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91 Cards in this Set

  • Front
  • Back

What is acute/transient pain?

Severe pain with a rapid onset and of short duration.

-Protective and has an identifiable cause

-Has a rapid onset

-Varies in intensity

-Is of short duration

-Generally disappears with healing

What is addiction?

A compulsive physiologic need for a habit-forming drug.

What is analgesia?

A decreased or absent sensation of pain.

What is anaphylaxis?

An exaggerated hypersensitivity reaction to a previously encountered antigen. The reaction may be localized or generalized.

What is cutaneous stimulation?

Stimulation of the skin.

What is drug tolerance?

A decreased physiological response after repeated administration of a drug or chemically related substance.

What is effleurage?

A type of massage stroke that glides without manipulating deep muscles, smooths and extends muscles, increases nutrient absorption, and improves lymphatic and venous circulation.

Massage upward and outward from vertebral column and back again. Circles.

What is epidural analgesia?

Delivery of an analgesic into the epidural space in pain control.

What is guided imagery?

Technique in which patient focuses on an image, becoming less aware of pain.

What is massage?

A form of cutaneous stimulation that involves the application of tough and movement to muscles, tendons, and ligaments.

What are nonopioids?

Analgesics that do not contain opioids.

What are opioids?

Pertaining to natural and synthetic chemicals that have opium-like effects although they are not derived from opium.

What is pain intensity?

The degree or extent of pain perceived by an individual.

What is a pain rating scale?

Graphic or numeric representations that allow patients to quantify their pain experience.

What is a PCA?

Patient controlled analgesia which is a technique that allows patients to self-administer small, continuous doses of IV or SQ opioids if they feel the need.

What is petrissage?

A massage technique in which the skin is gently lifted and squeezed.


What is physical dependence?

A physiological state in which abrupt cessation of a drug results in a withdrawal syndrome.

What is splinting?

Supporting the abdominal area to reduce pain caused by coughing or sneezing after surgery.

What are the three types of pain?

Acute, chronic/persistent, and cancer pain.

What are the JC pain standards?

-Recognize the right of patients to appropriate assessment and management of pain

-Assess pain in all patients

-Record the assessment in a way that facilitates regular reassessment and follow-up

-Educate providers/patients and families

-Establish policies that support appropriate prescription or ordering of pain medicines

-Include patient needs for symptom control in discharge planning

-Collect data to monitor effectiveness and appropriateness of pain management

How would you determine pain in a non-verbal patient?

-Attempt a self-report of pain using simple yes/no responses or vocalizations or a numeric rating scale.

-Explain why a self-report cannot be used.

-Search for the potential cause of pain by using physical examination techniques (e.g., palpation).

-Assume that pain is present after ruling out other causes (infection or constipation).

-Identify pathologic conditions or procedures that may cause pain.

-Observe patient behaviors (e.g., confusion, pacing, facial expressions, vocalizations, body movements such as guarding) that indicate pain. These vary based on patient's developmental level.

-Ask family members, parents, and caregivers for a proxy report of patient's pain.

-Attempt an analgesic trial if pathologic conditions or procedures that may induce pain are present.

What is chronic/persistent pain?

Pain that persists beyond the period of healing, ceases to serve a protective function, degrades patient function, and serves no adaptive purpose.

-Eventually becomes a disease in its own right

-Often lacks identified pathology

-Rarely has autonomic signs

-Does not provide a protective function

-Disrupts ADLs and sleep

-Degrades health and function of the individual

What is cancer pain?

Pain related to cancer that may be acute, chronic, or intermittent. It is usually related to tumor recurrences or treatment.

How often should you assess an individual on opioids for pain?

Every 4 hours for the first 24 hours.

When a PCA pump is used, who should press the button?

The patient should be the only person who presses the button.

What can NAPs do for pain?

They cannot assess for pain, but can provide selected non-pharmacologic strategies such as back rubs, heat, cold, or elevation as instructed by the nurse.

What are common PCA drugs?

Morphine sulfate, hydromorphone (Dilaudid), and fentanyl.

What does opioid naïve mean?

A person who has never taken any opioids for any reason or who have not taken opioids in the pas 5 weeks are more susceptible to effects of opioids.

Which patients may be at risk of over sedation when using a PCA pump?

Those with sleep apnea or obese patients with short, thick, necks.

What is the most common type of PCA error?

Incorrect programming. Other errors include failing to clamp or unclamp tubing, improperly loading syringe or cartridge, failing to monitor for side effects/overdose, and not responding to alarms.

What is an opioid reversing agent?

Naloxone (Narcan)

How should a massage end?

With long, stroking effleurage movements.

In which direction should a massage go?

From buttocks to shoulders.

What is a CRBSI?

Catheter-related bloodstream infection.

What is a CVAD?

Cardio vascular access device.

What is a CLABSI?

Central line-associated bloodstream infection.

What is an EID?

Electronic infusion device; Used to infuse intravenous (IV) fluid at a prescribed rate. There are two types: an infusion pump, which is designed to deliver a measured amount of fluid over a period of time; and an IV controller, which delivers fluid with the aid of gravity.

What is an electrolyte?

An element or compound that, when melted or dissolved in water or another solvent, dissociates into ions and is able to carry an electric current.

What is an embolus?

A foreign object, a quantity of air or gas, a bit of tissue or tumor, or a piece of thrombus that circulates in the bloodstream until it becomes lodged in a vessel.

