to severe pain +/- non-opioid +/- adjuvant
______ or ______ pain from surgery, terminal or chronic illness should be anticipated and treated so the person does not have to suffer pain episodes.
Expected or predictable
When should ATC dosing be considered?
If more than 2-3 doses of breakthrough are required in 24 hours and the PAIN IS NOT CONTROLLED
