Post op pain management Flashcards
- decreased mobility
- increased risk of infection
- atelectasis and pneumonia
- increased risk of venous thromboembolism
- impaired bowel function
- chronic pain syndromes
Complications related to uncontrolled pain
Each person’s pain is ______
Use same pain ____ each time
unique, scale
So pain can’t be compared on 2 patients with the same surgery. Each will have their own ______.
experience
What are the most common pain meds for moderate to severe pain post op ?
morphine
hydromorphone
fentanyl
Post-op meds should be given ____
IV
____ route is painful and has unpredictable absorption with pain meds
IM
______ has the fastest onset among pain meds
Fentanyl
______change from IV to po medications after patient is taking po without nausea.
Gradual
______ needs to be able to physically push the button and mentally able to understand when, why and how to push the button with a PCA
Patient
With PCA as well as with any narcotics given after surgery, monitor for _______.
respiratory depression
Splinting incision
Relaxation
Distraction
non medication pain relief measures
______ are often used after surgery in combination with opoids
NSAIDS
Teach patient to ______ incision when coughing. Remember patient must cough, turn and deep breathe! If they hurt too much they will avoid.
splint
Patients generally given___ pain medication at first after surgery. IM injections aren’t given as often. ____ medication works quickly and is more dependable (in timing) than IM injections which can be different depending on patient’s muscular build etc.
IV
Pain medication should be given ______ pain is severe. It should be given a bit ______ getting patient up to walk/changing dressing etc that will cause pain.
before
____ puts a patient at higher risk of respiratory depression.
OSA
Common adverse reactions of ______ include nausea, vomiting, delirium, hallucinations and constipation. Constipation will not decrease with tolerance so measures should be taken to prevent.
Itching may be controlled by antihistamines
Post op nausea and vomiting are unfortunate consequences of surgery
Assure patients afraid of becoming addicted that it is very rare when used in patients for surgical pain control
opoids
Prescreening for obstructive sleep apnea
Monitor rate, depth and quality of respirations
Sa02 should be monitored but is often a late sign- pulse ox may still read normal
Monitor sedation
Common adverse reactions of opoids
complications that can be associated with narcotic medication
Danger signs of ______ include:
* falling asleep in the middle of a conversation
* unable to arouse
* hypoventilation (decreased respiratory rate)
* apnea
* unable to participate in activities of daily living.
oversedation
t/f: A person that is awake sitting up in the bed having a normal conversation is not going to be one that is having trouble with respiratory depression related to narcotics.
true
Obtain an accurate medication -history, including over-the-counter medications, herbals/supplements, -recreational drugs, and alcohol.
Ask about medication allergies, including type of reaction and circumstances surrounding the reaction.
Ask about average daily dosage of opioids. (For example, if the patient’s prescription is for hydrocodone one to two tablets every 4 to 6 hours as needed, how many tablets does the patient normally take per day?)
Include the patient in the care plan.
Use a multimodal approach to pain -management.
Have a nonjudgmental attitude.
pain history questions
May use _____ in addition to narcotic pain medications.
NSAIDs
