HCC III FINAL EXAM SOLVED CORRECTLY TO
PASS!!
Guiding principles of pain management Answer - - Pain is what the pt. says it
is.
- State of physical ease, relief from discomfort.
- Pain appears differently for some pt., physical manifestations may not be the
same for all pt.s
Narcotics; Examples Answer - - Hydromophone (Dilaudid)
- Hydrocodone
- Fentanyl (Duragesic)
- Oxycodone
- Methadone
Narcotics: SE Answer - - Respiratory depression
- Sedation
- Nausea/Vomiting
- Constipation (give stool softeners)
narcotic reversal agent Answer - Naloxone (Narcan)
Narcotic: OD signs Answer - - Small constricted "pinpoint pupils"
- sedation
- Nausea and vomitting
,- Loss of consciousness
- Slow, shallow breath
- choking or gurgling sounds
- limp body,
- pale, or blue, or cold skin
Narcotic withdrawal symptoms Answer - - Abdominal cramping
- Diarrhea
- Restlessness
- Agitation
Non-Narcotic; Examples Answer - Acetaminophen
- Max dose 3000 mg, higher doses cause hepatotoxicity.
- Used in conjunction with opioids
NSAID; ibuprofen, Naproxen, Ketoralac, Celebrax.
SE; gastric ulceration, bleeding risk, and CV diseased > 60 years. Renal and
ototoxicity considerations
Antidepressants; Treat Pain Answer - - TCAs
- SNRI
- Duloxetine (Cymbalta)
- Venlafaxine (Effexor); used for neuropathic pain
Anticonvulsants; Treat Pain Answer - Gabapentic and Pregabalin used for
neuro pain
,Muscle relaxants; Treat Pain Answer - - Baclofen (Liorseal)
- Dantrolene Sodium (Dantrium)
- Diazepam (Valium)
Ketamine; Treat Pain Answer - Prevents pain via ascending pathways
PCA (Patient Controlled Analgesia) Answer - - Drug in pump self- administered
by pt.
- Not to be pushed by anyone but pt.
-Limits in place and monitored by pump.
- Pt. must be cognitively and physically able to administer
-Variety of drugs can be used, most commonly Morphine or Dilaudid.
PCA; Risks Answer - Risk of respiratory depression, and needs to be
continuously monitored.
- Pulse ox
- Capnography: measurement of respiratory rate and concentration of exhaled
carbon dioxide.
POSS Scale Answer - A POSS score of S, 1, or 2 indicates an acceptable level of
sedation
Ascore of 3 or 4 indicates over-sedation and the need for a reversal agent.
Actual Loss Answer - Can be recognized by others
- E.g.: death of a loved one.
, Perceived Loss Answer - Felt by person but intangible to others
- E.g: relocation to a nursing home
Physical loss/Psychological loss Answer - Amputation; Colostomy
Situational Loss Answer - Experienced as a result of an unpredictable event
E.g.; Job loss, financial loss, natural disaster
Anticipatory Loss Answer - Loss not yet taken but impending overwhelming
loss effect
E.g.: Terminal disease of a loved one, experienced by the patient, family, and
friends.
Complicated Grief Answer - Grief not diminished, prolonged, interferes with
life.
E.g.: Loss of a child, lasting longer than expected experienced when not having
worked through the grief work.
Perinatal Loss Answer - Newborn death
Rando Theory of Grief Answer - Recognize, React, Recollect and Re-experience,
Relinquish, Readjust, Reinvest
Therapeutic communication methods nurse-patient Answer - From Article;
- Ask-tell-ask
- Invitation to group/family to discuss emotions and medical situation.
PASS!!
Guiding principles of pain management Answer - - Pain is what the pt. says it
is.
- State of physical ease, relief from discomfort.
- Pain appears differently for some pt., physical manifestations may not be the
same for all pt.s
Narcotics; Examples Answer - - Hydromophone (Dilaudid)
- Hydrocodone
- Fentanyl (Duragesic)
- Oxycodone
- Methadone
Narcotics: SE Answer - - Respiratory depression
- Sedation
- Nausea/Vomiting
- Constipation (give stool softeners)
narcotic reversal agent Answer - Naloxone (Narcan)
Narcotic: OD signs Answer - - Small constricted "pinpoint pupils"
- sedation
- Nausea and vomitting
,- Loss of consciousness
- Slow, shallow breath
- choking or gurgling sounds
- limp body,
- pale, or blue, or cold skin
Narcotic withdrawal symptoms Answer - - Abdominal cramping
- Diarrhea
- Restlessness
- Agitation
Non-Narcotic; Examples Answer - Acetaminophen
- Max dose 3000 mg, higher doses cause hepatotoxicity.
- Used in conjunction with opioids
NSAID; ibuprofen, Naproxen, Ketoralac, Celebrax.
SE; gastric ulceration, bleeding risk, and CV diseased > 60 years. Renal and
ototoxicity considerations
Antidepressants; Treat Pain Answer - - TCAs
- SNRI
- Duloxetine (Cymbalta)
- Venlafaxine (Effexor); used for neuropathic pain
Anticonvulsants; Treat Pain Answer - Gabapentic and Pregabalin used for
neuro pain
,Muscle relaxants; Treat Pain Answer - - Baclofen (Liorseal)
- Dantrolene Sodium (Dantrium)
- Diazepam (Valium)
Ketamine; Treat Pain Answer - Prevents pain via ascending pathways
PCA (Patient Controlled Analgesia) Answer - - Drug in pump self- administered
by pt.
- Not to be pushed by anyone but pt.
-Limits in place and monitored by pump.
- Pt. must be cognitively and physically able to administer
-Variety of drugs can be used, most commonly Morphine or Dilaudid.
PCA; Risks Answer - Risk of respiratory depression, and needs to be
continuously monitored.
- Pulse ox
- Capnography: measurement of respiratory rate and concentration of exhaled
carbon dioxide.
POSS Scale Answer - A POSS score of S, 1, or 2 indicates an acceptable level of
sedation
Ascore of 3 or 4 indicates over-sedation and the need for a reversal agent.
Actual Loss Answer - Can be recognized by others
- E.g.: death of a loved one.
, Perceived Loss Answer - Felt by person but intangible to others
- E.g: relocation to a nursing home
Physical loss/Psychological loss Answer - Amputation; Colostomy
Situational Loss Answer - Experienced as a result of an unpredictable event
E.g.; Job loss, financial loss, natural disaster
Anticipatory Loss Answer - Loss not yet taken but impending overwhelming
loss effect
E.g.: Terminal disease of a loved one, experienced by the patient, family, and
friends.
Complicated Grief Answer - Grief not diminished, prolonged, interferes with
life.
E.g.: Loss of a child, lasting longer than expected experienced when not having
worked through the grief work.
Perinatal Loss Answer - Newborn death
Rando Theory of Grief Answer - Recognize, React, Recollect and Re-experience,
Relinquish, Readjust, Reinvest
Therapeutic communication methods nurse-patient Answer - From Article;
- Ask-tell-ask
- Invitation to group/family to discuss emotions and medical situation.
