First Aid and Pharmacology Quiz

Analgesia and Pain

• Pain is described as an unpleasant sensory and emotional experience associated with actual or potential tissue damage.
• Critical care patients often experience acute pain with an identifiable cause expected to resolve within a certain time frame.
• Interventions should aim to provide relief and comfort, especially for the elderly who may experience both acute and chronic pain. Pain can affect daily activities and personal relationships.
• Pain perception is a subjective experience and a patient's self-report is crucial. However, in critical care, some patients are unable to self-report.
• Factors in the ICU environment can influence pain experience including anxiety, sleep deprivation, unfamiliar surroundings and noise from machines.

Components of Pain

• Sensory: the characteristics of pain, such as its intensity, location, and quality.
• Affective: negative emotions such as unpleasantness, anxiety, and fear associated with the experience of pain.
• Cognitive: the person's interpretation of the meaning of the pain.
• Behavioural: the strategies used to express, avoid, or control the pain.
• Physiological: nociception and the stress response.

Types of Pain

• Acute pain: short duration, typically associated with the healing process (less than 30 days).
• Chronic pain: persisting for more than 6 months after the injury or illness.

Classification of Pain by Pathology

• Nociceptive pain: normal physiological response to noxious stimuli.
• Somatic pain: involves superficial tissues (skin, muscles, joints, and bones).
• Visceral pain: involves organs (heart, stomach, and liver), less localized.
• Neuropathic pain: abnormal processing of sensory input by the nervous system.
  • Can be peripheral (damage to peripheral nerves) or central (damage to central nervous system structures).

Physiology and Anatomy of Pain

• Transduction: noxious stimuli converted to an action potential
• Transmission: through afferent neurons to the spinal cord and the brain
• Modulation: process by which pain signals are enhanced or inhibited (in the spinal cord)
• Perception: integration of pain signals (in the cerebral cortex).

Strategies for Pain Management

• Pain assessment is individualized to each patient.
• Subjective/self-report: PQRSTU (Provocative/Palliative, Quality, Region/Location, Severity, Timing, and Understanding
• Behavioral pain scale (BPS) assesses facial expressions and limb movements.
• Critical care pain observation tool (CPOT) is useful for patients who cannot self-report.

Pain Management of Acute Pain

• Pharmacologic: WHO analgesic ladder (mild, moderate, & severe pain) uses opioids and NSAIDs.
• Non-Opioid Analgesics/ Therapy: Acetaminophen inhibits prostaglandin synthesis. NSAIDs block COX-1 and COX-2 enzymes.
• Adjuvant therapy: corticosteroids, antidepressants, anticonvulsants used alongside other analgesics.

Non-pharmacological management

• Techniques for appropriate pain management
• Ice/warm packs, relaxation techniques, guided imagery, biofeedback, and music therapy are examples of non-pharmacological pain relief methods that can be useful in improving pain relief.

Preventing and Treating Respiratory Depression

• Respiratory depression is a serious side effect of opioids, and risk increases with concomitant use of other CNS depressants.
• Naloxone (an opioid antagonist) can reverse respiratory depression.

Monitoring for Opioid-Induced Respiratory Depression

• Assessment of vital signs like age, disease, BMI, physical health.
• Identify factors in the hospital environment and patient care such as modality, environment and if the patient is intubated
• Recognize advancing sedations that are a sensitive indicator of impending Respiratory depression
• Reliable assessment tools are POST (Pasero Opioid-Induced Sedation Scale) and RASS (Richmond Agitation Sedation Scale)

Non-pharmacological management

• Techniques that are not focused on medications are utilized to manage pain; examples include application of ice/heat, relaxation methods, and other self-care methods.

Emergency Nursing

• Managing patients with emergency situations in a unique setting.
• Managing urgent medical condition from accidents, medical emergencies and or natural disaster events involving the patient's immediate physical or psychological safety.
• The nurse performs a thorough assessment and determines the highest priority based on the condition of the patient.

First Aid

• Temporary and immediate care to an injured/ill person.
• Effective procedures to keep the victim alive, involves life-threatening conditions and taking actions.

Triage Categorization

• Categorizing patients severity of injury/health condition.
• Emergent (Level 1): immediate threat, life threatening injury.
• Urgent (Level 2): serious injury, may die without immediate treatment.
• Non-urgent (Level 3): no immediate life-threatening issue.
• Minimal (Level 4): minor injury or condition.

Burns

• Tissue damage from exposure to heat, chemicals, radiation, or extreme cold.
• Types:
  • Thermal: dry or moist heat (burns)
  • Chemical: acids or bases
  • Electrical: high voltage, direct current
• Classification: first-degree (epidermis), second-degree (deeper dermis), third-degree (full thickness).
• Management involves cooling, debridement, wound care, and fluid replacement.

Drowning

• Death from suffocation while submerged in a body of water.
• Classifications and prevention approaches.
• Types of drowning (active and passive) and resulting medical conditions.

Poisoning

• Ingestion of toxic substances.
• Types of poisoning (ingested, inhaled, injected, and absorbed)
• Prevention focuses on safety measures in homes and communities.
• Emergency treatment includes decontamination methods like gastric lavage.

Animal Bites/Stings

• Common causes.
• Prevention approaches and emergency care protocols.

Other Biological Dressings

• Include amniotic membrane, cultured skin, and artificial skin.
• Provide wound coverage and prevent infection.

Nursing Interventions During the Rehabilitation Phase

• Promote activities that patients can tolerate, to avoid overexertion
• Monitor for fatigue, fever and pain tolerance
• Improve body image and self-concept; refer to support groups.

Other Environmental Emergencies

• Heat-related illnesses (stroke) and their treatment approaches
• Respiratory problems caused by environmental exposures- their treatment approaches.

Test your knowledge on first aid principles and pharmacological guidelines with this comprehensive quiz. Cover scenarios like providing care without consent, assessing patients, and understanding the use of medications. Perfect for healthcare professionals and students in medical fields.