Pain and Physiology
This type of pain originates from organ damage and often presents as cramping or pressure-like discomfort
visceral pain
Combining non-opioids, opioids, and non pharm methods for pain control describes what approach
multimodal analgesia
this anesthesia technique delivers medication into the CSF for lower abdominal or perineal surgery lasting longer than 90 minutes
spinal (intrathecal) anesthesia
a C6 injury risks this type of shock due to sympathetic nervous system disruption
neurogenic shock
what is the correct airway maneuver for a trauma patient with suspected cervical spine injury
jaw-thrust maneuver (no head tilt-chin lift)
A patient with diabetic neuropathy or chemotherapy-induced tingling experiences this type of pain
neuropathic pain
What opioid antidote is used to reverse respiratory depression in a PCA overdose
naloxone (narcan)
name one critical nursing responsibility for a patient under moderate (conscious) sedation
maintain airway and monitor ventilation with resuscitation equipment available
explain the patho difference between spinal shock and neurogenic shock
spinal shock is loss of reflexes below injury
neurogenic shock is loss of sympathetic tone causing vasodilation and hypotension
SCI patients are at high risk for paralytic ileus. what is one nursing intervention to prevent this
encourage early bowel training, stool softeners, and high fiber diet
FLACC scale
a patient on an epidural infusion develops hypotension and urinary retention, what is the first nursing action
stop the infusion and notify anesthesia/provider
this antidote for benzodiazepine overdose during procedural sedation is
flumazenil
a patient with flaccid paralysis, areflexia, and loss of bowel tone immediately post-injury is in what phase
spinal shock
in neurogenic shock, what medication is used to correct bradycardia and hypotension
atropine and vasopressors
Explain the differences between tolerance, dependence, and addiction
Tolerance - needing higher doses effect
Dependent - withdrawal upon cessation
Addiction - compulsive use despite harm
explain why intrathecal opioids require smaller doses compared to IV administration
because the drug is delivered directly into the CSF, providing more potent, localized effect
the major difference between anxiolysis and conscious sedation is
anxiolysis preserves full alertness and airway control
conscious sedation reduces awarenss but maintains protective reflexes
a SCI above T6 can cause severe hypertension, bradycardia, and HA due to this life-threatening complication
autonomic dysreflexia
IM injections should be given above or below level of SCI, and why
ABOVE because circulation is decreased below the injury, impairing absorption and increasing tissue damage risk
what is a goal RASS score
aim for +1 to -1
Benefits of epidural infusion
pain relief more controlled with smaller doses of opioid analgesics
earlier bowel recovery
earlier mobility
Two complications to epidural anesthesia
epidural abscess/hematoma
hypotension
respiratory depression
catheter migration
in assessing a patient with a suspected incomplete SCI, the presence of perianal sensation and rectal tone indicates this
sacral sparing
a patient in a halo device complains of pin site drainage and fever. what is the immediate nursing action
assess for infection and notify the provider immediately