WVU NSG 460 Pain and Sedation
Exam 4 Content Questions and
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Pain Transmission Can be Blocked at a Number of Sites
1. At the Site of Injury
• NSAIDS, ice, splint
2. At Opiate Receptors In the Brain/Spinal Cord
• opiates
3. In the Peripheral and Spinal Nerves and Topically
• local anesthetics
4. In the Higher Brain
• massage, distraction, antidepressants, and sedatives
Pain Control
• for the most part it is good to mix different pain control methods
• better control with fewer side effects
• for example, ice + toradol + morphine
NSAIDS
• inhibit prostaglandins at the pain source
• may work better than opiates for musculoskeletal and spasmodic pain
Examples
• fever: acetaminophen, aspirin, ibuprofen
• inflammation: aspirin, naproxen
• dysmenorrhea: ibuprofen, naproxen
What is the appropriate dosage for children's ibuprofen?
10 mg/kg
Side Effects of NSAIDS
• GI distress/bleed
, • nephrotoxic
• platelet inhibitor
Can NSAIDS be used during pregnancy?
• they cannot be used during pregnancy
• however, acetaminophen is ok to use during pregnancy
Opiates
• bind to opioid receptors
• examples: morphine, fentanyl, dilaudid
Endogenous Opiates
• otherwise known as "natural opiates"
Examples
• stress/pain
• exercise
• laughter
• chocolate
• kissing/sex
• tanning beds
Demerol
• opiate
• not commonly used because it was found to cause seizures
Opiates in the Acute Setting
• small doses of IV opiates administered frequently offer the best pain control
with the fewest side effects
• morphine and fentanyl can be administered as constant IV infusions
• morphine is most often used with terminally ill patients
• fentanyl infusions are used in the ICU setting along with a sedative infusion
^i.e. fentanyl and propofol
PO Morphine
• when morphine is administered PO, it is administered in higher doses
Exam 4 Content Questions and
Answers Best rated A+ Guaranteed
Success Latest Update
Pain Transmission Can be Blocked at a Number of Sites
1. At the Site of Injury
• NSAIDS, ice, splint
2. At Opiate Receptors In the Brain/Spinal Cord
• opiates
3. In the Peripheral and Spinal Nerves and Topically
• local anesthetics
4. In the Higher Brain
• massage, distraction, antidepressants, and sedatives
Pain Control
• for the most part it is good to mix different pain control methods
• better control with fewer side effects
• for example, ice + toradol + morphine
NSAIDS
• inhibit prostaglandins at the pain source
• may work better than opiates for musculoskeletal and spasmodic pain
Examples
• fever: acetaminophen, aspirin, ibuprofen
• inflammation: aspirin, naproxen
• dysmenorrhea: ibuprofen, naproxen
What is the appropriate dosage for children's ibuprofen?
10 mg/kg
Side Effects of NSAIDS
• GI distress/bleed
, • nephrotoxic
• platelet inhibitor
Can NSAIDS be used during pregnancy?
• they cannot be used during pregnancy
• however, acetaminophen is ok to use during pregnancy
Opiates
• bind to opioid receptors
• examples: morphine, fentanyl, dilaudid
Endogenous Opiates
• otherwise known as "natural opiates"
Examples
• stress/pain
• exercise
• laughter
• chocolate
• kissing/sex
• tanning beds
Demerol
• opiate
• not commonly used because it was found to cause seizures
Opiates in the Acute Setting
• small doses of IV opiates administered frequently offer the best pain control
with the fewest side effects
• morphine and fentanyl can be administered as constant IV infusions
• morphine is most often used with terminally ill patients
• fentanyl infusions are used in the ICU setting along with a sedative infusion
^i.e. fentanyl and propofol
PO Morphine
• when morphine is administered PO, it is administered in higher doses
