Term
Damage to ___ creates nociceptor pain.
Damage to ___ creates neuropathic pain. |
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Definition
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Term
| Describe neuropathic pain. |
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Definition
| Burning, shooting, numbing |
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Term
Tissue/nociceptor pain:
___ makes a sharp localized sensation.
___ makes a dull, throbbing sensation. |
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Definition
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Term
| What is the name for the pain receptors located throughout the body? |
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Definition
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Term
___ ___ is the neurotransmitter that transmits pain in the spinal cord.
___ act against this neurotransmitter. |
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Definition
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Term
| Opioids stimulate the ___ and ___ receptors. |
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Definition
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Term
| Name 6 opioid analgesics. |
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Definition
1. Codeine
2. Hydromorphone HCl (Dilaudid)
3. Butorphanol (Stadol)
4. Oxycodone HCl (OxyContin) [Percocet+Acetamin]
5. Hydrocodone [Vicodin5/500+Acetamin]
6. Fentanyl (Sublimaze) |
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Term
| Name 4 mixed opioid analgesics and what is in them. |
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Definition
Vicodin (Lortab): Hydrocodone + Tylenol
Percocet: Oxycodone + Acetamin
Darvocet: Propoxyphene + Acetamin
Percodan: Oxycodone + ASA |
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Term
___ (MS Contin) gives excellent pain relief.
It stimulates ___ muscle.
It decreases the ___ to open up the pulmonary bed. This causes better O2/CO2 exchange. |
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Definition
Morphine
Cardiac
PVR (Pulmonary Vascular Resistance) |
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Term
| Morphine causes ___ but is great for relieving ___ in CHF. |
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Definition
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Term
S/S of opioid overdose:
___ RR
___ HR
___ skin
Feels ___
Mental ___
___ pupils |
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Definition
Decreased RR
Decreased HR
Clammy skin
Feels drowsy
Mental confusion
Pinpoint pupils
*Possible select all that apply |
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Term
Morphine Nursing considerations
Severe ___ distress
Retained CO2 causes ___ and increases IICP
Dizzy and drowsy (___ precautions)
Urinary retention (___)
___ (Toxicity) |
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Definition
Severe resp distress
Retained CO2 causes vasodilation and increases IICP
Dizzy and drowsy (Fall precautions)
Urinary retention (Toxicity)
Constipation (Toxicity) |
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Term
| What do we use for people retaining CO2 with IICP? Why? |
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Definition
| Vasopressin; It stimulates angiotensin to reverse vasodilation. |
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Term
Mixed analgesics:
Tylenol: ___ g/day
Aspirin: ___ g/day
Ibuprofen: ___ g/day
*Ibu: Can manage on up to ___ g/day |
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Definition
Tylenol: 4 g/day
Aspirin: 4 g/day
Ibuprofen: 1.2 g/day
*Ibu: Can manage on up to 3.2 g/day |
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Term
| ___ is an opioid antagonist and works on OPIOIDS ONLY! |
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Definition
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Term
| Narcan can be used to dx opioid overdose. Why should we use caution with it and suspected opioid addiction? |
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Definition
| It can cause severe immediate withdrawal symptoms and seizures |
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Term
What are 5 S/S of Narcan withdrawal?
What are 2 other things to worry a/b? |
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Definition
1. Cramping
2. Vomiting
3. HTN
4. Anxiety
5. Tremors
1. V-tach
2. Hyperventilation |
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Term
| A patient on Narcan needs VS checked q___ min. They need continuous ___ monitoring and frequent ___'s. |
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Definition
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Term
Things we should try BEFORE giving Narcan:
Can I ___ them?
Can I stop the ___?
Can I give them ___? |
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Definition
Awaken
Infusion
O2*
*If COPD, skip O2 and do Narcan |
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Term
| Name 3 types of nonopioid analgesics. |
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Definition
1. NSAIDS
2. Acetaminophen
3. ASA |
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Term
| NSAIDs inhibit ___, then enzyme that forms ___. |
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Definition
| Cyclooxygenase; Prostaglandins |
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Term
| ASA inhibits ___ and ___. |
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Definition
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Term
Acetaminophen considerations:
Monitor ___'s
Works directly in the ___.
