PATIENT CONTROLLED ANALGESIA EXAM QUESTIONS AND ANSWERS 2024

PCA therapy is based on what theory Patients will automatically regulate the delivery of analgesic to provide effective pain relief Titration of maintenance PCA doses are based on Pain and Sedation Scores When evaluating a patient to place on PCA therapy, what factors take into account? Patient age and psychological state Concurrent disorders Tolerance of Opiods Nurse is caring for patient after abdominal surgery. For pain control, dr orders PCA with morphine. What parameters monitor? Respiratory rate Blood pressure Amount of opioid used Pain level When loading syringe into cradle, insert syringe into cradle how? Plunger facing down Prime the last section of tubing after the y branch with maintenance fluid obtain 2nd verification of PCA order and programming on pump by checking dosage-demand dose, loading dose, continuous rate Administrative Mode Lock out Interval One/Four hour limit PCA is better than other analgesics because it relieves pain more quickly, more successfully and fewer side effects Effective pain management leads to benefits such as Earlier patient mobilization and recovery Shorter hospital stays Reduced costs The health care provider chooses what Chooses the analgesic med administered The dose Timing of the dose lockout The programmed lockout interval does what limits patient access to analgesic to present times, helps prevent overmedication What is the usual maximum dose 1-4 hour limit Compared to PRN dosing, PCA mode minimizes what Minimizes "peaks and valleys" Indications for PCA therapy Moderate to severe pain needing opioid med Pain anticipated to last more than 10-12 hours Patient willing to take control of analgesia Patient able to understand PCA concept Oral route not appropriate Procedural or post op pain Contraindications to PCA therapy Patient unwilling to participate in pain management Lack of staff training in PCA Patient unable to understand PCA concept Patient is sedated Physical impediments to pushing PCA button Opioids are contraindicated Loading dose Bolus dose delivered during setup or whenever a supplemental booster dose is needed 4 hour dose limit Dr selected value that limits the total amount of drug that can be delivered in any 4 hours period. When the SUM of all doses in any "rolling" 4 hour period equals or exceeds the 4 hour dose limit, the patient's request for additional demand doses will be unsuccessful Demand Dose Amount of med patient receives each time dose is self administered. Unmet Demands Patient pushes button but no dose delivered. Result of pushing button during lockout period Lockout Period Timing determined by physician/provider that allows patient to access drug at certain time intervals, ie every 10 minutes. Usual range of time is 6 to 10 minutes, based on physiological response time of the drug Continuous Rate (Basal Infusion) Amount of drug administered continuously per hour Drug concentration Standardized concentration of drug mg/ml solution Analgesia Insensibility to pain without loss of consciousness analgesic Agent for producing analgesia Bioavailability The rate and extent to which an active drug or metabolite is absorbed and made available at the site of action Potency Dose or concentration of a drug required to produce a given effect Pruritis Generalized and or Localized Itching PCA by proxy Someone other than the patient presses the button to inject a dose of pain med to patient. Morphine-advantages Inexpensive Morphine-Disadvantages-Onset Slower onset after an IV bolus dose (10-15 minutes) Morphine-Disadvantages-Causes what release Causes histamine release, use with caution in asthmatics Morphine-Disadvantage-The active metabolite results in The active metabolite, M-6-G, results in sedation, nausea, vomiting, and respiratory depression Morphine-Disadvantage-can accumulate in patients with what can accumulate in patients with renal or liver dysfunction Morphine-Disadvantages-can cause following side effects Nausea, Vomiting, pruritus, constipation, sedation, respiratory depression Hydromorphine-Dilaudid-Advantages-No active what? No active metabolites, so better for patients with renal or liver dysfunction Hydromorphine-Dilaudid-Advantage-sedating effect less sedating than morphine Hydromorphine-dilaudid-advantage-onset Intermediate onset Hydromorphine-Dilaudid-Disadvantage-Cost More expensiv