J: Pain- Lauer Flashcards
“LOCATES” for pain evaluation, what does it stand for?
L-Location O-Other associated symptoms C- Character of the pain A-Aggravating and alleviating factors T-timing, duration, pattern E- Environment where the pain occurs S- Severity of the pain
“PAPA” for extended pain evaluation
P: Past history with pain medications
A: Allergies to medications
P: preconceived notions
A: Anticipated course
What are the four components of “total pain” concept?
P- physical pain
A- anxiety
I- interpersonal interactions
N- Non-acceptance
What is a the goal of pain treatment?
To match the pain curve/pattern as closely as possible: timing, duration, and pattern
constant vs. break through pain
What is meant by “the pain code”
Pain is an emergency!!!
Get them as comfortable as fast as possible, and don’t walk away until under control
What is “pain code” dosing for enteral opiates?
Look at maximum blood concentration, peaks about in one hour
If patient still in pain, give another dose (don’t wait for the 4 hour half life to adjust dosage)
If your patient is awake and talking to you, are they overdosed?
NO!
How do opiates kill people?
Respiratory depression
What is “pain code” dosing for parenteral opiates?
Look at maximum blood concentration, peaks in about 8 minutes IV (30 mins sub-q)
Avoid transdermal*
How often should patients on a long-acting drug be using their break-through medication?
Around 3 times
How should you adjust dosing if patients are needing to take their short acting drug many times?
Long-acting drug dosage needs to be increased
How should you adjust dosing if patients are needing to “stack” their short acting?
Need to increase the dose of the short acting
What are benefits to doing “pain code” dosing?
Safe Very low risk of overdose Stacking doses Allows the patient to become comfortable faster Avoids periods of no relief
What do you multiply IV morphine dosage by to get ORAL morphine?
x3
What do you multiple hydromorphone IV dosage by to get oral Hydropmorphone?
x5
