pain meds and anesthesia (exam 3)

Question 1

a sensory and emotional experience associated with actual or potential tissue damage

Answer 1

pain

Question 2

what kind of pain is r/t tissue injury

Answer 2

nociceptive

Question 3

where is somatic nociceptive pain

Answer 3

bone/muscle/joint

Question 4

where is visceral nociceptive pain

Answer 4

heart/liver

Question 5

what is pain produced by the nerves?

Answer 5

neuropathic pain

Question 6

what is an example of peripheral neuropathic pain?

Answer 6

diabetes

Question 7

what is an example of central neuropathic pain?

Answer 7

stroke

Question 8

what is the pain pathway?

Answer 8

site of injury -> spinal cord -> brainstem -> cerebrum

Question 9

is pain subjective or objective?

Answer 9

subjective

Question 10

when is the FLACC pain scale used?

Answer 10

in children 7 or younger

Question 11

what drugs relieve moderate to severe pain by blocking pain signals from reaching the brain and inhibiting prostaglandins

Answer 11

opioid analgesics

Question 12

what are drugs from different classes that change pain and help reduce opioid use?

Answer 12

multimodal therapy

Question 13

what is our example opioid agonist?

Answer 13

MORPHINE SULFATE
codeine, fentanyl, hydromorphone

Question 14

what med binds to pain receptors in the brain to block pain impulse?

Answer 14

opioid agonist (morphine sulfate)

Question 15

what is the use of opioid agonist (morphine sulfate)

Answer 15

prevent or relieve moderate to severe pain

Question 16

what is the onset of IV opioid agonist (morphine sulfate)

Answer 16

10-20 min

Question 17

what is the onset of PO opioid agonist (morphine sulfate)

Answer 17

60 min

Question 18

what are adverse effects of opioid agonist (morphine sulfate)?

Answer 18

resp depression, cns depression, constipation

Question 19

what is the BBW for opioid agonist (morphine sulfate)?

Answer 19

resp failure if used in combo with benzos or other CNS depressants
-risk for abuse and dependence

Question 20

contraindication for opioid agonist (morphine sulfate)

Answer 20

respiratory compromise, liver/kidney disease, increased ICP/head injury

Question 21

what is the reversal agent for opioid agonist (morphine sulfate)

Answer 21

naloxone

Question 22

what is the push rate for opioid agonist (morphine sulfate)

Answer 22

5 ml/5 mins

Question 23

what happens when opioid agonist (morphine sulfate) administration leads to a respiratory rate below 8?

Answer 23

naloxone administration is needed

Question 24

what kind of diet while taking opioid agonist (morphine sulfate)

Answer 24

high fiber, lots of water

Question 25

what is our example opioid agonist/antagonist

Answer 25

butorphanol

Question 26

which med activates some receptors and also blocks some, leading to pain blocking with less potential for abuse

Answer 26

opioid agonist/antagonist (butorphanol)

Question 27

what is used second line for moderate-severe pain, labor pain, and perioperatively

Answer 27

opioid agonist/antagonist (butorphanol)

Question 28

adverse effects of opioid agonist/antagonist (butorphanol)

Answer 28

CNS depression, resp depression, risk of abuse and dependence

Question 29

contraindications for use of opioid agonist/antagonist (butorphanol)

Answer 29

use of opioid agonist (blocks relief)

Question 30

T or F? -you can combine opioid agonist/antagonist (butorphanol) with opioid agonists (morphine)

Answer 30

false

Question 31

what is our example opioid antagonist?

Answer 31

naloxone

Question 32

what med reverses analgesia and displaces opioids at the receptor site?

Answer 32

opioid antagonist (naloxone)

Question 33

what are adverse effects of opioid antagonist (naloxone)

Answer 33

immediate withdraw symptoms

Question 34

opioid antagonist (naloxone) only reverses... ?

Answer 34

opioid agonists

Question 35

why may people need multiple doses of opioid antagonist (naloxone)

Answer 35

short half life

Question 36

what is the IV onset of opioid antagonist (naloxone)

Answer 36

2 minutes

Question 37

what is the intranasal onset of opioid antagonist (naloxone)

Answer 37

8 minutes

Question 38

what is important to regularly assess with a patient on morphine?

Answer 38

respirations

Question 39

a man is difficult to arouse after IV morphine sulfate. his resps = 7. which is priority? -place nasal cannula -administer naloxone -increase IV fluid rate -place in semi-fowlers

Answer 39

administer naloxone