NRSG258 - part 4 Flashcards
Nociceptive pain – cont
Visceral
Muscle spasm
Nociceptive pain – cont. - Visceral
- Walls of organs – liver, pancreas
- Deep
- Diffuse
- Associated with N&V
Examples
- Bowel obstruction
- Major surgery
- Pain maybe referred
Nociceptive pain – cont - Muscle spasm
- Skeletal or smooth muscle
- Mediated by prostaglandins
- Worse on movement
Neuropathic pain
Primary lesion or dysfunction
- Inflammation
- Trauma
- Degeneration
Neuropathic pain - Occurs in
- Neuralgia
* Diabetic neuropathy
Neuropathic pain - Described as
Burning
Shooting
Tingling
Neuropathic pain - Does not respond well to
opioids and NSAIDs
Neuropathic pain - Adjunctive medication
Tricyclics
tramadol
ketamine
Post operative pain - severe
Hip replacement
Post operative pain - Moderate
Abdominal
Thoracic
Post operative pain - Less severe
Limbs
Post operative pain - Multimodal analgesia
Opioids Infusions PCA Peripheral nerve blocks Oral analgesia
Characteristics of drugs
Potency
Selectivity
Specificity
Characteristics of drugs - Potency
Amount of chemical to produce an effect
Characteristics of drugs - Selectivity
The narrowness of the range of actions on receptors, processes or tissues
Characteristics of drugs - Specificity
Relationship between its structure and its pharmacological action
Drug Classifications
Source Chemical formula or structure Pharmacokinetics Activity Mechanism of action Clinical use Body system affected Drug schedule Pregnancy safety Popularity Approved for sporting activities
Role of the nurse - medication
Assess patient and take medication history 6 rights of medication administration Identify problems Documentation of dose Safe storage on the ward Follow policies and procedures Education Refuse to administer
Adverse drug reaction
Any response to a drug which is noxious, unintended, and which occurs at doses normally (and appropriately) used in man for the prophylaxis, diagnosis, or therapy of a disease
Adverse drug event
Injury resulting from medical interventions related to a drug
Adverse effect
Unwanted effect that occurs in a different mechanism from the pharmacological effect and may or may not be dose related
Adverse drug reaction - Risk factors
Age Gender Multiple chronic conditions Renal insufficiency Hepatic disease Genetic factors History of past drug reactions Poly pharmacy – 5 or more drugs Multiple prescribers Chemical characteristics – large molecules Class of drug Route of administration Dose Duration Frequency
Opioid Analgesics
Morphine Pethidine Fentanyl Hydromorphone Oxycodone Tramadol Methadone
morphine
- Mimics the actions of enkephalins and endorphins
- Moderate to severe pain
- Chronic pain
- Increased GI tone
- Decreases peristalsis
