Post-op Pain Flashcards
Elderly client has abdominal surgery and reports there is no pain. What is the best intervention for the nurse to do?
Get patients up into sitting position to prep for ambulation. (if pt reports there’s no pain then there’s no symptoms to further discuss)
What assessment finding requires intervention when pt is 24 hrs post op from surgery?
24 UO of 300 mL (sign of decreased renal function)
Why is checking allergy status important for pain managment ?
It underscores the need for thorough allergy checking to avoid administration/medication errors.
What is pain?
Unpleasant sensory and emotional experience associated with actual/potential tissue damage. Its the most common reason seek medical care
Acute vs chronic pain?
AP- duration <3 months, rapid onset, continually changing, associated with injury/surgery, decreases with healing, emotional/ANS arousal, usually reversible
CP- >3 months, difficult to manage, serves no biological purpose, impacts quality of life, can lead to addiction/tolerance/dependency, lasts beyond time expected for healing (can last a lifetime)
What is cancer, procedural, nociceptive, and neuropathic pain?
C- persistent, result of tumor growth, cancer treatments cause acute pain
P- pain associated with medical procedures/surgeries, generally acute
Nociceptive- result of actual/ptoential tissues damage or inflammation, can be somatic (skin, MSK) or visceral (organ)
Neuropathic- pain sustained by abnormal processing of stimuli mechanisms driven by damage to the PNS/CND
Physiologic impact of pain?
Prolongs stress response, decreased GI motility, delays healing, causes immobility, decreases immune response, increases Hr/Bp/O2 demands
Quality of life impact on pain?
Interferes with ADLs, impairs fam/social/work relationships, causes anxiety/depression/anger/hopelessness
What is the most reliable indicator of pain?
Self report
Different ways to assess pain?
Self report for 8+ (on a scale from 0-10…), self report for ages 4+ (faces of pain scale), overs action for infants/adolescents with disability (FLACC- face, legs, activity, cry, consolability), and OPQRSTUV
Populations that pose challenges for pain?
Chronic pain, elderly, children, obesity, opioid naive, neurological disorders, and OSA
Interventions for pain?
Good pain assessment, around clock administration dosing, pain meds, non pharmacological ways, opioid (morphine, fentanyl, codeine…), PCA
Nursing assessment for pain?
Monitor certain VS for some medication (like RR or LOC), complete full head to toe assessment, and take caution when resuming opioids after they’ve been stopped for a period of time
S+S of respiratory depression b/c of opioids?
RR<12, snoring, shallow resp/chest expansion, decreased air entry, difficulty rousing pt, depressed response to hypoxia, decreased SpO2, unable to stay awake/falls asleep quickly
What to do if respiratory depression happens?
Ensure IV access, O2 running, attempt to rouse pt, if ordered give Narcan (monitor BP/HR/LOC q5minx3 then q15minx3). After narcan assess VS (can be tachycardia or HTN), assess for return of pain
T or F: morphine is standard against which all other opioid drugs are compared
True
What is Narcan used for?
To combat the effects of respiratory depression because of opioid overdose. It has a very short duration and when it wears off, pain/apnea can return.
