Pain

Question 1

What population is at risk for inadequate pain control

Answer 1

Geriatrics

bc/ polypharmacy, chronic conditions

Question 2

What should the nurse think about when administrating a pain med or any med to a geriatric pt.?

Answer 2

Kidneys and liver not working at optical functional capicity

Question 3

If the pt. is able to self report pain what scales will the nurse use?

Answer 3

FACES, numerical

Question 4

If the pt. is not able to self report pain. What scale should the nurse use to assess their pain?

Answer 4

Checklist for Nonverbal Pain Indicators (CNPI)

Pain assessment in advanced Dementia Scale (PAINAD)

Question 5

The nurse just administered a PO opioid for pain. When should she come back to reassess pain?

Answer 5

30 min-1hr

Question 6

The nurse just administered Dilaudid IV push. When should the nurse return to assess if the pain med worked?

Answer 6

15-30 min

Question 7

Max dose of acetaminophen a pt. should take in one day

Answer 7

3000 mg or 3 g

Question 8

Norco

Answer 8

Hydrocodone and Acetaminophen

Question 9

Populations at highest risk for inadequate pain control

Answer 9

Older adults
Substance users
Those whose primary language differs

Question 10

Risk Factors for Respiratory depression

Answer 10

Obesity
Low body weight
Asthma
COPD
Sleep apnea
Meds
Advanced age

Question 11

Adjuvant Meds

Answer 11

Meds that increase effectiveness of other meds

Question 12

What population is at HIGHEST risk for inadequate pain relief

Answer 12

Pts that are not able to vocalize their pain

Question 13

Regional anesthetics

Answer 13

“Nerve blocks” often provide pain relief for 24-48 hr. after surgery

Question 14

Local anesthetics

Answer 14

Lidocaine patch

Long acting anesthetic that is injected into surgical area during surgery

Question 15

When should a Lidocaine patch be changed?

Answer 15

every 12 or 24 hrs

Question 16

If a pt. has a Lidocaine patch administered at 0700 and is ordered change q12hr. When does the nurse take the patch off? When will a new patch be admin?

Answer 16

Take the patch off at 1900

Put new patch on at 0700

Question 17

Common SE of Opioids

Answer 17

Constipation
N/V
Pruritus (itching)
Sedation
Respiratory Depression

Question 18

Acetaminophen SE

Answer 18

Hepatotoxicity

No sedation

Question 19

What is the antidote for Acetaminophen?

Answer 19

Acetylcysteine

Question 20

True/False: Acetaminophen produces an anti-inflammatory response

Answer 20

False, acetaminophen does not produce an anti-inflammatory response

Question 21

NSAID SE

Answer 21

GI Bleeding

Renal toxicity

Question 22

Antidote for opioid overdose

Answer 22

Naloxone (narcan)

Question 23

Pt. is taking Norco after discharge. The pt. expressed that sometime when the Norco doesn’t work she will take Tylenol until her next dose of Norco. What is the nurse’s response?

Answer 23

You should find a different PRN med in between Norco doses. Norco contains Tylenol as well and you should not exceed 3000 mg /day. Try an NSAID

Question 24

Pre-Emptive Analgesia

Answer 24

Tx that is initiated before the surgical procedure in order to reduce this sensation of peripheral and central nerve pathways

Question 25

Around the clock dosing is used for what kind of pain?

Answer 25

Moderate to severe Chronic

Question 26

The nurse is caring for a pt. who is a recovering narcotic abuser. The pt. has just undergone total hip reconstruction and denies any narcotics offered. What can effectively control this pt. pain?

Answer 26

Multimodal Analgesia

Ex. Tylenol, Tordol, and Gabapinton all 3 together instead of a narcotic may effectively manage the pt. pain

Question 27

When should pt. teaching about PCA be done?

Answer 27

PreOp

Question 28

True/False: An LPN is able to assess when the pt. is having respiratory depression

Answer 28

False, LPN cannot ASSESS anything. Should be assessed by RN

Question 29

Sedation Monitoring Scale: RASS scale acceptable level

Answer 29

Want a level of 0

But will accept +1 and -1

Question 30

What type of monitoring should be used when a pt. is using a PCA?

Answer 30

Capnography - measures exhaled CO2
Pulse Ox
Both TOGETHER!

Question 31

What can provide an early warning that the pt. has received too much pain medication and will be in respiratory depression soon?

Answer 31

Capnography

Question 32

True/False: 2 RN must perform and document double checks and verify orders per medication when programming a PCA

Answer 32

True, must have 2 RNs

Question 33

Background infusion of PCA

Answer 33

Usually isotonic fluid

Should be on Keep Vein Open setting (KVO) for optimal function

Question 34

Lock-Out Interval

Answer 34

Pre-set time in which the pt. cannot receive another bolus dose via the PCA despite pt. demand

Question 35

Hourly-Dose limit

Answer 35

A pre-set dosage limit that prevents the pt. receiving more than the designated amount of analgesia within a set amount of time
Only programmed if prescribed

Question 36

Meds that may be use in adjuvant with PCA

Answer 36

Acetaminophen and NSAIDS

Question 37

True/False: The nurse should Dilute IV push meds with 5 mL NS before admin

Answer 37

False, Nurse should NEVER dilute IV push meds

Question 38

What port should the nurse use for an IV push med?

Answer 38

Proximal port (closest to pt.)