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Medical-Surgical Nursing, 9th Ed., Ignatavicius & Workman, 2018 Nursing (RN) School Study Aid


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4 - Assessment and Care of Patients with Pain
27 Picmonics to Learn | 37 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
Delirium
Mechanism
Rapid Onset
Reversible
Assessment
Hallucinations
Decline in Cognition
Short Attention Span
Rapid Speech
Change in Activity Level
Mood Swings
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
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
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
P450 Inhibitors
Quinidine
Ciprofloxacin
Isoniazid
Grapefruit Juice
Acute Alcohol Use
Erythromycin (Macrolide)
Indinavir
Cimetidine
Sulfonamides
Ketoconazole
Amiodarone
1 min
P450 Inducer
Griseofulvin
Phenytoin
Carbamazepine
Rifampin
Barbiturates
Chronic alcohol use
St. John's Wort
50 secs
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
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
Naloxone (Narcan)
Mechanism
Competitive Opioid Receptor Antagonist
Indications
Opioid Induced CNS Depression
Side Effects
Severe Nausea and Vomiting
Excitable State
Opioid Withdrawal Symptoms
Considerations
Repeated Dosing Often Required
1 min
Opioid Abuse and Withdrawal Assessment
Abuse Assessment
Euphoria
Miosis
CNS Depression
Abuse Withdrawal
Yawning
Gooseflesh
Sweating
Rhinorrhea
Kicking Movements
Consideration
Naloxone
1 min
Opioid Antidote
Antidote
Naloxone
28 secs
Tramadol
Indications
Chronic Pain
Mechanism of Action
Weak Opioid
Inhibit Serotonin and NE reuptake
Side Effect
Increased Risk of Seizure
47 secs
Meperidine (Demerol)
Mechanism
Opioid Receptor Agonist
Indications
Moderate to Severe Pain
Post Anesthesia Shivering
Side Effects
Tremors
Constipation
CNS Depression
Sedation
Considerations
Short Term Administration
Increased Risk Serotonin Syndrome
Does NOT cause Miosis
Renal Failure Increases Toxicity Risk
1 min
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
Diazepam (Valium)
Indications
Anxiety
Seizures and Status Epilepticus
Muscle Spasms
Alcohol Withdrawal
Side Effect/Assessment
Dizziness/Vision Changes
Confusion/Amnesia
Urinary Incontinence
Behavioral Changes
Respiratory Depression
Antidote
Flumazenil (Romazicon)
Nursing Considerations
Fall Precaution
Do Not Stop Abruptly
1 min
Benzodiazepine Intoxication Assessment
Drowsiness
Confusion
Respiratory Depression
Hypotension
Coma
Treatment
Flumazenil (Romazicon)
1 min
Benzodiazepine Antidote
Antidote
Flumazenil
29 secs
Promethazine (Phenergan)
Mechanism
Histamine H1 Receptor Antagonist
Weak Dopamine Antagonist
Indications
Nausea and Vomiting
Motion Sickness
Side Effects
Respiratory Depression
Sedation
Anticholinergic Effects
Extrapyramidal Symptoms
Considerations
Use Large Bore IV
Monitor for Tissue Necrosis
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
Pregabalin (Lyrica)
Mechanism
GABA Analog
Indications
Seizures
Neuropathic Pain
Fibromyalgia
Side Effects
Headache
Dizziness
Somnolence (Fatigue)
Weight Gain
Angioedema
Rhabdomyolysis
Considerations
Dependence
1 min
Tricyclic Antidepressants (TCAs)
Mechanism of Action
Inhibits Reuptake of Norepinephrine and Serotonin
Indications
Depression
Bipolar Disorder
Fibromyalgia
Side Effects
Sedation
Orthostatic Hypotension
Anticholinergic Effects
Cardiac Toxicity
Considerations
Delayed Effect
Do Not Stop Abruptly
2 mins
Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
Indications
Depression
Diabetic Peripheral Neuropathy
Duloxetine
Panic and Anxiety
Venlafaxine
Mechanism of Action
Inhibits Reuptake of Serotonin and NE
Side Effects
Hypertension
Insomnia
Nausea and Vomiting
Decreased Libido
1 min
Lidocaine
Mechanism
Blocks Na+ Channels
Indications
Ventricular Arrhythmia
Anesthetic
Side Effects
Paresthesias
Seizures
Respiratory Depression
Drowsiness
Consideration
Anesthetic Effects Extended with Epinephrine
1 min
Transdermal Medication Administration
Application
Patch or Disc
Directly on Skin of Arms, Chest, Upper Back
Benefits
Avoids First Pass Metabolism
Sustained Administration of Medication
Nursing Considerations
Clean Skin After Removal
Rotate Sites of Patches
Apply to Dry Skin
Avoid Shaved Skin
Avoid Heat
Nitro Effects Lost After 24 Hours
1 min

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