It Hurts
These are polymodal and signal tissue injury and pain.
What are nociocepters?
This drug is an NSAID that has a "ceiling effect" and is given in limited doses via IV in the acute care setting
What is Toradol (or Ketorolac)?
Current EBP states to treat pain first prior to adding this medication.
What are sedatives?
These agents block the transmission of nerve impulses by blocking cholinergic receptors and result in muscle paralysis.
What are neuromuscular blocking agents or NMBs?
These NMB agents have a steroidal-like molecular structure and can result in myopathies and neuropathies when given in addition to steroids during treatment.
What are vecuronium and rocuronium and pancuronium (long-acting)?
These afferent sensory fibers are unmyelinated, have a slower conduction speed and dull or unlocalized pain signal.
What are "C fibers"?
These drugs bind with certain receptors and provide pain relief via the CNS by altering the perception of pain.
What are opioids?
Hyperactive, hypoactive, and mixed and presentation are 3 types of this.
What is delirium?
This short-acting NMB drug is often used for rapid intubation and used on medical TV shows
What is succinylcholine?
This occurs when air flow does NOT return to zero at end exhalation and can increase patient-ventilator asynchrony and increase end-expiratory lung volume.
What is "auto-PEEP"?
This is an unpleasant sensory and emotional experience associated with actual or potential tissue damage
What is Pain?
This type of analgesia provides better and longer pain control, less sedation, lower opioid doses as well as decreased morbidity and mortality.
What is epidural analgesia?
This short-term sedative is often used in the ICU setting and does not produce respiratory depression but does often produce bradycardia and hypotension
What is Precedex?
RNs assess this using four small electrical stimuli and observe muscle twitches to determine the degree of NMB
What is the Train of the Four?
This often used intermediate-term sedative is lipophilic, may accumulate in older adults or patients with decreased liver function
What is lorazepam or Ativan?
acute, chronic, neuropathic
What are types of pain?
This technique promotes relaxation, increases endorphins, and alters the perception of painful stimuli and can be done by anyone or an "app".
What is guided imagery?
This short-term sedative produces analgesia, anesthesia, and amnesia without loss of consciousness.
What is Ketamine?
This intermediate acting NMB is often used for rapid intubation and used on medical TV shows it has the shortest onset of 45-60 seconds
What is Rocuronium?
This short-term sedative is often used for general anesthesia or a continuous infusion, is used cautiously in patients with high triglycerides and is contraindicated in patients with egg allergies (Michael Jackson should have been more cautious!)
What is propofol?
Everyone responds to pain in the same way. True or False
What is false?
This type of patient population may require special consideration for pain management.
What is the elderly population?
This medication used often for delirium, provides sedation without severe respiratory depression - it also may prolong the QTc interval.
What is Haldol?
Patients on continuous NMBs must always have these infusing, no exceptions.
What are analgesics and sedatives?
This is associated with increased mortality, prolonged hospitalization, and cognitive impairment.
What is delirium?