NUR 198 EXAM 1
nurses role in caring for a client with hypophosphatemia
○ Oral phosphate
○ Diet education
○ Vitamin D
Hyperphosphatemia manifestations
Neuromuscular irritability and tetany (hypocalcemia)
Calcified deposition in soft tissue such as joints, arteries, skin,
kidneys, and corneas (can cause organ dysfunction)
nurses role in caring for a client with hyperphosphatemia
○ Give calcium citrate or carbonate
○ Laxative and diuretics
○ Diet education
Pain
• Acute: intense, defined period of time
• Chronic: longer than 6 months, interferes with daily activities
nociceptive pain
body tissue
- due to injury to tissues
- sharp, localized
- dull, throbbing, aching
neuropathic pain
,nerve pain
- due to injury to nerves
- burning, throbbing, numbing
interruption of pain transmission
Several target areas
- Peripheral level
- CNS level
Pharmacological
Nonpharmacological
pain assessment
○ Pain Scales
§ Faces, Numeric, non-verbal cues
§ OLDCART
○ Pain Goals and Reassessment
when nonpharmacological techniques are used
○ Used alone or in conjunction with pharmacotherapy
○ May allow for lower doses and possibly fewer drug-related adverse
effects
nonpharmacological therapies
○ Acupuncture
○ Biofeedback
○ Massage, therapeutic or physical touch
○ Heat or cold
○ Meditation or prayer
○ Relaxation
○ Art or music therapy
○ Chiropractic manipulation
○ Hypnosis
,○ TENS
○ Energy therapies such as Reiki and Qi gong
classes of pain medication
§ Opioid Analgesic (affects central nervous system)
□ PCA, patient controlled analgesia
§ Non Opioid Analgesic (does NOT affect central nervous system)
○ Multimodal Pain Management
§ Combo of pharm and non-pharm
opioid
Natural or synthetic morphine-like substances responsible for
reducing moderate to severe pain
§ Suppressing the cough reflex
§ Slowing the motility of the GI tract
§ Powerful CNS depressants (sedation can either be therapeutic or a
side effect)
opioid agonist
stimulates receptors
opioid antagonist
blocks receptors
narcotic
a drug affecting the central nervous system, which can cause nausea
and vomiting
adverse effects: respiratory depression, sedation
opioids for pain: high effectiveness
, - fentanyl: assess RR/BP, slow IV push to prevent muscle/chest wall
rigidity
- hydromorphone (Dilaudid): 6-8 times stronger than morphine
- morphine (MS Contin): administer slow IV push
fast administration of opioids can cause what?
increased respiratory depression, hypotension, circulatory collapse
opioids for pain: moderate effectiveness
- codeine
- oxycodone (oxytocin)
opioid antagonist medications
naloxone (Narcan): Primary use: to reverse respiratory depression
and other acute symptoms of opioid addiction, toxicity, overdose
□ IV: 0.4mg, may repeat q2-3 min
□ Onset 1-2min, Peak unknown, Duration 45min
□ Administer over 30 sec.
nonopioid analgesics
○ Used for fever, inflammation, and analgesia
○ Used for mild or moderate pain associated with inflammation
Include NSAIDs, acetaminophen, and a few centrally acting drugs
nonopioid analgesic medication
○ Acetaminophen (Tylenol-PO) (Ofrimev-IV)
§ Therapeutic Class: antipyretic
§ PO: 325-650mg q 4-6 hr (DO NOT EXCEED 4g/day)
§ Adverse effects: GI Bleeding, Hepato-toxicity -liver, renal failure
§ Side effects: rash, constipation
NSAIDs/ Non-Opioids Analgesics
nurses role in caring for a client with hypophosphatemia
○ Oral phosphate
○ Diet education
○ Vitamin D
Hyperphosphatemia manifestations
Neuromuscular irritability and tetany (hypocalcemia)
Calcified deposition in soft tissue such as joints, arteries, skin,
kidneys, and corneas (can cause organ dysfunction)
nurses role in caring for a client with hyperphosphatemia
○ Give calcium citrate or carbonate
○ Laxative and diuretics
○ Diet education
Pain
• Acute: intense, defined period of time
• Chronic: longer than 6 months, interferes with daily activities
nociceptive pain
body tissue
- due to injury to tissues
- sharp, localized
- dull, throbbing, aching
neuropathic pain
,nerve pain
- due to injury to nerves
- burning, throbbing, numbing
interruption of pain transmission
Several target areas
- Peripheral level
- CNS level
Pharmacological
Nonpharmacological
pain assessment
○ Pain Scales
§ Faces, Numeric, non-verbal cues
§ OLDCART
○ Pain Goals and Reassessment
when nonpharmacological techniques are used
○ Used alone or in conjunction with pharmacotherapy
○ May allow for lower doses and possibly fewer drug-related adverse
effects
nonpharmacological therapies
○ Acupuncture
○ Biofeedback
○ Massage, therapeutic or physical touch
○ Heat or cold
○ Meditation or prayer
○ Relaxation
○ Art or music therapy
○ Chiropractic manipulation
○ Hypnosis
,○ TENS
○ Energy therapies such as Reiki and Qi gong
classes of pain medication
§ Opioid Analgesic (affects central nervous system)
□ PCA, patient controlled analgesia
§ Non Opioid Analgesic (does NOT affect central nervous system)
○ Multimodal Pain Management
§ Combo of pharm and non-pharm
opioid
Natural or synthetic morphine-like substances responsible for
reducing moderate to severe pain
§ Suppressing the cough reflex
§ Slowing the motility of the GI tract
§ Powerful CNS depressants (sedation can either be therapeutic or a
side effect)
opioid agonist
stimulates receptors
opioid antagonist
blocks receptors
narcotic
a drug affecting the central nervous system, which can cause nausea
and vomiting
adverse effects: respiratory depression, sedation
opioids for pain: high effectiveness
, - fentanyl: assess RR/BP, slow IV push to prevent muscle/chest wall
rigidity
- hydromorphone (Dilaudid): 6-8 times stronger than morphine
- morphine (MS Contin): administer slow IV push
fast administration of opioids can cause what?
increased respiratory depression, hypotension, circulatory collapse
opioids for pain: moderate effectiveness
- codeine
- oxycodone (oxytocin)
opioid antagonist medications
naloxone (Narcan): Primary use: to reverse respiratory depression
and other acute symptoms of opioid addiction, toxicity, overdose
□ IV: 0.4mg, may repeat q2-3 min
□ Onset 1-2min, Peak unknown, Duration 45min
□ Administer over 30 sec.
nonopioid analgesics
○ Used for fever, inflammation, and analgesia
○ Used for mild or moderate pain associated with inflammation
Include NSAIDs, acetaminophen, and a few centrally acting drugs
nonopioid analgesic medication
○ Acetaminophen (Tylenol-PO) (Ofrimev-IV)
§ Therapeutic Class: antipyretic
§ PO: 325-650mg q 4-6 hr (DO NOT EXCEED 4g/day)
§ Adverse effects: GI Bleeding, Hepato-toxicity -liver, renal failure
§ Side effects: rash, constipation
NSAIDs/ Non-Opioids Analgesics
