WVU NSG 460 Exam 4 Review | Questions With 100% Correct Answers | Verified

What treatment is used to block pain transmission at the Site Of Injury: - NSAIDS, Ice, Splint What treatment is used to block pain transmission In The Brain, Spinal Cord: - Opiates What treatment is used to block pain transmission in The Peripheral And Spinal Nerves And Topically: - Local Anesthetics What treatment is used to block pain transmission in The Higher Brain: - Massage, Distraction, Anti- depressants, (Sedatives?) Do we like to mix different pain control methods for our patients? why? - yes, better control with fewer side effects Examples of NSAIDs - Ibuprofen, naproxen, indomethacin, ketorolac, diclofenac What is the proper Ketorolac (toradol) Dosage - 60 mg IM / 30 mg IV What is the proper Children's dose of Ibuprofen - 10 mg / kg Where do NSAIDs work and how? - They inhibit prostaglandins at the pain source. Which kind of pain is better treated with NSAIDs than opiates? - musculoskeletal and spasmodic ("crampy") pain Three big side effects of NSAIDs - 1) GI distress / bleed 2) nephrotoxic 3) platelet inhibitorsCan you take NSAID in pregnancy? - No. Contraindicated especially in 3rd trimester What are some advantages of acetaminophen? - NO SEDATION, OK IN PREGNANCY Is acetaminophen anti-inflammatory? - nope What are opitates? - opium and its derivatives, such as morphine and heroin; they depress neural activity, temporarily lessening pain and anxiety What are Endorphins? - ("endogenous morphine") --natural, opiatelike neurotransmitters linked to pain control and to pleasure. What are some famous "triggers" that stimulate the body to release these natural opiates??? - 1) stress / pain 2) exercize 3) laughter 4) chocolate 5) kissing / sex 6) tanning beds Opiate Dose per KG IV Morphine: HYDROMORPHONE (Dilaudid): MEPERIDINE (Demerol): FENTANYL (Sublimaze): - Morphine: 0.1 mg HYDROMORPHONE (Dilaudid): 0.015 mg MEPERIDINE (Demerol): 1 mgFENTANYL (Sublimaze): 1-2 mcg Average Adult IV Opiate Dose Morphine: HYDROMORPHONE (Dilaudid): MEPERIDINE (Demerol): FENTANYL (Sublimaze): - Morphine: 2-4 mg HYDROMORPHONE (Dilaudid): 0.5-1 mg MEPERIDINE (Demerol): 25-50 mg FENTANYL (Sublimaze): 25-50 mcg Which regimen is best to offer the best pain control with the fewest side effects? - small IV doses of Opiates Administered Frequently ex PRN Q4 Dilaudid 0.5 mg IV push In the Acute Setting Morphine And Fentanyl Can Be Administered As - Constant IV Infusions. Which kind of patient most often has orders for Morphine? - Terminally Ill patients Which kind of Infusions Are Used In The ICU Setting Usually Along With A Sedative Infusion? - Fentanyl When Morphine Is Administered PO, what happens to the dosage? What's the 'rule'? - it increases The "Rule" Is 3 Times Higher Dose If Given PO.(bc FIRST PASS EFFECT) Opioids Side Effects (7) and Treatments - 1) Decreased mental status: stimulate. Narcan if severe 2) *Respiratory depression: stimulate. Narcan if severe 3) Hypotension: not as common as is feared. (Why does it happen?) TX: Venous vasodilation Give fluids 4) N/V: PHENERGAN (SLEEPIER?!) ZOFRAN IS SAFER 5)CONSTIPATION: FLUIDS, STOOL SOFTENER 6) URINARY RETENTION: STRAIGHT CATH; FOLEY 7) PRURITIS: BENADRYL