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Med Surg > Pain > Flashcards

Pain Flashcards

1
Q

What population is at risk for inadequate pain control

A

Geriatrics

bc/ polypharmacy, chronic conditions

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2
Q

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

A

Kidneys and liver not working at optical functional capicity

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3
Q

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

A

FACES, numerical

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4
Q

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

A

Checklist for Nonverbal Pain Indicators (CNPI)

Pain assessment in advanced Dementia Scale (PAINAD)

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5
Q

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

A

30 min-1hr

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6
Q

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

A

15-30 min

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7
Q

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

A

3000 mg or 3 g

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8
Q

Norco

A

Hydrocodone and Acetaminophen

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9
Q

Populations at highest risk for inadequate pain control

A

Older adults
Substance users
Those whose primary language differs

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10
Q

Risk Factors for Respiratory depression

A 
Obesity
Low body weight
Asthma
COPD
Sleep apnea
Meds
Advanced age
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11
Q

Adjuvant Meds

A

Meds that increase effectiveness of other meds

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12
Q

What population is at HIGHEST risk for inadequate pain relief

A

Pts that are not able to vocalize their pain

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13
Q

Regional anesthetics

A

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

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14
Q

Local anesthetics

A

Lidocaine patch

Long acting anesthetic that is injected into surgical area during surgery

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15
Q

When should a Lidocaine patch be changed?

A

every 12 or 24 hrs

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16
Q

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?

A

Take the patch off at 1900

Put new patch on at 0700

17
Q

Common SE of Opioids

A 
Constipation
N/V
Pruritus (itching)
Sedation
Respiratory Depression
18
Q

Acetaminophen SE

A

Hepatotoxicity

No sedation

19
Q

What is the antidote for Acetaminophen?

A

Acetylcysteine

20
Q

True/False: Acetaminophen produces an anti-inflammatory response

A

False, acetaminophen does not produce an anti-inflammatory response

21
Q

NSAID SE

A

GI Bleeding

Renal toxicity

22
Q

Antidote for opioid overdose

A

Naloxone (narcan)

23
Q

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?

A

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

24
Q

Pre-Emptive Analgesia

A

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

25
Q

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

A

Moderate to severe Chronic

26
Q

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?

A

Multimodal Analgesia

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

27
Q

When should pt. teaching about PCA be done?

A

PreOp

28
Q

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

A

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

29
Q

Sedation Monitoring Scale: RASS scale acceptable level

A

Want a level of 0

But will accept +1 and -1

30
Q

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

A

Capnography - measures exhaled CO2
Pulse Ox
Both TOGETHER!

31
Q

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

A

Capnography

32
Q

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

A

True, must have 2 RNs

33
Q

Background infusion of PCA

A

Usually isotonic fluid

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

34
Q

Lock-Out Interval

A

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

35
Q

Hourly-Dose limit

A

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

36
Q

Meds that may be use in adjuvant with PCA

A

Acetaminophen and NSAIDS

37
Q

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

A

False, Nurse should NEVER dilute IV push meds

38
Q

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

A

Proximal port (closest to pt.)

Med Surg (22 decks)

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