Comfort
Non-opioid analgesics
Acetaminophen (tylenol) and NSAIDs
Antidote for acetaminophen toxicity
Acetylcysteine
Adverse effects of opioid analgesics
CNS depression, n+v, urinary retention, CONSTIPATION, disaphoresis, itching, pupil constriction
NSAIDs do not depress ________ and do not interfere interfere with __________ and _________ function, but irritates _____________.
CNS, bowel and bladder, gastric mucosa.
During an assessment, what TWO things should you gather information about?
Cause of pain and ability to function
Adjuvants are _________.
Co-analgesics.
When assessing pain, use PQRSTU. What is it?
Provocative factors (what makes it worse) Quality (Describe your pain) Relief (what makes it go away) Severity (pain scale) Timing (all of the time? certain times? certain days?) Uffect of pain (what can't you do)
What aspects are affected by pain (4)?
Quality of life, self-care, work, and
What is the most common and tolerated non-opioid?
Acetaminophen
Max dose for Ibuprofen
3200mg/24 hours
Max dose for acetaminophen
4 g/24 hours
What is the single most reliable indicator of pain?
A patient's self-report of pain
IASP definition of Pain
An unpleasant, subjective sensory and emotional experience associated with actual or potential tissue damage.
Routine Clinical Approach to Pain Assessment and Management (ABCDE)
Ask about pain regularly Believe patient and family Choose pain control options appropriate for patient Deliver interventions in a timely, logical, coordinated manner Empower patient and family
Non-pharmacological pain interventions include
Distraction, relaxation, guided imagery, music therapy, prayer
What are common factors that influence the pain process?
Drugs, trauma, tumor growth, and metabolic diseases.
When changing from IV opioid to oral opioid, the oral dose should be _________ because of __________________.
Higher, first-pass effect
The nurse is caring for a client who has just received epidural anesthesia. The nurse would monitor for which adverse effects?
Hypotension
The sympathetic nervous system is associated with what kind of pain?
Low-Moderate and superficial pain
The nurse suspects that the client has shift-work sleep disorder (SWSD). Which medication is indicated to treat this disorder?
Modafinil Rationale: This medication promotes wakefulness in patients.
What is the antidote for opioid overdose?
Narcan (naloxone)
A client reports overwhelming and irresistible attacks of sleep. Which sleep disorder is she or he describing?
Narcolepsy
Opioids are _________.
Narcotics
What are the two categories of pain?
Nociceptive and neuropathic
What are the 3 kinds of pharmacological pain therapies?
Non-opioids, opioids, adjuvants.
What is nociception?
Observable activity in the nervous system in response to a stimulus.
What is referred pain?
Pain at the actual site.
In regards to pain, as a nurse, what must you accept?
Pain is whatever the experiencing person says it is and exists whenever they said it does.
What is idiopathic pain?
Pain that has no identifiable physiological or psychological cause.
What is a PCA
Patient Controlled Analgesia: patient self administers opioid with minimal risk of overdose.
What are 3 components of pain?
Physical, emotional, and cognitive.
Factors that influence pain include _______, _________, _______, _________, and ________.
Physiological (age, fatigue, and genes), neurological, social (previous experience, family, social network, spirituality), psychosocial (attention, anxiety, fear, coping), and cultural.
What is Transduction?
Process whereby an activated nociceptor converts energy produced by a stimuli into an action potential.
What is perception?
The point at which a person is aware of nociceptive impulses and perceives pain.
The parasympathetic nervous system is associated with what kind of pain?
Severe or deep pain
Common nonverbal cues of pain
Teeth clenching, facial grimacing, holding/guarding, and bent posture.
What is modulation?
The inhibition of pain impulses.
What is the goal of a PCA?
To maintain a constant plasma level of analgesic to avoid the problems of prn dosing.
What are the 4 physiological components of nociception?
Transduction, Transmission, Perception, and Modulation
What is Transmission?
Travel of an impulse from periphery to spinal cord.
What is sensitization?
When the threshold of a nociceptor is lowered.
With older adults consider ___________ and __________ predictable drug responses.
frailty and less
When teaching, it is important to _________ pain under___________.
have, under
Acute pain is _______, usually has a ______cause, ______ duration, and has ________ tissue damage and emotional response.
protective, identifiable, short, limited
Chronic pain is not ___________, and serves ______ purpose, but has a _________ effect on a person's ______________.
protective, no, dramatic, quality of life
5 characteristics of pain
timing, location, severity, quality, aggravating/precipitating factors