Pharm Chapter 17 Flashcards
What is a visual analog pain scale?
May be as simple as a scale from 1-10 with 10 being the worst pain imaginable or a line where the patient indicates their pain is, or a faces scale with smiling and frowning faces
Assessing pain in a dementia Pt.
Some pts are not capable of effective communication (dementia Pts, young children, those w/mental conditions). If you have an elderly pt with dementia they may not be able to verbalize their pain. Look for grimacing and tears, and other that they may be in pain
Name a condition what would merit use of a PCA
Cancer, post surgery
Define Loading dose
Single dose to achieve analgesia in the therapeutic window
Define Demand dose
amount of drug delivered each time patient activates PCA
Define Lockout interval
required time interval where PCA pump will not deliver an additional dose (usually 10-15 min range)
Define Background infusion rate
continuous infusion combined with PCA for patients who are sleeping
In what ways do the pumps push the medications to the Pts?
syringe driver, cassette systems, peristalsis
What errors are possible w/PCA pumps what you should look for?
Operator Errors, Patient Errors, and Mechanical Errors
Operator Errors
mis programming device, failure to clamp/unclamp tubing, improper loading of syringe, not responding to alarms, or losing the key to pump
Patient Errors
Abusing the analgesics, not understanding the pump or PCA therapy
Mechanical Errors
failed drug delivery, cracked vials/syringes, defective valves, faulty alarms, or malfunctions
How can Total demands be used to determine efficacy of PCA in controlling pain?
How many times you’re pushing the button. If the pt is still pushing the button during a lockout, their pain might not be well controlled.
What types of drugs can provide “opioid sparing” effects in PCA?
Ketorolac, droperidol, ketamine *low dose naloxone local anesthetics, bupivacaine or ropivacaine.
Name potential routes of administration for PCA
IV, epidural, transdermal
Most common is IV
