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44 Cards in this Set
- Front
- Back
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What are analgesics and what 3 types are there?
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Analgesics are medications that relieve pain. They include narcotics, nonsteroidal anti-inflammatory drugs (NSAIDS), and Antimigraine agents.
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What are the four types of anti-inflammatory agents?
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Salicylates, glucocorticoids, antigout medications, and disease-modifying antirheumatic drugs (DMARDs)
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What anti-inflammatory drugs can reduce a fever?
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Antipyretic medication includes salicylates and ibuprofen.
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What type of analgesic (1) and anti-inflammatory(1) drug causes reduced platelet aggregation?
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Salicylates and NSAIDs can be therapeutic to reducing thrombosis, but can cause risks for bleeds.
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What three medications can cause gastric ulceration?
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(Anti-inflammatory)- Salicylates, glucocorticoids.
(Analgesics)- NSAIDS |
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Tylenol or acetametiphen has what effects?
Doesn't have what effects? |
Tylenol is an analgesic and antipyretic.
It does not have anti-inflammatory effects, and does not reduce platelet aggregation. |
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List 6 types of opioid analgesics?
List 3 types of nonopiod analgesics? |
1) Morphine, Fentanyl, Meperidine(Demoral), Hydromorphone, Codeine, methadone.
2) Acetaminophen, NSAIDs (Tordol), Adjuvants |
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What is the sympathetic nervous response to being in pain? (5)
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1) Tachycardia
2) Hypertension 3) Tachypnea 4) Increased muscle tone in area of pain 5) Sweating, pallor, and hypervigilance. |
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What is the difference between the 1st (asprin) and second(celebrex) generation of NSAIDs?
What are the two inhibitor's in NSAIDs? |
- 1st generation is COX-1 and COX-2 inhibitor. 2nd generation is a selective COX-2 inhibator.
COX-1= reduces platelet aggregation. COX-2= reduces inflammation, pain, fever |
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What can be given with opioids to increse the analgesic effect w/o adverse effects?
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Opioids such as morphine can be given with ketorolac (Toradol) for up to 5 days.
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What is the max dose of acetaminophen in 1 day?
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4g
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What are the thrapeutic effects of opioids?
What is an action to be aware of? |
1) Relief of moderate to severe pain, sedation, reduction of bowel motility, and codeine is a cough suppression.
2) Opioids can cause respiratory depression. |
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How should you limit meperidine and why?
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Limit to 600mg/24hrs and use less than 48 hrs. Accumulations of normeperidine occurs sometimes and can cause seizures and neurotoxicity.
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If a patient on opioids has a rr less than 12/min what should you do?
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Notify the care provider and withhold the medication.
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What is fentanyl primarily used for?
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Used in surgury to induce anethesia. It is approx. 100x more potent than morphine.
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What is an opioid antagonist, and when is it used?
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Naloxone (Narcan) has no effects unless the person has been given opioids.
It is used to treat opioid overdose, and reverse the effects of respiratory depression. |
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What is the expected pharmacological action of DMARDs?
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SLow joint degeneration and progression of rheumatoid arthritis. These include Cytotoxic medications, gold salts, antimalarial agents, sulfasalazine, biologic response modifiers, and penicillamine.
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In 1969 what was the goal of AACN?
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To educate CC nurses in acute, critical, and progressive care areas.
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In 1970 what was the goal of SCCM?
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To ensure excellence and consistence in practice of critical cares multidisciplinary team members thru pt care, education, research, and advocacy.
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What are the AACF's 8 standards of care?
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Quality of care, individual practice regulation, education, collegiality, ethics, collaboration, research, resource utilization.
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What is the primary triage ranks?
What are people triaged by? |
1) Emergent, urgent, non urgent
2) Airway, breathing, circulation, disability (neuro), Evaluation (search body, and maintain heat) |
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How are people tagged in a mass casualty?
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Red tag- immediate treatment to maintain life
Yellow tag- Major and requires immediate care. Green tag- Minor injury Black tag- allow to die |
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What are the 6 defining ethical principles?
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1) Autonomy= make decisions w/o coercion or interference (recieving consent)
2) Beneficence= doing good and preventing harm 3) Nonmaleficence= prevent harm, correct harmful situations, quality of live vs. sanctity of life. 4) Veracity= truth telling 5) Fidelity= faithfullness, confidentiality, privacy. 6) Justice/ allocation of resourses= utilize your resourses acurately. |
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What are the 4 elements of negligence that gives cause for a nurse to be sued?
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duty, breach, cuase, damage. A duty must be established between the caregiver and patient, then a the cause for the damage must be because of a breach.
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what are torts?
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Defamation- communication that compromises a person's integrity or reputation. 2 types Libel= written and Slander= verbal.
It is also Assult (person feels immediate threat) and battery (Auctual harmful or offensive contact) |
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What are the three stages of general adaptation system (GAS) with ANS stimulation?
2) when does this physiologic response occur? |
1) Alarm reaction- release of neurotransmitters and endocrine hormones.
2) Adaptation/resistance- response to long term protection= increased blood glucose, and corticosteroids. 3) Exhaustion- unable to continue adaptation. - This occurs under stress. |
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What is the emotional response to stress?
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General inhibition system (GIS)= parasympathetic stimulation and defense mechanisms (withdrawal, avoidance, detachment)
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What is the long term psychological response to stress?
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Anxiety, self-concept, powerlessness, hoplessness, spiritual distress.
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what is the first indicator of increased confusion?
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Loss of orientation
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What are the 3 forms of delirium?
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1)Hyperactive= pt climbing out of the bed and trying to leave.
2)Hypoactive= stay very quiet and when they do speak they don't make sense. 3)Mixture of both. |
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What is confusion?
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-comes secondary to an organic cause
-50% of hospitalized elderly, >80% is an organic cause -Reversible -Abrupt onset |
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What is dementia?
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-Non-reversable
- gradual onset, for a long duration. |
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What is sleep?
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A reversible behavioral state of perceptual disengagement and unresponsiveness to the enviorment.
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What are the 2 stages of sleep?
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- non rapid eye movement= 70-75% of sleep, parasympathetic nervous system predominates, hormonal changes promote anabolism, protein synthesis and tissue repair, restorative period
- rapid eye movement= Dream stage (25-30%), sypathetic nervous system predominates, increased oxygen consumption, increased BP, HR, RR, CO. Inreased cardiac events such as dysrthmias, decreased response to low and high oxygen levels. |
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What are the circardian rhythms from suprachiasmatic nucleus (SCN)?
Where is the SCN located? |
1) These rhythms have internal controls (Body temp, sleep/wake cycle) and external controls (Posture, exercise, light)
2) The suprachiasmatic nucleus is found in the hypothalmus. |
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What are 2 devices used for the different types of sleep apnea?
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CPAP and BiPAP
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What are the 2 ways to control pain non-pharmacologically?
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1)Therapies= reduce pain transmission (TENS, heat, cold, message)
2) cognitive techniques= pt teaching, relaxation, guided imagery, music therapy, hypnosis. |
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What could you do to decrease ICP?
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1- pull fluid out of the cells (salt)
2- may need to sedate the patient or knock them out. |
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What should you know before you call the MD?
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the situation, background of the pt, assessment, and your reconmendation.
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What is a benzodiazepine?
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A sedative or hypnotic drug
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What is an anesthetic?
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Deep sedation drug
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What is a neuroleptic drug?
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An antipsychotic or antidelirium medication.
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What is an alpha-adrenergic recoptor agonist used for?
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Used to withdrawal symptoms, and short sedation
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When is an autopsy automatic no matter how the family feels?
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If the death is due to an injury.
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