Pain

Question 1

The american pain society in collaboration with the american society of anesthesiologist recommendations for post-op clients include:
Acetaminophen/nsaids

Regional anesthetic

Neuraxial analgesia

Multimodal therapy

Answer 1

Acetaminophen/NSAIDS if there are no contraindications

Surgical-site specific peripheral regional anesthetic for procedures

Neuraxial analgesia aka epidural for major throracic and abdominal procedures if clients has risk for cardiac complications or prolonged ileus

Multimodal therapy which includes other types of medications and other therapies

Question 2

Gabapentin

Corticosteroids

Hydromorphone

Lorazepam

Answer 2

Antiepileptic drug but is also used to treat diabetic neuropathy

Corticosteroids are for pain associated with inflammation

Strong opioid and not the first choice for chronic pain

Is an anxiolytic

Question 3

Factors at greatest risk for respiratory depression receiving opioids?

Answer 3

Older adult clients

Opiate-naive clients

Underlying pulmonary disease like (cystic fibrosis)

Question 4

Pain titrations

Smallest dose to relieve pain

Titrated upward

Downward titration

Answer 4

This is done to control pain

This is done for severe pain, until controlled

Downward titration occurs when pain begins to subside

Question 5

Pain patch (fentanyl)

Heat can

Rotate the site

Dont reuse

Answer 5

Heat can increase the release of medication and could result to sudden overdose (like hot tubs)

Rotate sites to prevent irritation of skin

Dont reuse patch because it gives less pain relief

Question 6

IV metoclopramide and prochlorperazine and subcutaneous sumatriptan are recommended for

Sumatriptan should not be used if

Dexamethasone increases

Answer 6

Adults with first time onset of migraine

Ergotamine,dihydroergotamine or other triptan medications has been used in past 24 hours due to additive effect of narrowing of blood vessels

Glucose levels

Question 7

Placebos are considered

Answer 7

Unethical. But in research clients are aware of possibility of placebo being used. So report to charge nurse for advice and suggestions and the charge nurse will locate hospital policy

Question 8

If pain is constant, best schedule to give pain meds is

Answer 8

Around the clock, to provide steady analgesia and pain control

Question 9

Medical use of opioids does not

Withholding does not

Answer 9

Cause addiction

For addicted clienta, withholding medications does not resolve addictive behavior

Question 10

SBAR stands for

Answer 10

Situation. The nurse identifies self and clients name then describes the situation

Background. Relevant background information such as the clients diagnosis,medications, laboratory datas

Assessment. Includes both nurses client assessment and analysis of situation

Recommendation. Indicating what the nurse thinks is needed