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60 Cards in this Set
- Front
- Back
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Diffuse pain originating in the tendons, bones, blood vessels and nerves |
Somatic Pain |
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A temporary flare-up of moderate to severe pain despite medication |
Breakthrough Pain |
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Pain occurring after a weak or nonpainful stimulus |
Allodynia pain |
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Pain that is perceived in an area that is not the site of origin |
Referred Pain |
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Pain that is rapid in onset and varies in intensity |
Acute pain |
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Pain that occurs when organs are distended or inflamed |
Visceral pain |
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Pain that lasts longer than six months |
Chronic pain |
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Pain where a physical cause cannot be identified |
Psychogenic |
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Pain within the skin or subcutaneous tissue |
Cutaneous |
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Pain that is resistant to therapy |
Intractable |
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Which action would be the most appropriate when a client reports that an injection of morphine sulfate has not provided pain relief? |
Notify the MD |
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Which of the following information is most important for the nurse to assess prior to administering an opioid injection? |
Respiratory rate |
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In managing care for a client receiving a transdermal pain patch, it is important for the nurse to: |
Rotate the placement of site
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The priority nursing diagnosis for a client who will be placed on a pain-control analgesic (PCA) pump post-operatively is: |
Knowledge deficit |
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The nurse should question which of these medicaiton orders for a client admitted with a diagnosis of breast cancer and bone metastases? |
Morphine sulfate 50mg IV every 2 hours prn for breakthrough pain-------this dose exceeds the normal dose. |
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It is important for the nurse to include which of these findings when assessing a client receiving epidural analgesia? Assessment of the client's: |
lower leg sensation |
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After surgery, the client tells you that she would rather not take the prescribed opioid analgesic because she is afraid she might become addicted to the drug. What is your best response? |
When opioid drugs are taken for acute symptoms, they are not addictive. |
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An 85 year old client is receiving meperidine 100mg IM for postoperative pain. This client would be at increased risk for which specific complication of meperidine therapy? |
central nervous system irritability and seizures |
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The family of a client just started on a fentanyl transdermal patch for analgesic adminstration calls to report that 12 hours later the client is still in severe pain. What is your best response? |
"Continue to give the oral medication the first day as the patch may take up to 36 hours before enough medication is absorbed to relieve the pain." |
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A nurse would monitor for gastric irritation, signs of bleeding, and bruising as side effects of which pain medication? |
Aspirin, Ibuprofen |
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What is the drug category of choice for the treatment of mild-to-moderate bone pain? |
Opioids |
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The acid base disorder associated with elevated respirations is? |
Resp. alkalosis |
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A mass amount of ketones in the blood would give rise to.... |
Metabolic acidosis |
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Respiratory failure is often associated with? |
Pco2 above 45---too much co2, not enough being blown off |
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in a long standing metabolic acidosis, the resp rate may increase. This is an example of... |
Compensation |
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PH 7.51, Pco2 40, Hco3 31: |
Uncompensated metabolic alkalosis |
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PH 7.33, PCo2 29, HCo3 16: |
Partially compensated metabolic acidosis |
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PH 7.40, PCox 40, Hco3 24: |
Normal |
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PH 7.12, PCO2 60, Hco3 29: |
Partially compensated respiratory acidosis |
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PH 7.30, Pco2 59, Hco3 28: |
Partially compensated resp. acidosis |
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T/F? There is an inverse relationship between the pH and the number of Hydrogen ions |
True. If one goes up, the other goes down |
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If there is a decrease amt. of carbon dioxide available, what will happen to the pH? |
The ph will rise above 7.45--- |
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If a client is losing bicarbonate because of diarrhea, what will happen to pH? |
It would become more acidic. |
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When hydrogen ions are lost, we would expect the pH to do what? |
The pH would rise |
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Between the respiratory and metabolic (kidney) systems, which one responds within mins. to hours? |
Respiratory system.....The metabolic (kidneys) take hours to days. |
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A client is admitted with a diagnosis of metabolic acidosis. Which system will be first to compensate? Also, which will come in second? |
1. Buffers 2. Respiratory |
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A client is on a ventilator causing the pt. to hyperventilate. What will happen to pH? |
Will go up. Alkalosis |
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A patient has resp. alkalosis. what assessment will tell the nurse that compensation is occurring?
Respiratory effort is deep, and rapid or urinary output of 100 ml per hr? |
Urinary output of 100 ml per hour.---metabolic compensates for resp. |
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What will happen to pH if a pt. is unable to conserve Hco3? |
The ph will become depressed. |
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What does ROME stand for? |
Respiratory opposite, Metabolic equal. |
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A pt. has metabolic acidosis, which will tell the nurse that patient is compensating?
urinary output of 25 ml per hr or deep, rapid respirations? |
Deep, rapid respirations.---respiratory will compensate for kidneys. |
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A pt. has metabolic acidosis. which nursing intervention is most important to help client compensate? Raise hob to high fowlers or record intake and output? |
Raise the HOB. |
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A pt. has metabolic alkalosis. which assessment is most important and would indicate compensation is occurring? irregular pulse or decreased twitching in face/hands. |
Decrease twitching in the face and hands.--symptoms of alkalosis include: tingling of fingers/toes/face |
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How would the respiratory rate of a patient be if he had severe diarrhea? |
Increased rate and depth.---lungs are trying to fix metabolic problem. |
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Y/N? would you expect to see metabolic acidosis in a infant who had extreme vomitting? |
No. Vomit=acid, decrease acid= alkalosis. |
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As the pH decreases in serum. will H+ ions more into or out of the cell? |
They move into the cell. when H+ goes into the cell. it means you are no longer in a acidic state, ph is in vascular system now versus being in blood. |
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As metabolic acidosis is corrected, which assessment should be reported to MD Asap? Irregular pulse or respiratory rate 24? |
Irregular pulse. |
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when the pH is elevated as a result of a metabolic alkalosis, what will happen first? |
The lungs will slow respirations to retain Co2. |
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As ph increases, H+ in blood do what? |
H+ ions in blood decrease |
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What interventions can be done for a pt. who is hyperventilating and has respiratory alkalosis? |
*Decrease ventilator settings*increase sedation level*have pt. breath in paper bag |
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Will Pneumonia cause the pH in the serum to drop or rise? |
pH will drop because they are retaining too much Co2. |
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Vomiting causes... |
Met. alkalosis. fluid excreted from stomach |
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Diarrhea causes... |
Met. Acidosis--loss of bicarb |
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Renal failure causes... |
met. acidosis--cant conserve bicarb |
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diuretics (lasix) causes.... |
met. acidosis-- too much loss of bicarb |
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fever causes... |
met. acidosis---over production of H+ |
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hyperventilation causes.... |
resp. alkalosis--rid of too much Co2 |
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acute pulmonary edema causes.... |
resp. acidosis---too much co2 |
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diabetic ketoacidosis causes.... |
met. acidosis--overproduction of ketones (acid) |
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opioid overdose causes.... |
resp. acidosis---cannot blow off co2 |
