LEC 2: Pain and Comfort in the Post-Op patient Flashcards
Patient Controlled Analgesia (PCA)
- Self- administration of opioid analgesic
- Push a button to release opioid by bolus via IV route
- Orders written by anesthesia
- Set up and monitored by RNs
What are key assessments that need to be done when a patient is using a PCA?
- Respiratory depression
- Sedation level
- Comfort level
- Oxygen saturation
How often are the opioid analgesic administered with a PCA?
Every 4 hours minimum
What drug do you give a patient is they go into respiratory depression due to opioids?
Naloxone
Epidural Analgesia
- Injection of anesthetic and narcotic agents into epidural space
- Can be continuous infusion and/or patient controlled boluses
- Orders written and set up by anesthesia
- Adjustments and assessments by RNs, under direction from anesthesia
What are key assessments that need to be done when giving a patient an epidural analgesia?
- Hart rate
- Respirations
- Blood Pressure
- Sedation level
- Comfort level
- Oxygen saturation
- Sensory levels
- Motor function
- Epidural site q4h
What is the sedation scale that is used for epidural assessment?
- S: Normal sleep, easy to rouse
- 0: Alert
- 1: Sometimes drowsy
- 2: Frequently drowsy, easy to rouse
- 3: Somnolent; difficult to rouse
What is the motor function scale that is used for epidural assessments?
- 2: No weakness
- 1: Some weakness of legs/feet
- 0: Unable to move leges/ feet
What is the sensory level assessment that is used for epidurals?
Dermatome levels; need the patient to describe both sides of body
Dermatomes
Area on the skin that us supplied by spinal nerve
How do you assess sensory level?
Touch patients skin with ice and run it up their body. Patient will feel warm at the parts that are “frozen”.
What is the role of the nurse regarding epidurals?
- Assessing the patient once the epidural is in
- Taking out the epidural
