Pharm: Module 9 Pain Management

Question 1

what is the number one goal of a nurse

Answer 1

help control pain

Question 2

what is the nurses priority with drug addiction

Answer 2

pain management NOT managing addiction( HCP determines substance abuse management)

Question 3

how do you determine the best pain management course of action

Answer 3

take assessment

Question 4

how should you ask a patient to tell you their pain level

Answer 4

pain scale (o is no pain and 10 is worst pain ever)

Question 5

what sis a realistic goal regarding pain

Answer 5

MANAGABLE PAIN(not no pain)
tolerable pain, get out of bed and perform ADLs

Question 6

typical pain
dull, aching, cramping, throbbing
get relief from opioids or NSAIDs

Answer 6

nociceptive

Question 7

burning, shooting, numbness, stabbing
relief from opioids and adjuvants, tricyclic antidepressants
direct nerve injury

Answer 7

neuropathic

Question 8

nonspecific cause
no tests to validate
lasted more than 6 mos
not protective mechanism
affects quality of life
no VS changes
signs symptoms of depression or anorexia

Answer 8

chronic pain

Question 9

what does chronic pain often lead to

Answer 9

suicide

Question 10

short duration
protective mechanism
treated aggressively

Answer 10

acute pain

Question 11

not painful until progresses

not unusual to give high doses of opioids (no ceiling)

Answer 11

cancer pain

Question 12

non opioid

Answer 12

tramadol

Question 13

what is acetaminophen

Answer 13

analgesic

Tylenol

Question 14

what is the daily max limit of acetaminophen

Answer 14

2,000 mg/day for daily users

4,000 mg/day for occasional users

Question 15

how do you assess how often someone uses acetaminophen

Answer 15

liver enzyme serum assessment

Question 16

describe acetaminophen

Answer 16

very hepatotoxic

non opioid

Question 17

what occurs if patient has high liver enzyme

Answer 17

pull back tylenol

Question 18

what liver enzyme level is normal and what is toxic

Answer 18

10-20 mcg/mL and over 200 mcg/mL is toxic

Question 19

what do opioids work on

Answer 19

CNS and PNS (specific pain receptors)

Question 20

side effects of opioids

Answer 20

sedation(CNS), pain relief(PNS), drowsiness, decreased respiratory

Question 21

priority nursing intervention for opioid patients

Answer 21

worried about breathing (RR)

Question 22

what can opioids be used for

Answer 22

as an antitussive (depress cough) or for consitpation

ie/ Coedine

Question 23

this is the opioid that everything is compared to

Answer 23

morphine

Question 24

this is given for moderate to severe pain

Answer 24

morphine

for post op or acute pain

Question 25

how is morphine given

Answer 25

IV push, IM, SQ, or PO | PO is not as potent and rarely given

Question 26

how often do you reassess a patient on morphine

Answer 26

every 15-30 min

Question 27

this is 6x stronger than morphine

Answer 27

Hydromorphone (Dilaudid)

Question 28

describe hydromorphone

Answer 28

given at smaller does than morphine due to its higher concentration faster onset than morphine but shorter CAN be addictive

Question 29

shorter duration than morphine

Answer 29

Meperidine (Demerol)

Question 30

describe Meperidine

Answer 30

can cause issues with strokes, seizures, cardiac not for long term use used in labor/delivery associated with tremors

Question 31

what is the max time meperidine can be given

Answer 31

72 hours

Question 32

this is 100x stronger than morphine

Answer 32

fentanyl

Question 33

describe fentanyl

Answer 33

potent high when used recreationally chronic pain and cancer pain given transdermal (sticker/patch) only for opioid tolerated patients

Question 34

how long does fentanyl last

Answer 34

``` extended relief lasts days (48-72 hours) ```

Question 35

who is fentanyl cautioned in

Answer 35

patients over 100 lbs

Question 36

fentanyl lollipop is good for what

Answer 36

breakthrough pain of cancer patients | only takes 15 min to dissolve

Question 37

acetaminophen immediate release acute pain and post op.

Answer 37

Percocet

Question 38

extended release (potent) chronic pain relief when used recreationally, pill is crushed for quick high

Answer 38

oxycodone hydrochloride (oxytocin)

Question 39

Vicodin

Answer 39

hydrocodone/acetaminophen

Question 40

what does 5/325 mean

Answer 40

5 mg of opioid and 325 of acetaminophen

Question 41

this gives autonomy to control pain | perception of pain is better with this

Answer 41

PCA

Question 42

describe PCA interventions

Answer 42

med given via IV, not used more than 48 hours, don't overdose, need witness, family members cannot press button, patient education, continuously assess

Question 43

what is the max mg given per hour for PCA

Answer 43

0.2 mg max per hour (0.03 mg Q5 min)

Question 44

considerations when giving opioids

Answer 44

continuously assess drug history with drugs(recreational and opioids) assess vital signs (RR) concerning if VS are dropping (even if still in range) easier to control pain if consistent (PRN) for acute

Question 45

describe methadone

Answer 45

detox people on narcotic (heroin etc) blocks without leading to withdrawal or cravings very potent only given under medical observation

Question 46

Naloxone

Answer 46

Narcan saves lives immediately blocks receptors so drug can no longer bind