Pain
What is the best combination for the most effective pain relief ?
Opioids and Non-opioids
When should the patient take medication for pain?
When the pain level is low or rising towards tolerable level
True or False?
Is vision loss permanent ?
TRUE!
What are some triggering factors causing seizures?
Intense physical activity, excessive stress, caffeine, flashing lights
Sudden/Onset/Acute
Delirium
A cancer patient is needing a higher and higher dose for pain relief, what should they do?
Patient has built a tolerance, and should seek treatment for the underlying cause
People with auto immune disorders are treated with this to improve hearing
Corticosteroids
The lens of the eye becomes less, flexible
Normal part of aging
Presbyopia
Jerking (Clonic), Stiffening Muscles (Tonic), Apnea, Cyanosis, Biting of cheek or tongue, incontinence, aura, confusion and sleepiness pos-ictal
Diagnostic Tools for Delirium (2)
Confusion Assessment Method in ICU
Brief Confusion Assessment Method
What is a PCA pump?
Medication delivery system, programmed doses, self administered
This helps with decrease IOP, what’s the name there are 3, how do you give it, and how does it work?
Latanoprost: increase outflow of aqueous
Timolol: Reduces the production of aqueous humor
Dorzolamide: Decreases the production of aqueous humorClean the eye from inside to out , Tilt the patient head back, pull lower eye lid down, drop in the pocket w/o touching the eye, instruct patient to close eyes.
Infection, sue antibiotics to treat any acute infection before surgery, and patient should discontinue/stop taking any ototoxic drugs.
These types of seizures the patient maintains consciousness
Simple Partial Seizure
If patient is at risk for suicide what is the nursing intervention ?
Complete a suicide risk assessment, observe covert cues, listen to convert messages, ask about plans, don’t leave the room, remove harmful objects, initiate one to one observation
Location, Quality (Sharp, Dull, Aching, Cramping), Intensity, Duration
Numeric Pain Scale : Alert and Oriented
Wong- Baker Faces Pain Scale: Confused
Vancomycin (Antibiotics), Aspirin, Lasix (Diuretics)
What are some nurse implications for hearing aids?
Ensure hearing aids are prescribed to patient, ensure aids are set to the lowest setting to prevent feedback noise, use mild soap and water to clean the ear mold, turn off device and store away when not in use, ensure there are batteries or a charger
A patient is known to having seizures, what are equipments needed?
Suction, Oxygen via simple mask, pad for side-rails, Functional IV Access, Fall pre-cautions
HEART STANDS FOR?
Help from friends and family
Environment must be structured
Advanced directive is an essential document
Respite care is best for a long break
Time away each dat us good for a short break
There are many medications given for pain management but what is more suitable for chronic pain
What are the side effects? What should you have incase?
What is Fentanyl Transdermal?
Naloxone
Respiratory Depression, hypoxia, bradycardia, hypotension, site reaction
What is Phenytoin used for ? What are the side effects? What are some nurse education for patient?
treatment/prevention of tonic-clonic seizures and complex partial seizures
Side Effects : Hypotension, Cardiac Arrest, Hepatic Failure, Rash,Take as directed, don’t double dose, if missed dose take as soon as possible within 4 hrs and go back to normal schedule, if abruptly stopped can cause epilepticus
Post Surgical Intervention for Tympanoplasty (4 Parts)
Reconstruction of the middle ear
Patient flat and turned to the side with operative side facing up for up to 12 hrs to prevent packing from coming off
Avoid Straining, coughing, and sneezing forcefully with mouth closed
No water should enter the ear when bathing or washing hair
Remind patient the hearing will be impaired until packing is removed from the ear
This patient is having an active seizure what should you do???
Turn Patient to the side-lying positions, loosen restrictive clothing, be prepared for suction, and note time of onset for duration documentation, DO NOT RESTRAINT, DO NOT INSERT ANY OBJECTS in mouth.
What are some symptoms of Dementia ?
Forgetfulness, Difficulty with language, impaired sort-memory loss, inability to process information, personality changes, loss of cognitive skill, emotional lability