HCC 2008 Pain Management
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| What are the three main types of pain? | show 🗑
|
||||
| show | Recent onset, usually associated with a specific injury, indicates damage or injury has occurred; draws attention to its existence, lasts from seconds to 6 weeks, stimulates the stress response which negatively affect health status
🗑
|
||||
| show | faster recovery and improved outcomes
🗑
|
||||
| Tell me about Chronic Pain. | show 🗑
|
||||
| What are some adverse effects of chronic pain? | show 🗑
|
||||
| Tell me about Cancer Related Pain. | show 🗑
|
||||
| What are some other ways to classify pain? | show 🗑
|
||||
| show | Headache, pelvic pain, chest pain
Helpful in communicating and treating pain
🗑
|
||||
| Etiology classification? | show 🗑
|
||||
| show | pain often referred to an amputated leg where receptors and nerves are clearly absent is a real experience for the patient
🗑
|
||||
| Harmful effects of pain | show 🗑
|
||||
| show | Pulmonary, Cardiovascular, GI, endocrine and immmune systems
🗑
|
||||
| How does acute pain affect those systems? | show 🗑
|
||||
| show | Suppress immune function (Physiologic response), may promote tumor growth, over time can cause depression, anger, fatigue, and disability, may result in high does of opioid medications to control chronic, progressive pain
🗑
|
||||
| What are some common misconceptions? | show 🗑
|
||||
| show | It doesn't matter whether or not you believe the client is in pain. You have an ETHICAL and LEGAL obligation to act on what the client says, regardless of how you feel
🗑
|
||||
| Pain Categories include ___, ____, ____, _____, ______, | show 🗑
|
||||
| You better know cutaneous...moving right along to somatic...what is it? | show 🗑
|
||||
| show | occurs when organs are abnormally stretched and becomes inflamed: abdominal area an chest
🗑
|
||||
| What is neuropathic pain | show 🗑
|
||||
| show | painful sensation perceived in a missing body part
🗑
|
||||
| Tell me what intractable means | show 🗑
|
||||
| What is referred pain? | show 🗑
|
||||
| Threshold | show 🗑
|
||||
| show | transduction, transmission, perception, modulation (TTPM)
🗑
|
||||
| show | activation of pain receptors; involves conversion of painful stimuli into electrical impulses that travel from the periphery to the spinal cord at the dorsal horn.
🗑
|
||||
| show | pain sensations from the site of an injury or inflammation are conducted along pathways that have been rather clearly defined in certain areas but are still somewhat unclear in other areas to the spinal cord and then on to higher centers
🗑
|
||||
| ***Bonus****What is Perception? | show 🗑
|
||||
| show | process where the sensation of pain in inhibited or modified
🗑
|
||||
| What is the Gate Control Theory | show 🗑
|
||||
| The gate is opened or closed depending on ____ | show 🗑
|
||||
| show | Increased activity in small fibers opens gate
🗑
|
||||
| show | increased activity of large fibers
🗑
|
||||
| When stimuli to the brain surpass the threshold limit, ______ | show 🗑
|
||||
| show | culture, ethnicity, family, gender, age, religious beliefs, environmental and support, anxiety, and other stressors, past experience
🗑
|
||||
| Behavioral responses to pain? (What do you do when you're in pain?) | show 🗑
|
||||
| Physiologic responses to pain? | show 🗑
|
||||
| show | AVOID IM, you know those kids are scared as hell of those needles.....if you can give it to them PO, IV, or epidurally
🗑
|
||||
| show | milligrams of medication per kilograms of weight
🗑
|
||||
| show | No, some medications are contraindicated in children due to safety or dosage issues
🗑
|
||||
| Instruments for assessing pain | show 🗑
|
||||
| show | pain is an expected outcome of aging
🗑
|
||||
| show | pain is often under reported- fear of not being seen as a good patient
🗑
|
||||
| show | respiratory depression, excessive sedation, confusion. Use cautiously if debilitated or if there is hepatic, renal, or respiratory impairment
🗑
|
||||
| Pain Diagnosis | show 🗑
|
||||
| show | Relieve pain and suffering; improve the quality of life
🗑
|
||||
| show | Determine the client's need, strengths, and resources. Discuss where the nearest pain center is located. Remember to document the plan on the client's record
🗑
|
||||
| You know about implementing and evaluating....i'll put it on here anyways | show 🗑
|
||||
| show | drugs used to relieve pain. Reduce an individual's perception of pain and alters the person's discomfort.
