1050: Pain NEW (OPS) EXAM 2

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Author:
xiongav
ID:
286736
Filename:
1050: Pain NEW (OPS) EXAM 2
Updated:
2014-10-23 18:36:47
Tags:
NURS
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Description:
Pain mgmt
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  1. Morphine (mod-sev, chronic, post-op pain)

    max dose
    action
    Pt teaching
    SFX/AFX
    nurse interventions
    • 10 mg/24 hr
    • action: Binds with opioid receptors in the CNS, altering perception of and emotional response to pain.
    • Pt teaching:
    • -post-op use incentive spirometer.
    • -avoid hazardous activities
    • SFX: confusion, constipation, hypotension, sedation, urinary retention, N/V (CCHSUNV)
    • AFX: RESPIRATORY DISTRESS
    • Nurse Interventions: 
    • -Reassess pain 15 & 30 minutes after giving parenterally/orally
    • Alert: Keep opioid antagonist (naloxone) and resuscitation equipment available.
    • -Monitor: circ., resp., bladder, and bowel functions carefully.
    • -If respirations <12 breaths/minute, withhold dose and notify prescriber.
  2. fentaNYL (mod-sev pain)

    max dose
    action
    Pt teaching
    SFX/AFX
    nurse interventions
    • 1,600 mcg; 1.6 mg
    • action: *same as morphine (CNS)
    • Pt teaching: 
    • -Take before intense pain
    • -If used for post-op drug, use incentive spirometer to increase lung capacity.
    • -Avoid hazardous activities & alcohol
    • SFX: bradycardia, confusion, constipation, N/V, restlessness, sedation.
    • AFX: APNEA
    • Interactions: grapefruit juice
    • Nursing interventions:
    • -Monitor circ., resp., status and urinary function carefully (for RESP. DISTRESS)
    • -Monitor post-op VS and bladder function. 
    • -Immediately report RR <12 breaths/min, decreased respiratory volume, or decreased Sao2.
  3. codeine (mild-mod pain & diarrhea/cough)

    max dose
    action
    pt teaching
    SFX
    AFX
    nurse interventions
    • 60 mg P.O for mild-mod pain 
    • Action: *same for OPs
    • Pt teaching: 
    • -Take before intense pain
    • -Take w/ milk or meals if GI distress PO.
    • -Avoid hazardous activities & alcohol
    • -May cause drowsiness, dyspnea, difficulty breast-feeding
    • SFX: confusion, constipation, hypotension, N/V, sedation
    • AFX: NONE IDENTIFIED
    • Nurse Interactions: 
    • -Assess 15 & 30m after use.
    • -Usually given w/ aspirin or acetaminophen.
    • -Drug is ANTI-TUSSIVE, should not be given when cough is valuable diagnosis.
    • -Monitor cough, circ. & resp. status
  4. HYDROmorphone

    max dose
    action
    pt teaching
    SFX
    AFX
    nurse interventions
    • 64 mg (extended release), mod-sev pain.
    • Action: *same for OPs
    • Pt teaching: 
    • -Take before intense pain.
    • -Take w/ food if GI upset occurs.
    • -If taken post-op, encourage pt to turn, cough, and breath deeply to avoid lung problems.
    • -Avoid hazardous activities & alcohol.
    • SFX: blurred vision, confusion, constipation, hypotension, physical dependence, restlessness, sedation
    • AFX: RESP. DEPRESSION, bronchospasm, bradycardia.
    • Nurse Interaction:
    • -Reassess pain 15 & 30m after.
    • -Black Box Warning: Routinely monitor all patients for s&s of misuse, abuse, and addiction during treatment.
    • -Monitor resp. and circ. status and bowel function.
    • -Keep opioid antagonist (naloxone) available.

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