Medical surgical chapter 8 & 10 Flashcards
Placebos
Not justified in the treatment of pain
Who is at the center of the healthcare team?
the patient
Regulatory bodies that review pain management practices
The Joint Commission
Centers for Medicare and Medicaid Services
Agency for Healthcare Research and Quality
key areas of cultural expression
Language
Family engagement
Spirituality
Treatment preferences
risks of uncontrolled pain
Body produces a stress response that causes harmful substances to be released from injured tissue.
Reactions. (Breakdown of tissue
Increased metabolic rate
Impaired immune function)
Prevents patient from participating in self-care activities.
Acute pain
Lasts less than 3 months
Prompts an inflammatory response
Signs and symptoms are short-term, objective, physical (for example, increased heart rate)
chronic pain
Lasts more than 3 months
Signs and symptoms persistent
Nociceptive pain
tissue pain
neuropathic pain
nerve damage
Opioid antagonists
narcan
chain of infection
infectious agent reservoir portal of exit mode of transmission portal of entry susceptible host
Microbiota
Microbes occurring naturally in a body part
Pathogen
Disease-causing microbe
Body’s Defense Mechanisms
Skin and mucous membranes Cilia Gastric acid Immunoglobulins Leukocytes and macrophages Lysozymes Interferon Inflammatory response
Sepsis
Can lead to septic shock:
decreased blood pressure
Laboratory Assessment
labs for infection
Gram staining Culture and sensitivity (C&S) Antibody test Complete blood count (CBC) with differential Erythrocyte sedimentation rate (ESR)
who is at greatest risk for infection?
older adults
early signs of localized infection
red
pain
heat
swelling at the sight
early signs of systemic infection
Tachycardia, hypotension
zika virus
mosquitos
pregnant women
will not isolate
spread through unprotected sex
Ebola virus
west Africa ELISA- is the test unexplained bleeding and bruising body fluids, fruit bat isolate them
mono
EBV- is the herpes simplex
no sex/contact sports
rest periods
enlarged spleen
direct transmission
touching, kissing, or sexual intercourse
indirect transmission
soiled bedding, food, surgical instruments, toys, water, and wound dressings.
most common infection of from surgical wounds
staph
most common organism of UTI
e.coli
for possible infection
CBC with differential
culture and sensitivity- 24 to 48 hours
do not give an antibiotic before
spores
can live 30 days on surfaces
bleach
soap and water not sanitizer
kill with heat
C diff pt.s are what kind of precaution
contact
spores
c-diff
elevated wbc
elevated fever
liquid stool
red man’s syndrome
caused by vancomycin
burning red rash
droplet precautions
add gown. 3 feet away (in life 6 feet).
airborne precautions
N95
sick patients can wear what? when being transported around the hospital
surgical mask
ex. TB
pt.’s receives morphine and within 4 hours is still in pain. What do you do?
fast acting opiate
assess respirations before administering a
opioids
pupils are constricted when they overdose on
opioids
antidepressant for nerve pain
amitriptyline
PCA can a pt. overdose?
no
assess for pain
vital signs
facial expressions
normal systolic
100 to 120
normal dystolic
60 to 80
normal range of temperature
97.6 to 99.4
normal respirations
12 to 20
normal pulse ox
90 to 100
nsaids cause
gastric bleeding
black tarry stools
in a community setting how do you promote prevention of infectious diseases?
hand hygiene, vaccines, not sharing personal items, cough in your elbow, cook food, proper food handlings.
biofeedback technique
monitor/headphones – helps you recognize stress, massage, heat, ice, reading, meditation, guided imagery, music, animal therapy, TV
what are analgesics adjuvants?
corticosteroids-prednisone
benzodiazepines-valium
antidepressants-cymbalta
anticonvulsants -gabapentin
airborne disease processes
TB, chickenpox, measles
droplet disease processes
flu, and diphtheria
only drug that can kill you from withdrawal
alcohol
Wearing pain patch
never cover, no windowpane cover, or use lotion on area. Alternate sites, initial date and time. End of shift make sure it is present before you leave.
Contact disease processes
impetigo, c-diff, MRSA
pt. does not respond to PRN. What do you do?
call pcp
get regular medication
Tegretol
is a anti-convulsant
