Flashcards in Meds Deck (67)
4 types of meds we need to be aware of ?
2. sedatives and paralytics
3. vasopressors and inotropes
To optimize analgesia, use what kind of pain scale?
patient-specific validated pain scale
Infusion goals should be reassessed every __ hours; reduce by ___% if sedation goals are met
Goal in the ICU is to keep pt's pain intensity rating NRS < __ or BPS < __
BPS scores range from __ (no pain) to __ (max pain)
What are the 3 categories in the BPS?
1. facial expression
2. upper limb movements
3. compliance with mechanical ventilation
The critical-care pain observation tool ranges from _-_
_____ = pain relief; includes opiates, NSAIDS, other oral meds
______ = blocking sensation, including pain; includes general anesthetic, nerve blocks, numbing agents
____ _____ analgesia uses multiple types of analgesia, and works on different levels of the NS
_____ blocks pain signals sent from brain to the body and release large amounts of dopamine
3 non-opioid drugs used in the ICU?
3. gabapentin or pregabalin
Issues with acetaminophen?
caution with liver failure / alcoholism
Issues with NSAIDS?
long term use can increase GI / renal bleeding complications
Take note of what with gabapentin or pregabalin?
- for neuropathic pain
- can sedate
- monitor renal dysfunction
3 opioid drugs used in ICU?
Issues with morphine ?
drug accumulates in renal failure, itchy skin
Take note of what with hydromoroph / dilaudid?
- 5 x as strong as morphine
- preferred in elderly and renal dyfunction
Take note of what with fentanyl?
- quick onset
- good for procedural pain
- 100x as strong as morphine
Opioid side effects in CNS?
decreased LOC, delirium
Opioid side effects in resp?
depression (decreased drive to breathe, decreased RR)
Opioid side effects in CVS?
Opioid side effects in gut?
decreased motility, nausea
Opioid side effects derm?
3 common anti-emetics?
1. dimenhydrinate (gravol)
4 PT implications with analgesics?
1. consider timing of analgesia with active treatment for optimal pain control
2. look for trends in analgesia needs with care / movement
3. be alert for resp side effects
4. be aware of how our interventions can increase or prevent pain, and consider what we can offer for pain control
Always address ______ sources for sedation
3 types of sedation ?
1. Light IV sedation
2. Daily sedation interruption
3. Deep IV sedation
Current best practice is to _____ sedation
minimize (least amount to reach goal)