Advanced Med-Surg Principles Jersey
College Exam 1
What would help reduce complications related to pain for patients? - provide a PCA
How do we administer around the clock pain relief for post-op and chronic pain? - provide
analgesics, never wait for chronic pain to reoccur
What is pain is associated with? - actual or potential tissue damage
When pain stimulates the sympathetic nervous system, what does it result in? - - increase in BP
- increase in HR
- increase in RR
Where are catecholamines released from? - adrenal medulla
Where are steroid hormones (cortisol & aldosterone) released from? - adrenal cortex
What does unrelieved pain lead to? - - increases glucagon production
- decreases insulin secretion
- depress immune function
- can lead to addictive behaviors
What initiates inflammation, contributes to tissue sweeling, and pain? - Prostaglandins
What can nerve root injury lead to? - allodynia (pain that is associated with non-noxious stimuli)
What is needed for renal blood flow? - Prostaglandin
,Pain is? - whatever the patient says it is
What is the single most reliable indicator of pain? - the patient's self-report
How do NSAID's preimarily produce pain relief? - by preventing prostaglandin formation
What does acetaminphen not have? - any inflammatory properties
What do you manage nociceptive pain with? - - local anesthetics
- non-opioids
- opioids
What does 0 on the 0 - 10 numeric pain rating scale indicate? - no pain
What does the Wong-Baker FACES pain scale consist of? - cartoon faces that the patient (ages 3
and up) selects to report thier pain level
What does the visual analog 10cm scale represent? - no pain to the worst pain, the patient marks
a spot somewhere in between indicating their pain level
What during labor increases the risk of neonate aquiring acute encephalitis? - active herpes
simplex virus-2
How do you administer meds? - starting with the lowest dose and titrating up slowly
What pain scale helps indiviuals describe the intensity of pain? - verbal descriptor scale
What does a comprehensive pain assessment consist of? - - duration (when it started/lasted)
- type (intensity/assoc factors/influencing fators)
,- location
What patients do we avoid the rectal route for med administration? - thrombocytopenic
What type of effect do topical agents produce? - local
What type of effect do transdermal agents produce? - drug absorption into the systemic
circulation
What is provided for mild to moderate pain? - aspirin or acetaminaphen
What is provided for moderate pain? - NSAID's
What is provided for severe pain? - morphine
Why would you wake patients who have chronic pain or who have moderate to severe pain folowing
surgery? - to administer prescribed analgcsics
What can excessive use of acetaminophen cause? - hepatoxicity
What does of acetaminophen could lead to hepatoxicity? - 4,000 mg/day
What can NSAID's meds result in? - - gastric ulcers
- contribute to CV events (MI or stroke)
What can the use of NSAID's lead to in patients with volume depletion or who take it for chronic pain? -
acute renal failure
What undesirable effects do opioids produce? - - constipation
, - nausea
- pupil constriction
- respiratory distress
Physical dependence and tolerance are not the same as what? - addiction
Why do you never apply heat over a transdermal patch? - it could increase absorption and result
in lethal complications
How should you manage neuropathic pain? - with adjuvant meds such as antidepressants or
anticonvulsants
What should not be used in a clincial practice that it would violate the nurse-patient relationship? -
placebos
What are some non-pharmacologic pain management strategies? - - physical modalities
- mind-body methods
- biologic and energy-based therapies
What are the clinical manifestations of hyponatremia? - - headaches
- seizures
- lethargy
- tachycardia
- decreased BP
- thready pulse
- hyperactive bowel sounds
- abdominal cramps
What are signs of hypoxia? - - restlessness
College Exam 1
What would help reduce complications related to pain for patients? - provide a PCA
How do we administer around the clock pain relief for post-op and chronic pain? - provide
analgesics, never wait for chronic pain to reoccur
What is pain is associated with? - actual or potential tissue damage
When pain stimulates the sympathetic nervous system, what does it result in? - - increase in BP
- increase in HR
- increase in RR
Where are catecholamines released from? - adrenal medulla
Where are steroid hormones (cortisol & aldosterone) released from? - adrenal cortex
What does unrelieved pain lead to? - - increases glucagon production
- decreases insulin secretion
- depress immune function
- can lead to addictive behaviors
What initiates inflammation, contributes to tissue sweeling, and pain? - Prostaglandins
What can nerve root injury lead to? - allodynia (pain that is associated with non-noxious stimuli)
What is needed for renal blood flow? - Prostaglandin
,Pain is? - whatever the patient says it is
What is the single most reliable indicator of pain? - the patient's self-report
How do NSAID's preimarily produce pain relief? - by preventing prostaglandin formation
What does acetaminphen not have? - any inflammatory properties
What do you manage nociceptive pain with? - - local anesthetics
- non-opioids
- opioids
What does 0 on the 0 - 10 numeric pain rating scale indicate? - no pain
What does the Wong-Baker FACES pain scale consist of? - cartoon faces that the patient (ages 3
and up) selects to report thier pain level
What does the visual analog 10cm scale represent? - no pain to the worst pain, the patient marks
a spot somewhere in between indicating their pain level
What during labor increases the risk of neonate aquiring acute encephalitis? - active herpes
simplex virus-2
How do you administer meds? - starting with the lowest dose and titrating up slowly
What pain scale helps indiviuals describe the intensity of pain? - verbal descriptor scale
What does a comprehensive pain assessment consist of? - - duration (when it started/lasted)
- type (intensity/assoc factors/influencing fators)
,- location
What patients do we avoid the rectal route for med administration? - thrombocytopenic
What type of effect do topical agents produce? - local
What type of effect do transdermal agents produce? - drug absorption into the systemic
circulation
What is provided for mild to moderate pain? - aspirin or acetaminaphen
What is provided for moderate pain? - NSAID's
What is provided for severe pain? - morphine
Why would you wake patients who have chronic pain or who have moderate to severe pain folowing
surgery? - to administer prescribed analgcsics
What can excessive use of acetaminophen cause? - hepatoxicity
What does of acetaminophen could lead to hepatoxicity? - 4,000 mg/day
What can NSAID's meds result in? - - gastric ulcers
- contribute to CV events (MI or stroke)
What can the use of NSAID's lead to in patients with volume depletion or who take it for chronic pain? -
acute renal failure
What undesirable effects do opioids produce? - - constipation
, - nausea
- pupil constriction
- respiratory distress
Physical dependence and tolerance are not the same as what? - addiction
Why do you never apply heat over a transdermal patch? - it could increase absorption and result
in lethal complications
How should you manage neuropathic pain? - with adjuvant meds such as antidepressants or
anticonvulsants
What should not be used in a clincial practice that it would violate the nurse-patient relationship? -
placebos
What are some non-pharmacologic pain management strategies? - - physical modalities
- mind-body methods
- biologic and energy-based therapies
What are the clinical manifestations of hyponatremia? - - headaches
- seizures
- lethargy
- tachycardia
- decreased BP
- thready pulse
- hyperactive bowel sounds
- abdominal cramps
What are signs of hypoxia? - - restlessness
