PCA Flashcards
What do the orders for a PCA administration have included?
- drug and it’s concentration
- PCA dose
- demand dose interval
- lockout interval (amount of drug in a specific amount of time)
How often do you do VS, pain assessment, and sedation score for a patient on a PCA?
30min x2 then every hour x3, then every 4 hours
Your patient is on a PCA and has a respiration rate less than 8, what do you do?
- admin Narcan
- if needed, use bag-valve-mask
Continuous epidural analgesia is used for patients who have…?
Thoracic, Abdominal, and Orthopedic surgery…. and of course pregos
Highest acceptable dermatome level?
T4
Patients with a PCEA and reporting back pain or lower extremity weakness may be a sign of what?
epidural hematoma pressing against the spinal cord
Patient with PCEA reports pruritus, what causes this and what is the treatment?
itching is a common side effect of opioid analgesics and Benadryl is given
What is a intrathecal migration of the catheter?
catheter migrates from the epidural space into the spinal fluid
symptoms and signs from intrathecal migration of the catheter?
motor block, higher sensory levels, hypotension/bradycardia, total spinal anesthesia, apnea, unresponsiveness, lethargy, respiratory
what is a intravascular migration of the catheter?
the catheter migrates into an epidural vein
Symptoms and signs of an intravascular migration of the catheter?
perioral numbness, dizziness, agitation, confusion, lethargy, seizures, increasing levels of pain
Color and solution of PCEA?
Yellow and preservative-free solutions
Your patient is on PCEA and is hypotensive, why?
vasodialation secondary to Bupivacaine that blocks sympathetic vasoconstrictor fibers
Tx for patient with PCEA who is hypotensive?
- prepare for fluid admin (NS bolus)
- maby start a vasoconstrictor (epi)
