Pain Scales and Opioid Terms
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Questions and Answers

What role can family play in patient education for certain cultures?

  • They are only involved during emergencies.
  • They may assist in financial decisions only.
  • They may play a central role in decision-making. (correct)
  • They are usually excluded from decision-making.
  • What is the primary cause of gout?

  • Infection of the joint space.
  • Autoimmune disorder affecting joint tissues.
  • Buildup of uric acid crystals in the joints. (correct)
  • Insufficient hydration leading to joint inflammation.
  • What is a common side effect of Diphenoxylate with atropine?

  • Increased bowel motility.
  • Reduced intestinal fluid absorption.
  • Increased appetite.
  • Reduced bowel movements. (correct)
  • Why should PPIs be used cautiously in ICU patients?

    <p>They can prevent stress ulcers.</p> Signup and view all the answers

    What is a potential consequence of long-term laxative use?

    <p>Dependency and decreased bowel tone.</p> Signup and view all the answers

    What is a serious risk associated with giving aspirin to children?

    <p>Reye's syndrome</p> Signup and view all the answers

    What is the maximum recommended dosage of acetaminophen for adults per day?

    <p>4 grams</p> Signup and view all the answers

    Why should NSAIDs be taken with food?

    <p>To avoid GI upset or ulcers</p> Signup and view all the answers

    What potential risk is associated with long-term use of NSAIDs?

    <p>Kidney damage</p> Signup and view all the answers

    What should be monitored when a patient uses opioids?

    <p>Signs of respiratory depression</p> Signup and view all the answers

    Why should patients using NSAIDs avoid alcohol?

    <p>Increases the risk of liver and GI issues</p> Signup and view all the answers

    What important measure should be taught for the safe storage of unused opioid medications?

    <p>Keep in a locked location</p> Signup and view all the answers

    What is a common misconception about the use of alternative therapies in medication administration?

    <p>They can interfere with conventional medications</p> Signup and view all the answers

    What is the primary consideration when assessing a patient?

    <p>Airway, breathing, and circulation</p> Signup and view all the answers

    Which pain scale uses a numerical range from 0 to 10 to represent pain levels?

    <p>0-10 Numeric Pain Intensity Scale</p> Signup and view all the answers

    What does opioid tolerance require from patients over time?

    <p>Higher doses for the same effect</p> Signup and view all the answers

    What is hydromorphone's strength compared to morphine?

    <p>7 times stronger</p> Signup and view all the answers

    What is the recommended respiratory rate before administering opioids?

    <p>12/min or higher</p> Signup and view all the answers

    What is a common side effect of opioid use that requires patient education?

    <p>Constipation management</p> Signup and view all the answers

    What defines opioid dependence?

    <p>Physical withdrawal symptoms upon cessation</p> Signup and view all the answers

    What is naloxone commonly used for?

    <p>Overdose reversal</p> Signup and view all the answers

    Study Notes

    Pain Scales

    • Verbal Pain Intensity Scale: Describes pain levels from "no pain" to "worst possible pain."
    • 0-10 Numeric Pain Intensity Scale: Rates pain on a scale from 0 (no pain) to 10 (worst possible pain).
    • Visual Analogue Scale: Uses a line to represent pain intensity, with "no pain" at one end and "worst possible pain" at the other.
    • Wong-Baker FACES® Pain Rating Scale: Uses faces to represent pain levels, with "no hurt" corresponding to 0 and "hurts worst" corresponding to 10.

    Opioid Terms

    • Opioid naive: Individuals with no prior opioid use.
    • Opioid Tolerance: The body requires higher doses of opioids to achieve the same pain relief.
    • Partial Agonist: An opioid medication that binds to opioid receptors but has a weaker effect than a full agonist. Can also block the effects of other opioids.
    • Opioid Dependence: Physical dependence on opioids, marked by withdrawal symptoms when the drug is stopped.

    Opioid Analgesics

    • Hydromorphone (Dilaudid): 7 times stronger than morphine, requiring smaller doses for pain relief.
    • Respiratory Depression: A critical side effect of opioids, which can lead to fatal respiratory failure; monitor respiratory rate before and after administering.
      • Older adults: Post-operative older adults are at higher risk for respiratory depression.
      • Naloxone (Narcan): Opioid antagonist for reversing opioid-induced respiratory depression; keep available in case of overdoses or surgical anesthesia.
    • Discharge Teaching:
      • Constipation: Encourage fluids, fiber, and stool softeners.
      • Opioid safety: Highlight the risks of tolerance and dependence.
      • Side effects: Educate patients on common side effects like drowsiness and dizziness.

