pain, anxiety, and delirium

Question 1

T/F. The Acute Pain Service (APS) should be established and be an integral part of casualty care starting at the role 1

Answer 1

false

Question 2

T/F sedation should be optimized as a priority over pain control

Answer 2

false

Question 3

adjuncts can greatly increase patient safety and the effectiveness of narcotics to treat pain while reducing side effects. What are examples of adjuncts?

Answer 3

acetaminophen, ketamine, non-steroidal anti-inflammatory drugs (NSAIDs), continuous peripheral nerve infusions, and continuous epidural infusions

Question 4

If is it not feasible to incorporate the APS into trauma rounds, then the APS is responsible for ______ pain rounds, pain management consults, and reports to the trauma team leader

Answer 4

daily

Question 5

what is scoring system for the assessment of pain?

Answer 5

DVPRS

Question 6

what is scoring system for the assessment of anxiety?

Answer 6

RASS

Question 7

what is scoring system for the assessment of delirium?

Answer 7

CAM

Question 8

the goal for patients with delirium is to achieve a delirium free state as measured by the _______

Answer 8

cam

Question 9

the ABCDEs should be incorporated into treatment care plans as efforts to prevent delirium in critically injured patients. The E stands for__

Answer 9

early exercise

Question 10

T/F. Seriously injured patients who are not intubated should be assesses every 1-4 hours for the presence of pain.

Answer 10

True

Question 11

T/F. Adequate early pain control has been shown to reduce post-traumatic stress disorder and ongoing pain control is an obligatory part of trauma care.

Answer 11

true

Question 12

____________, in parenteral doses of 0.15-0.3 mg/kg, has been shown to reduce pain scores, total narcotic use, and need for rescue medication when used with morphine for acute pain control.20

Answer 12

ketamine

Question 13

what is not a narcotic agent of choice approved for repeated patient controlled analgesia pump?

Answer 13

meperidine (demerol)

Question 14

T/F. low molecular weight heparin (LMWH) use in patients undergoing epidural anesthesia greatly increases the risk of epidural hematoma, which can lead to paralysis.

Answer 14

true

Question 15

what are the medications used to treat anxiety and agitation?

Answer 15

clonidine

Question 16

T/F. continuous dosing of analgesics and anxiolytics, as opposed to intermittent dosing, has been shown to reduce the duration of mechanical ventilation and continuous dosing of analgesics and anxiolytics should be instituted prior to intermittent dosing.

Answer 16

false, flip the continuous and the intermittent

Question 17

Continuous infusions should be stopped ______ to obtain a reliable physical examination, including neurologic assessment, and to perform a spontaneous breathing trial in ventilated patients.

Answer 17

daily

Question 18

__________is a safe antiemetic in the adult population and is increasingly the therapy of choice for acute undifferentiated and trauma-related nausea.

Answer 18

Ondansetron