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NSG 102 > Pain Management > Flashcards

Pain Management Flashcards

1
Q

nociceptive pain

A

caused by damage to body tissue

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2
Q

neuropathic pain

A

lesion, disease of NS

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3
Q

nociplastic pain

A

pain but there is nothing wrong

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4
Q

referred pain

A

pain in one area but perceived in another area
ex. heart attack pain in arm

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5
Q

PQRST

A

precipitating factors
quality
region
severity
time

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6
Q

what are NSAIDS

A

nonopioid analgesics that have an anti-inflammatory effect

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7
Q

NSAIDS contraindications

A

pt with bleeding disorders, infections, and pregnancy 20 wks+

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8
Q

all NSAIDS except aspirin…

A

increase risk of heart attack or strok

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9
Q

Ibuprofen (advil, motrin)

A
  • caution in older adults w GI disorders, PUD, hepatic or renal disease
  • GI BLEED major risk
  • dose: 400-800 mg
  • max dose 3.2 g
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10
Q

naproxen (aleve)

A
  • harder on stomach than ibuprofen
  • dose varies
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11
Q

ketorolac (toradol)

A
  • short term for mod/severe pain
  • treatment should not exceed 5 days
  • dont use if under age 17
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12
Q

acetaminophen (Tylenol)

A
  • safest
  • acute pain
  • assess liver function tests; hepatoxicity huge risk!
  • dose: 325-650 mg q4-6h
  • max dose: 4g/day
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13
Q

opioid analgesics

A
  • narcotics
  • for mod to severe nociceptive, neuropathic, and cancer related pain
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14
Q

opioid agonists

A

produces the analgesia

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15
Q

opioid antagonists

A

do not produce analgesia

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16
Q

opioid side effects

A

sedation, nausea, constipation, respiratory depression

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17
Q

what do you do if constipation persists while on opioids?

A

increase fluids & fiber, or administer laxative/stool softener

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18
Q

what do you do if respiratory depression occurs?

A

continuous pulse ox, may need naloxone, pasero opioid induced sedation scale

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19
Q

oxycodone

A

5mg-80mg q4-6hours
depends on immediate release vs. ER

20
Q

Methadone (dolophine)

A
  • may have advantages over other opioids
  • 5 to 100 hour half life
  • watch closely for excessive sedation
21
Q

norco

A

acetaminophen & hydrocodone

22
Q

percocet

A

acetaminophen & oxycodone

23
Q

Morphine

A

slow onset, long duration

24
Q

Fentanyl

A
  • 100x more potent than morphine
  • fast onset
  • measured in mcg
25
Q

Hydromorphone (dilaudid)

A
  • 10x more potent than morphine
  • used as an alternative to morphine , especially for acute pain
  • major concern for resp. depression
  • dose varies
26
Q

Naloxone (Narcan)

A
  • reverses effects of opioids
  • dose: 0.2-2mg
27
Q

physical dependence

A

normal response, occurs w/ repeated admin of opioids for several days

28
Q

tolerance

A

normal response, occurs w/ regular administration of opioids & consists of decrease in effect of opioid

29
Q

adjuvant analgesics

A

used for other purposes, can enhance opioid effects, may lessen anxiety regarding pain

30
Q

what is a PCA pump?

A

device that lets the pt decide when & how much of the medication they need

31
Q

most frequently used meds for PCA

A

morphine, fentanyl, hydromorphone

32
Q

PCA basal rate

A

continuous rate per hour

33
Q

PCA demand dose

A

what the pt can dose self w when hitting the button OVER the basal rate

34
Q

clinician bolus

A

amount of med the nurse may bolus on the PCA

35
Q

who should never touch a PCA pump?

A

the patient’s friends & family

36
Q

what should you monitor when a patient is on a PCA pump?

A

sedation & resp level q12h

37
Q

what is a patient usually on when using PCA?

A

continuous pulse ox

38
Q

what are the two important things to do when on PCA?

A
  • check dose every shift
  • double nurse sign off to load cartridge
39
Q

benefits to PCA pump

A
  • better pain control
  • need for less med
  • no waiting for nurse
  • sustained relief
  • pt can press button
40
Q

how long does regional anesthesia last?

A

4-12 hours

41
Q

what is regional anesthesia good for?

A

pain relief

42
Q

what is the S in the pasero opioid-induced sedation scale?

A

sleep, easy to arouse, no action necessary

43
Q

what does the 1 in the pasero opioid-induced sedation scale mean?

A

awake & alert, no action necessary

44
Q

what does the 2 in pasero opioid-induced sedation scale mean?

A

occasionally drowsy but easy to arouse, requires no action

45
Q

what does the 3 in the pasero opioid-induced sedation scale mean?

A

frequently drowsy & drifts off to sleep during conversation; decrease opioid dose

46
Q

what does the 4 mean in pasero opioid-induced sedation scale?

A

drowsy with no response to stimuli; stop opioid and use naloxone

47
Q

when would you give opioids?

A

pain 6-10

NSG 102 (11 decks)

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