Dilates ___ blood vessels.
NO ___ PROPERTIES! |
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Definition
Monitor LFT's
Works directly in the hypothalamus.
Dilates peripheral blood vessels.
NO ANTI-INFLAMMATORY PROPERTIES! |
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Term
Name the time periods of the 4 stages of Acetaminophen overdose.
Phase 1 (___-___ hrs)
Phase 2 (___-___ hrs)
Phase 3 (___-___ hrs)
Phase 4 (___-___ days) |
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Definition
Phase 1 (2-24 hrs)
Phase 2 (24-72 hrs)
Phase 3 (72-96 hrs)
Phase 4 (6-7 days) |
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Term
S/S of Phase 1 of Acet. OD (2)
(__-__ hrs) |
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Definition
Vomiting, abd pain
2-24 hrs |
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Term
S/S of Phase 2 of Acetamin OD (4)
__-__ hrs |
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Definition
Hepatomegaly
RUQ pain
Acute Tubular Necrosis
Elevated LFTs
24-72 hrs |
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Term
S/S of Phase 3 of Acetamin OD (4)
___-___ hrs |
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Definition
Jaundice
Confusion
Coma
Dramatic LFT rise
72-96 hrs |
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Term
Phase 4 of Acetamin OD is called the ___ ___. This means what?
___-___ days |
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Definition
Crisis point; Pt improves or develops liver failure.
6-7 days |
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Term
True or False:
Tylenol has anti-inflammatory properties |
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Definition
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Term
| Acetamin OD: Give ___ ___ within ___ hours. |
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Definition
| Activated charcoal w/in 4 hrs |
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Term
Acetamin OD: Give oral liquid formation ___. This has a terrible ___ ___ smell.
Where does the acetaminophen go? |
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Definition
Acetylcysteine; rotten egg smell
Sent out in the feces |
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Term
| What do you do if your client vomits w/in 1 hr of acetylcysteine administration? |
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Definition
| Give them an anti-emetic and re-dose |
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Term
| What 2 systems are a concern with NSAIDs? |
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Definition
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Term
NSAID considerations:
___ and ___ tests
Can't take if allergic to ___.
Take with ___ to decrease GI upset.
Watch for ___ ___.
___ indicates OD. *If pt shows this, what do we look at next? |
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Definition
LFT and renal tests
Can't take if allergic to ASA.
Take with food to decrease GI upset.
Watch for GI bleed.
Tinnitus indicates OD.
*Look for GI bleed and S/S bleeding |
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Term
Celecoxib (Celebrex) is a COX-2 inhibitor. It's contraindicated with:
___ allergy
___ allergy
___ patient*
___ failure and ___*
*Why? |
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Definition
Sulfa allergy
ASA allergy
CABG patient*
Heart failure and HTN*
*Causes fluid retention |
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Term
Considerations for ASA:
Not for children <___ yo
Caution with ___ pts.
Anti___ effects |
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Definition
| 15; asthma; anti-platelet |
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Term
ASA is an anti-platelet.
D/C ___ wk(s) before surgery
Good for an ___
Contraindicated with ___. |
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Definition
| 1 week; MI; Anticoagulants |
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Term
What is the danger of giving ASA to kids <15?
Be familiar w/ S/S of it. |
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Definition
Reye's Syndrome
S/S (Chronologically):
Vomiting, stupor, fatty liver, coma, IICP, hepatic probs, seizure, organ failure, flaccid, high ammonia, death |
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Term
| ASA OD: ___ventilation results in respiratory ___. |
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Definition
| Hyperventilation = Resp Alkalosis |
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Term
ASA levels 250-400 mcg/mL OD:
Name 5 s/s |
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Definition
Nausea
Vomiting
Tinnitus
Tachycardia
Diaphoresis |
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Term
ASA levels >400 mcg/mL OD:
Name 5 S/S. |
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Definition
Resp alk
Hemorrhage
Seizure
Coma
Resp failure |
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Term
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Definition
| Activated charcoal/gastric lavage |
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Term
| Even though Torodol is an NSAID, why do we need a prescription? |
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Definition
| Because it is so hard-hitting on the kidneys. |
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