Pain Management and Surgical Patient

What are the four psychological factors influencing pain?

1. meaning of pain 2. anxiety 3. depression 4. coping style

How long do you wash your hands for surgical aspesis?

5 minutes -- 2.5 minutes on each hand

What are some surgical risk factors?

Age smoking obesity pregnancy

What are some types of pharmacological pain therapy?

Analgesics Patient controlled analgesics Perineural local anesthetic infusion local anesthetics epidural analgesics

What does ABCDE stand for?

Ask Believe Choose Deliver Empower and enable

What are some potential complications post-op

Atelectasis, pneumonia, hypoxemia, thrombus, UTI, nausea and vomiting

What vital signs elevate with pain?

BP and Heart Rate

What type of pain is not protective, occurs for more than 6 months, and may not have an identifiable cause?

Chronic/persistent noncancer pain

What is the disease that you need to make sure to inquire about prior to surgery?

Malignant hyperthermia

What is used for procedures that does not require complete anesthesia?

Moderate sedation (conscious sedation)

What is the device given to a pt usually after surgery where they are given a button that they can press to receive their meds?

PCA pump

What helps promote rehab for surgery patients?

Prehabilitation

What are the classifications for surgical procedures?

Seriousness Urgency Purpose

What is malignant hyperthermia?

Severe genetic side effect from general anesthesia, can be fatal

What is cellular damage from injury that results in the release of excitatory neurotransmitters?

Transmission

What is the role of the circulating nurse during surgery?

Verify patient identity review consent forms verify type of surgery aid pt comfort assess strategic body systems asess positioning of pt on OR bed

What is the pain scale that we use for kids called?

Wong-baker face scale

What type of pain usually follows an injury, disease or surgery and has a rapid onset?

acute pain

What are some factors that can influence pain?

age, fatigue, family and support, loss of independence, cultural beliefs

What is the group of drugs that relieve pain called?

analgesics

What are way to relieve cancer pain?

analgesics transdermal patches (lidocaine) continuous drip (morphine)

What is the first action of the nurse if a patient says they have pain?

assess

When a pt is having acute pain, what do you do?

assess location, severity, and quality

What labs should be done before surgery?

blood typed and crossed UTI screening ECG

What type of pain is usually caused from a tumor and can be acute or chronic?

cancer pain

What type of pain happens sporadically over an extended period of time?

chronic episodic pain

What happens in phase 1 of recovery?

close monitoring

What interventions can help reduce the risk of postoperative complications?

cough and deep breath turn and reposition nutrition and fluid balance exercise and ambulation pain management

What is chronic pain without cause or seen as excessive called?

diopathic

What are some nonpharmacological pain-relief measures?

distraction cutaneous stimulation relaxation and guided meditation

What types of signs are important for pain when pt is nonverbal

facial grimacing and guarding

What regulates and possibly blocks some pain impulses and happens in the spinal cord?

gate control theory

What type of anesthesia causes loss of sensation and consciousness?

general

What are the types of anesthesia?

general, regional, local

What are some medical risk factors for surgery?

hypertension DM Fever Renal Disease

What is the purpose of lower leg exercises?

improves venous blood flow and prevents clot formation

What term refers to during surgery?

intraoperative

What age group is very sensitive to narcotics and opioids?

kids

What are two types of advance directives?

living will and power of attorney

What type of anesthesia is the loss of sensation at a site?

local

What is the purpose of end-tidal carbon dioxide monitoring?

measures oxygenation status

What are the three types of gloving procedures?

open, closed, and assisted gloving

Who is the best judge of a patients pain?

patient

What is it called when the CNS extracts information from the pain impulse?

perception

What ensures continuity of care?

perioperative communication

What phase of recovery prepares pt for discharge?

phase 2

What is the PACU

post anesthesia care unit

What term refers to after surgery?

postoperative

What does PQRSTU stand for?

precipitating factors quality relief measures severity timing usual effect of pain on pt

What term refers to before surgery?

preoperative

What type of anesthesia is the loss of sensation on one area of the body?

regional

During immediate post-op nursing, what assessments need to be done q15 minutes until stable?

respiratory cardiovascular CNS

What vital sign do narcotics/opioids lower?

respiratory rate

What are the four rights of surgery?

right patient right surgical procedure on right body part right set of data in chart right frame of mind of patient

What are the four patient positions in the OR?

supine lateral prone lithotomy

What converts energy produced by stimuli into electrical energy?

transduction

What is the role of the nurse when it comes to informed consent?

witness

Can someone still pain pain if they are sedated?

yes