NURS 440 Module 2 – Questions With A+ Answers
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Terms in this set (308)
EBP Pain Management in Critical Care -Patients report memory of pain
-Undermedication
-Lack of knowledge (assume part of CC illness; fear
addiction; fear pain)
pain can be related to what? illness
treatments
suctioning
turning
tubes
immobility
edema
acute & chronic
untreated pain is related to what? decreased healing
decreased immune system
lack of sleep
decreased coughing/deep breathing
what pain scale is used with standardized behavioral pain scale
intubated/ sedated patients
,assessing pain do it first
-If no physiological signs of pain, assess for anxiety,
nausea that may contribute to pain
-Determine acceptable level of pain
-Assess minimum every 2 hours in CC
-Re-assessment after any treatment -
pharmacological/non-pharmacological
-Self-Assessment of attitudes; pre-conceived ideas,
empathy
behavioral pain scale painless (3), mild (4-6), moderate (7-9), or severe (10-
12) pain; scores of 6 and higher of moderate-to-
severe pain require treatment
critical care pain observation tool painless (0), mild (0-3), moderate (3-6), or severe (6-
(CPOT) 8)
respiratory depression •No if RR <10
•assess Resp Rate & Depth, BP, HR before &
Breathing Ongoing
•assess pulse oximeter continuously (ETCO2)
•assess LOC & sedation before and ongoing
•assess Pain Severity & reassess
•Monitor q1-2 h
•Observe closely if snoring
Nurses should frequently assess for ___ respiratory depression & side effects
when giving opiates/ narcotics
Assess Closely before & after giving opiates/ narcotics
___ especially patients who SNORE or
have Obstructive Sleep Apnea (OSA)
,narcotic side effects •Sedation
•Hypotension
•Constipation
•N/V
•IV site
•Pruritis
Elderly
what should you assess before and Pain, respiratory depression, LOC, other effects
after giving narcotics
morphine action Depresses pain impulse transmission at the spinal
cord level by interacting with opioid receptors
morphine side effects respiratory depression
LOC
confusion
itchy skin
vertigo
N/V
constipation
morphine facts most common opioid prototype
water soluble
slow onset
long duration
1-2 mg IV every hour PRN (MI)
MONA Morphine
Oxygen
Nitroglycerin
Aspirin
hydromorphone (dilaudid) •Semi-synthetic opioid More Potent than morphine
(5-10 x more)
•Slower onset, longer duration
•0.25-1 mg per dose
•IV push, PCA, Spinal
, hydromorphone action Binds to opiate receptors in the CNS, alters
perception of and response to painful stimuli while
producing generalized CNS depression, suppresses
cough reflex
hydromorphone side effects Drowsiness, sedation
n/v/ anorexia
respiratory depression
constipation, cramps
orthostatic hypotension
confusion, headache
rash
fentanyl (sublimaze) •Opioid 100 more potent than morphine
•Lipid soluble; rapid onset, shorter duration
•25-50 mcg IV per dose
•IV push/drip, intraspinal, Duragesic Patch-72 hours
Fentanyl Action Binds to opiate receptors in the CNS, altering the
response to and perception of pain.
Fentanyl Side Effects Respiratory depression
Apnea
Rigidity of the diaphragm and intercostal muscles
Bradycardia
high risk for OD
chest wall rigidity
Narcan (naloxone) side effects pain
sweating
tachycardia
increased BP
addiction
overdose
narcan facts •0.4 mg in 10 mL NS
•Reverses respiratory depression
Save Groups
Terms in this set (308)
EBP Pain Management in Critical Care -Patients report memory of pain
-Undermedication
-Lack of knowledge (assume part of CC illness; fear
addiction; fear pain)
pain can be related to what? illness
treatments
suctioning
turning
tubes
immobility
edema
acute & chronic
untreated pain is related to what? decreased healing
decreased immune system
lack of sleep
decreased coughing/deep breathing
what pain scale is used with standardized behavioral pain scale
intubated/ sedated patients
,assessing pain do it first
-If no physiological signs of pain, assess for anxiety,
nausea that may contribute to pain
-Determine acceptable level of pain
-Assess minimum every 2 hours in CC
-Re-assessment after any treatment -
pharmacological/non-pharmacological
-Self-Assessment of attitudes; pre-conceived ideas,
empathy
behavioral pain scale painless (3), mild (4-6), moderate (7-9), or severe (10-
12) pain; scores of 6 and higher of moderate-to-
severe pain require treatment
critical care pain observation tool painless (0), mild (0-3), moderate (3-6), or severe (6-
(CPOT) 8)
respiratory depression •No if RR <10
•assess Resp Rate & Depth, BP, HR before &
Breathing Ongoing
•assess pulse oximeter continuously (ETCO2)
•assess LOC & sedation before and ongoing
•assess Pain Severity & reassess
•Monitor q1-2 h
•Observe closely if snoring
Nurses should frequently assess for ___ respiratory depression & side effects
when giving opiates/ narcotics
Assess Closely before & after giving opiates/ narcotics
___ especially patients who SNORE or
have Obstructive Sleep Apnea (OSA)
,narcotic side effects •Sedation
•Hypotension
•Constipation
•N/V
•IV site
•Pruritis
Elderly
what should you assess before and Pain, respiratory depression, LOC, other effects
after giving narcotics
morphine action Depresses pain impulse transmission at the spinal
cord level by interacting with opioid receptors
morphine side effects respiratory depression
LOC
confusion
itchy skin
vertigo
N/V
constipation
morphine facts most common opioid prototype
water soluble
slow onset
long duration
1-2 mg IV every hour PRN (MI)
MONA Morphine
Oxygen
Nitroglycerin
Aspirin
hydromorphone (dilaudid) •Semi-synthetic opioid More Potent than morphine
(5-10 x more)
•Slower onset, longer duration
•0.25-1 mg per dose
•IV push, PCA, Spinal
, hydromorphone action Binds to opiate receptors in the CNS, alters
perception of and response to painful stimuli while
producing generalized CNS depression, suppresses
cough reflex
hydromorphone side effects Drowsiness, sedation
n/v/ anorexia
respiratory depression
constipation, cramps
orthostatic hypotension
confusion, headache
rash
fentanyl (sublimaze) •Opioid 100 more potent than morphine
•Lipid soluble; rapid onset, shorter duration
•25-50 mcg IV per dose
•IV push/drip, intraspinal, Duragesic Patch-72 hours
Fentanyl Action Binds to opiate receptors in the CNS, altering the
response to and perception of pain.
Fentanyl Side Effects Respiratory depression
Apnea
Rigidity of the diaphragm and intercostal muscles
Bradycardia
high risk for OD
chest wall rigidity
Narcan (naloxone) side effects pain
sweating
tachycardia
increased BP
addiction
overdose
narcan facts •0.4 mg in 10 mL NS
•Reverses respiratory depression