🗑
|
||||
| show | Opioids (narcotics), non opioids, and adjuvant drugs
🗑
|
||||
| What is used to treat moderate to severe pain? | show 🗑
|
||||
| show | Inhibit the release of substance "P" in the peripheral and central nerves by reducing the perception of pain sensation in the brain. Provide a sense of euphoria by binding to opiates receptors. Binds to opiate receptors in the CNS
🗑
|
||||
| What do opioids produce? | show 🗑
|
||||
| Schedule I of controlled narcotics | show 🗑
|
||||
| Schedule II of controlled narcotics | show 🗑
|
||||
| show | Intermediate potential for abuse: codeine+acetaminophen, hydrocodone+acetaminophen
🗑
|
||||
| Schedule IV of controlled narcotics | show 🗑
|
||||
| show | minimal abuse potential: codeine cough syrup, lomotil
🗑
|
||||
| Morphine | show 🗑
|
||||
| Fentanyl | show 🗑
|
||||
| Meperidine | show 🗑
|
||||
| Routes of Analgesic Administration | show 🗑
|
||||
| show | When the route of a drug is changed the dose must also be changed to prevent over or under-dosage
🗑
|
||||
| show | respiratory depression, sedation, hypotension, nausea and vomiting, constipation, pruritis, urinary retention
🗑
|
||||
| What are some nursing implications? | show 🗑
|
||||
| What are some opioid antagonists (antidote) | show 🗑
|
||||
| show | derugs that are used to reverse the effects of opioid agonists: they block or reverse analgesia, CNS and respiratory depression. Compete for opiate receptor site in the brain
🗑
|
||||
| Adjuvant Drugs | show 🗑
|
||||
| show | Anticonvulsants - dilantin, tegretol
Corticosteroids - Decadron, medrol (reduce swelling)
Antidepressants - Elavil, Tofranil (nerve pain)
SSRI - prozac, Paxil
🗑
|
||||
| What is addiction? | show 🗑
|
||||
| What is Tolerance? | show 🗑
|
||||
| show | Withdrawal symptoms may occur if medication is stopped. Withdraw slowly to avoid.
🗑
|
||||
| Principles for Administering Analgesics | show 🗑
|
||||
| show | Ongoing assessment, Nurse must evaluate whether medication is working or not- if not get changed, monitor for adverse effects; timing: need to know peak action of drug; administer in timely fashion at regular intervals
🗑
|
||||
| show | Before pain becomes severe
🗑
|
||||
| Acute Pain Management - Surgery | show 🗑
|
||||
| show | frequent regular dosing intervals in early post op period, then PRN
🗑
|
||||
| Advantages of Post op pain management | show 🗑
|
||||
| Chronic Pain Management Goals | show 🗑
|
||||
| show | Medicate client around the clock rather than PRN; If possible, give meds orally. Allow client control of med regimen whenever possible.
🗑
|
||||
| show | 1. NSAID or acetaminophen
2. Add opioid analgesic to above
3. Increase potency of opioid
🗑
|
||||
| PCA pumps are designed with what? | show 🗑
|
||||
| What is the most frequently prescribed analgesic? | show 🗑
|
||||
| What is the most frequent route when using a PCA pump? | show 🗑
|
||||
| show | Consistent analgesic blood level maintained; the client decides when doses of opioid is needed. Medication is administered IV, therefore, absorption is faster and more predictable. The client tends to USE LESS medication.
🗑
|
||||
| Why does the client use less medication when on a PCA pump? | show 🗑
|
||||
| show | Initial loading dose
🗑
|
||||
| Contiuous dose | show 🗑
|
||||
| lockout interval | show 🗑
|
||||
| show | Check for allergy; monitor VS, sedation level, pain control, s/e, verify correct settings on pump with other RN, observe IV site for infiltration, monitor the client q2h for 1st 24 hrs. Have benadryl and narcan available, teach pt and fam how to use pump.
🗑
|
||||
| show | may be administered topically or mucous membranes; sub q into or near surgical site to relieve post op pain; via epidural catheter
🗑
|
||||
| Who administers an epidural cathether? | show 🗑
|
||||
| How is the epidural administered? | show 🗑
|
||||
| Nursing Responsibilities for Epidural catheter | show 🗑
|
||||
| What complications/ side effects do you look for with an epidural catheter? | show 🗑
|
||||
| Non-Opioid Analgesics | show 🗑
|
||||
| show | liver toxicity, rash; antidote mucomyst; precautions; do not exceed 4 grams per day
🗑
|
||||
| NSAIDS | show 🗑
|
||||
| What are NSAIDS used for? | show 🗑
|
||||
| show | anti-inflammatory, antipyretic, analgesic: prostaglandin inhibitor, Cox-2 inhibitor (celebrex)
🗑
|
||||
| NSAID s/e | show 🗑
|
||||
| show | Aspirin hypersensitivity/allergy
History of bleeding disorders, ulcer, severe kidney, liver, or heart disease
🗑
|
||||
| Nursing Implications: NSAIDS | show 🗑
|
||||
| show | Medicate with 50-75% of the normal average adult dose then increase as necessary
Observe closely for over medication
Discourage self medication
Monitor for behavioral changes that may be due to Meds
🗑
|
||||
| show | imagery, relaxation, distraction, humor, music therapy, cutaneous stimulation, Tens unit, hypnosis, accupressure, therapeutic touch, biofeedback, heat and cold
🗑
|
||||
| Ethical issues regarding Pain Management | show 🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
lcano2288
Popular Nursing sets