Medications
Acetaminophen! Analgesic!
name
s/e
drug to reverse OD
Tylenol
s/e- liver toxicity!, headache, chest pain, jaudice, dark urine, gray stool, hypersensitivity.
Does not have anti inflammatory effect
OD- acetylcysteine
1) What is an example of chronic pain?
A) Pain that precedes injury
B) Pain that follows injury and ends when healing is complete
C) Pain that is felt during injury and immediately after
D) Pain that outlasts the healing process
D. pain that outlasts the healing process
3 types of apnea
Obstructive- airway is blocked
Central- weakness to chest muscles and diaphragm, causes pt to stop breathing.
Mixed-both of the symptoms above mixed together
-women older than 60
-mental health disorder
-obesity
-large neck circumference
-narrow airway
-drug and alcohol abuse
The nurse is teaching a patient about risks related to the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief.
Which risk related to NSAID use should the nurse include in the teaching?
a. Hepatotoxicity
b. liver toxivity
c. gastric distress
d. constipation
Name nsaids , S/E
nsaids-non selective reversible
nasaid- selective
nsaid nonselective irreversible
nonselective reversible- Naproxen(aleve) Ibuprofen (advil)
~Heartburn, nausea, vomiting,ringing in ears
selective- Celecoxib(celebrex)
~Nausea, vomiting, cold symptoms, stomach pain
nonselective irrversible- Aspirin
~upset stomach , bloody stool, heartburn, nausea, vomiting , hallucination, confusion
Name the pain scale used on a child under 6 months
FLACC pain scale
types 3 of insomnia
Hypersomnia- drowniness all day, severe is narcolepsy, severe motions, age 15-30, emotional support.
Parasomnia- n3,4, sleep walking, bed wetting, eating, grinding teeth, likely in children, sleep aides,
Dyssomnias- Parkinson's, stress, old age, diabetes, kidney disease
name some risk factors for pain
-type of illness or injury
-daily activities, occupation
-lack of healthcare personnel knowledge.
-alcohol/drug abuse
-stress
what is a PCA PUMP? what should you check?
Used to control pain in small doses.
Patient Controlled Analgesia
•End Tidal CO2 (output) Monitoring
OPIOIDS
•Mixed Agonist/antagonist
•Opioids mixed w/nonopioids
mixed with NONOPIOIDS. - codeine mixed with aspirin, Tylenol, & ibuprofen.
s/e- liver toxicity, constipation, nausea, vomiting.
mixed agonist- nalbuphine (nubain) pentazocine(talwin)
s/e- lightheadedness, psychoses, hallucinations, nausea, vomiting, urine retention. resp depression
The nurse is assessing a patient during a routine clinic appointment.
Which physiologic change should indicate to the nurse that the patient might be experiencing pain?
a. Increased perspiration
B. Blood pressure 90/60 mmHg
c. pupil constriction
D. d. Heart rate 58 beats/min and regular
a. Increased perspiration
Pupil constriction
Heart rate 58 beats/min and regular
NONPHARM for sleep 3 examples
CPAP machines deliver the same pressure when breathing in and breathing out.
BiPAP machines provide two different pressure levels, one level of air pressure during inhalation and a lower level for exhalation.
•Surgery-only is CPAP therapy failed
•Tonsillectomy
•Adenoidectomy
•Partial removal soft palate, uvula, lateral pharyngeal wall
treatments for sleep nonpharm
-surgery
polysomnography/ eeg
sleep hygeine
relaxation
cpap
bipap
explain gate theory
The gate control theory of pain is based on the concept of preventing the transmission of pain signals to the brain by using distraction techniques.
OPIOIDS
•Full Agonists
•Weak or partial Agonist
Full: morphine, fentanyl, oxycodone(oxytcotin), hydromorphone(dilaudid), hydrocodone
s/e- resp depression, constipation, nausea, vomiting, dizzy, weak pulse, low cortisol, headache, drowsy
Weak & partial: Codeine (weak) Tramadol(partial)
s/e- dizzy, sweating, drowsy, nausea, vomiting, constipation, resp depression.
Which of the following is a pharmacologic therapy for acute pain?
A) Antidepressants
B) Muscle relaxants
C) Opioid analgesics
D) Stimulants
C. Opioid analgesics
1) Which client is exhibiting hypersomnia?
A) The client only gets about 5 or 6 hours of sleep each night.
B) The client gets roughly 8 hours of sleep each night but cant stay awake during the day.
C) The client consistently has trouble getting to sleep and often lies awake for hours after
bedtime.
D) The client experiences repetitive involuntary leg movements that interfere with sleep.
B) The client gets roughly 8 hours of sleep each night but cant stay awake during the day.
Treatments for pain pharm and nonpharm.
pharm;
~Coanalgelsic, opioids, nonopioids, nsaids
- injection, nerve block, cam therapies
-Surgery
The nurse is performing an assessment of a patient reporting abdominal pain and discomfort.
Which aspect of the comfort assessment should the nurse obtain during the health history?
a. Nurse observation of symptoms
b. Visual inspection
c. Patient description of symptoms
d. Vital signs
Patient description of symptoms
this is used in treat an overdose of opioid medicines.
Narcan( naloxone)
Block or reverses effects of opioids
Name some types of pain. (10 types)
Somatic-can be deep or superficial, with the deeper pain coming from the skeletal structure, tendons, and muscles.
Acute –caused by injury, surgery, illness, trauma or painful medical procedures.
Chronic- long standing pain that persists beyond the usual recovery period
Idiopathoic pain- unknown cause
Psychopgenic- pain that happens due to, or is worse because of, factors other than illness or injury
Phantom- pain is a common occurrence after amputation or extremity loss
Referred pain-when you have an injury in one area of your body but feel pain somewhere else.
radiating - a pain that begins in one area and spreads to another causing discomfort and in many situations pain.
break through pain- a transitory increase in pain intensity from a baseline pain of moderate intensity in patients receiving regularly administered analgesic treatment.
REM vs. NONREM
REM
•First REM sleep – occurs around 70 – 90 minutes after sleep begins
•Most dreams take place during REM sleep
•Healthy sleeper will spend more than 2 hours each night dreaming
•~ 80% of sleep during a night
•4 stages
•N1 – light sleep lasting only a few minutes
•N2 – light sleep where body continues to slow down, constitutes 50% of total sleep
•N3 – DEEP SLEEP extremely slow brain waves appear, punctuated with smaller faster waves
•N4 – DEEP SLEEP delta waves predominate, combined together with N3
•N3,4- PARASTOMAS, BED WETTING, NIGHT TERRORS, SLEEPWALKING.
what is narcolepsy?
daytime drowsiness, sleep attacks, sleep paralysis, cataplexy
The nurse is teaching a patient muscle-relaxation techniques.
Which patient statement best describes the impact these techniques have on comfort?
a. "These techniques can help me to focus on something else, thereby reducing my focus on the discomfort."
b. "Muscle-relaxation techniques can help reduce the swelling in my muscles caused by the injury."
c. "These techniques will help me learn to consciously relax my muscles when they become tense due to stress."
d. "These techniques will not have a huge impact on the discomfort but will help to strengthen my muscles."
"These techniques will help me learn to consciously relax my muscles when they become tense due to stress."