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Medical-Surgical Nursing, 11th Ed., Harding, Kwong, Roberts, Hagler & Reinisch Nursing (RN) School Study Aid


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8 - Pain
19 Picmonics to Learn | 28 mins

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Pain Assessment
Types of Pain
Acute Pain
Chronic Pain
OPQRST Mnemonic
Onset
Provoking or Palliative
Quality
Radiation
Severity
Timing
Nursing Considerations
Subjective Findings
Objective Findings
Reassessment of Pain
1 min
Acetaminophen
Indications
Fever
Pain
Mechanism of Action
Reversibly inhibits COX
Acts primarily in CNS
Side Effect
Hepatic Necrosis
N-acetylcysteine Antidote
51 secs
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of PDA
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
1 min
Celecoxib
Indications
Rheumatoid Arthritis
Osteoarthritis
Pain
Mechanism of Action
NSAID
Selectively Inhibits COX-2
Side Effects
Sulfa Allergy
Increased Risk of Thrombosis
GI Bleed
Contraindication
Pregnancy > 30 Weeks
1 min
Ibuprofen (Advil, Motrin)
Mechanisms
NSAID
COX Inhibitor
Indications
General Pain
Fever
Inflammatory Conditions
Side Effects
GI Ulcers
Nephrotoxicity
Rash
Considerations
Avoid with Alcohol
Risk of Thrombotic Event
1 min
Aspirin (Acetylsalicylic Acid)
Mechanism
Inhibits Platelet Aggregation
NSAID
Indications
Thrombotic Event Prevention
General Pain
Inflammatory Conditions
Fever
Side Effects
Pancytopenia
GI Ulcers
Bleeding
Considerations
Withhold Before Surgery 7-10 Days
Reye's Syndrome
2 mins
Morphine
Mechanism
Opioid Receptor Agonist
Indications
Pain
Myocardial Infarction
Side Effects
Nausea and Vomiting
CNS Depression
Biliary Colic
Constipation
Increased Intracranial Pressure (ICP)
Pupillary Constriction
Hypotension
2 mins
Codeine
Mechanism
Opioid Receptor Agonist
Indications
Mild to Moderate Pain
Cough Suppressant
Side Effects
Sedation
Constipation
Miosis
Considerations
Close Monitoring When Breast Feeding
Often Combined with Non-Opioids
1 min
Butorphanol
Indications
Migraine
Severe Pain
Labor
Mechanism of Action
Partial Agonist at Mu and Full Agonist at Kappa Receptors
Less Respiratory Depression
Side Effects
Withdrawal Symptoms
1 min
Opioid Antidote
Antidote
Naloxone
28 secs
Lidocaine
Mechanism
Blocks Na+ Channels
Indications
Ventricular Arrhythmia
Anesthetic
Side Effects
Paresthesias
Seizures
Respiratory Depression
Drowsiness
Consideration
Anesthetic Effects Extended with Epinephrine
1 min
Selective Serotonin Reuptake Inhibitor (SSRI) Overview
Indications
Depression
Anxiety
Mechanism of Action
Selective Serotonin Reuptake Inhibitors
Drugs
Paroxetine
Sertraline
Escitalopram
Fluoxetine
Side Effects
Sexual Dysfunction
Serotonin Syndrome
Treat with Cyproheptadine
2 mins
Bupropion
Indications
Depression
Smoking Cessation
Mechanism of Action
Increase Dopamine and NE
Side Effects
Stimulant Side Effects
Seizure
1 min
Carbamazepine (Tegretol)
Mechanism
Inactivates Na+ Channels
Indications
Seizures
Bipolar Disorder
Trigeminal Neuralgia
Side Effects
Nystagmus
Ataxia
Hepatotoxicity
Blood Dyscrasias
Water Retention
Stevens-Johnson Syndrome
Considerations
Avoid Grapefruit Juice
1 min
Gabapentin
Primary Indication
Seizure Treatment
Secondary Indications
Peripheral Neuropathy
Postherpetic Neuralgia
Bipolar Disorder
Migraine Prophylaxis
Mechanism of Action
Inhibits Voltage-Gated Ca2+ channels
GABA Analog
Side Effects
Ataxia
Sedation
1 min
Lamotrigine (Lamictal)
Mechanism
Blocks Na+ Channels
Indications
Seizures
Bipolar Disorder
Side Effects
Diplopia
Stevens-Johnson Syndrome
Headache
Aseptic Meningitis
Nausea and Vomiting
Considerations
Screen for Suicide Risk
1 min
Pregabalin (Lyrica)
Mechanism
GABA Analog
Indications
Seizures
Neuropathic Pain
Fibromyalgia
Side Effects
Headache
Dizziness
Somnolence (Fatigue)
Weight Gain
Angioedema
Rhabdomyolysis
Considerations
Dependence
1 min
Routes of Administration Part One
Enteral Administration
Oral
Sublingual
Buccal
Rectal
Tubes
Topical or Mucous Membrane Administration
Transdermal
Drops/Spray
Vaginal
Inhalation Administration
Inhalation
1 min
Routes of Administration Part Two (Parenteral)
Parenteral Administration
Intradermal
Subcutaneous
Intramuscular (IM)
Intravenous
Epidural
Intrathecal
Intraosseous
Intraperitoneal
1 min

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