    Non-Opioid Analgesics and NSAIDs

    • Aspirin:
      • Children: Avoid aspirin in children due to the risk of Reye's syndrome.
      • Adult prophylaxis: Used to prevent coronary artery disease and cardiovascular accidents in high-risk adults.
      • Intoxication: Hyperventilation and drowsiness are common signs in children.
    • Acetaminophen (Tylenol):
      • Max dosage: Do not exceed 4 grams/day to prevent liver damage.
      • Common uses: Effective for mild pain and fever reduction.
      • Preferred for children: Safest option for pain relief and fever in children.
    • Ibuprofen (Advil) and NSAIDs:
      • Action: Reduces inflammation, pain, and fever.
      • GI considerations: Take with food to minimize stomach upset or ulcers.
      • Bleeding risk: Monitor patients for bleeding, particularly those taking anticoagulants or the elderly.
    • Patient Teaching:
      • Alcohol: Avoid alcohol to minimize liver and GI complications.
      • Long-term use: Educate patients on potential kidney damage, increased bleeding risks, and gastric ulcers.

    Discharge Instructions

    • Opioids:
      • Dependence and tolerance: Discuss the risks of these conditions.
      • Respiratory depression: Teach signs of slowed breathing and confusion.
      • Medication safety: Provide guidance on safe storage and disposal of unused medications.
    • NSAIDs:
      • GI risks: Emphasize the importance of taking NSAIDs with food, and advise reporting stomach pain or black stools.
      • Max doses: Clarify daily maximums and potential risks of exceeding them.
      • Contraindications: Explain that NSAIDs are not suitable for patients with renal disease.

    Cultural Considerations in Medication Administration

    • Tailored education: Consider cultural preferences and provide communication strategies for different cultures, such as using interpreters or providing written instructions in the preferred language.
    • Health beliefs: Respect alternative therapies and provide guidance that aligns with individual beliefs.
    • Family involvement: Engage families in decision-making and patient education when appropriate, especially in cultures where families play a central role in healthcare.

    Anti-Gout

    • Gout: Arthritis caused by uric acid crystal buildup in joints, resulting in severe pain, swelling, redness, and tenderness.
    • Uric acid: Gout occurs when the body produces too much uric acid or cannot remove enough of it effectively.
    • Medications: Allopurinol (Zyloprim) and Colchicine are common treatments.

    Gastrointestinal Drugs and Bowel Disorder Drugs

    • Diphenoxylate with atropine (Lomotil): OPIOID prescription laxative that slows intestinal motility to reduce diarrhea.
    • Bismuth Subsalicylate (Pepto-Bismol): Can cause dark stools, tongue discoloration, and constipation.
    • Simethicone (Mylicon): Treats excessive and painful intestinal gas; safe for infants and adults.
    • Calcium antacids: Not frequently used due to potential complications.
    • Magnesium-containing antacids: Use cautiously in patients with kidney failure due to the risk of complications like kidney stones.
    • H. pylori treatment: Often involves omeprazole (PPI) and antibiotics.

    Antacid and Medication Administration

    • Administration timing: Administer medications at least one hour apart from antacids to prevent interactions.

    Cimetidine Side Effects

    • Elderly patients: Can cause confusion and disorientation in older individuals.

    PPIs and ICU Patients

    • Stress ulcers: PPIs are used in this context to prevent stress ulcers in patients with nasogastric tubes and ventilation.
    • Osteoporosis: Long-term PPI use increases the risk of osteoporosis.
    • Sodium bicarbonate: Overuse can lead to metabolic alkalosis.

    Long-Term Laxative Use

    • Dependency and bowel tone: Prolonged laxative use can cause laxative dependency and weakened bowel tone.

    Histamine (H2)-Receptor Antagonists

    • Know your medications: Familiarize yourself with the specific properties and implications of histamine (H2)-receptor antagonists.

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    Description

    This quiz covers critical concepts related to pain assessment scales and opioid terminology. It includes questions on the Verbal Pain Intensity Scale, Numeric Pain Intensity Scale, and various opioid-related terms such as opioid naive and opioid dependence. Test your understanding of pain management and opioid use in clinical settings.

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