What is the exit site?

The point at which a catheter leaves a body site.

What is FVD?

Fluid volume deficit; An alteration characterized by the loss of fluids and electrolytes in an isotonic fashion.

What is FVE?

Fluid volume excess;

An alteration characterized by the abnormal retention of fluids and electrolytes in an isotonic fashion.

What is a heparin lock?

An IV needle connected to a small "well" that allows for the intermittent injection of medication without the need for repeated venipuncture.

What is infiltration?

Presence of IV fluids within the subcutaneous space surrounding the venipuncture site.

What is an infusion pump?

A device designed to deliver a measured amount of fluid over a period of time.

What is an isotonic solution?

A solution with a total electrolyte content of approximately 310 mEq/L

What is a ONC?

Over-the-needle catheter; A type of angiocatheter. The needle used for peripheral intravenous access is encased in a catheter made of Teflon, plastic, or another flexible material. After the needle pierces the skin, the catheter is threaded into a vein, and the needle is withdrawn. The catheter remains in the vein for the instillation of fluid.

What is percutaneous?

Performed through the skin, such as a biopsy or the aspiration of fluid from a space below the skin using a needle, catheter, and syringe.

What is a PICC?

A peripherally inserted catheter that extends to the superior vena cava or right atrium.

What is phlebitis?

Inflammation of the vein.

What is a smart pump?

Infusion devices, referred to as a smart pumps by the Institute for Safe Medication Practices (ISMP), are commercially available infusion systems that perform a “test of reasonableness” to check that programming is within pre-established institutional limits before infusion can begin.

What is a subcutaneous tunnel?

A tunnel under the skin between the exit site of a catheter and the entrance into a body cavity (such as the epidural space) or vein.

What is thrombosis?

An abnormal vascular condition in which thrombus develops within a blood vessel of the body.

What is venipuncture?

Technique in which a vein is punctured transcutaneously by a sharp rigid stylet (such as a butterfly needle), a cannula (such as an angiocatheter that contains a flexible plastic catheter), or a needle attached to a syringe.

What is the goal of IV therapy?

To maintain or prevent fluid and electrolyte imbalances, administer continuous or intermittent solutions or medications, replenish blood volume, and assist in pain management.

What are hypotonic solutions used for?

Used to hydrate cells.

What are hypertonic solutions used for?

Used to increase intercellular fluid, or pull fluids from cells.

When is a central line used?

When fluid to be administered via IV has a pH less than 5.0 or greater than 9.0 and osmolarity greater than 600 mOsm/L

Which type of PVAD would you use for a patient needing continuous infusion for 1 to 4 weeks?

A midline peripheral catheter

What catheter size would you use for a trauma, surgery, or blood transfusion?

14, 16, or 18.

What size catheter would you use for children or elderly patients?


What size catheter would you use for someone with fragile veins?


How often should gauze dressing that cover a catheter site be changed?

Every 48 hours.

How long to IV tubing sets remain sterile for?

96 hours.

What are signs of FVD?

-Decreased urine output

-Dry mucous membranes

-Decreased cap refill

-Disparity in central and peripheral pulse




What are signs of FVE?

-Crackles in lungs

-Shortness of breath


What are indicators of IV infiltration?

-Slow infusion

-Insertion site is cool to touch

-Insertion site is pale

-Insertion site is painful when touched

When should IV fluids be changed?

Before 24 hours.

When should primary and secondary continuous infusion sites be changed?

-Every 96 hours for fluids other than lipid, blood, or blood products.

When should primary intermittent infusion sites be changed?

-Every 24 hours because of increased risk of infection with repeatedly disconnecting and reconnection the administration set.

What is a systematic IV complication?

Complications that occur within the vascular system and are usually remote to the infusion site.


-Circulatory overload


What is a local IV complication?

Complications resulting from trauma to the inner layer of the vein as a direct result of many factors such as poor insertion technique, inappropriate size of short peripheral device, pH of solution not within recommended ranges, and poor assessment and incorrect technique for short peripheral dressing changes.

What is the most common site of colonization and infection for IV catheters?

The skin insertion site.

What can be done to prevent colonization and infection with IV catheters?

Securely apply catheter dressing and change dressings when wet, soiled, or loosened.

When removing an IV and the patient is not taking anticoagulants, how long should you apply pressure for?

A minimum of 30 seconds.

When removing an IV and the patient is taking anticoagulants, how long should you apply pressure for?

5 to 10 minutes.

How long can a PICC line be in place?

As long as it functions properly with no evidence of IV related complications.

Which types of CVADs are considered permanent?

Hickman, Broviac, and Groshong external tunneled devices.

What is bacteremia?

The presence of bacteria in the blood.

What are amino acids?

An organic compound composed of one or more basic amino groups and one or more carboxyl groups. Amino acids are the building blocks that construct proteins and the end products of protein digestion.

What is parenteral nutrition?

The administration of nutrition into the vascular system. It is intended to meet the nutritional needs of patients until their GI function has improved enough to allow adequate intake using the oral or tube feeding route.

What are risks of PN?

-Risk of sludge in gallbladder

-Liver disease

-Severe GI disease

How is a PN solution produced?

Using sterile technique in a laminar airflow hood in a pharmacy to reduce the risk of microbial and pyrogen contamination.

What is in a PN solution?

Amino acids, glucose, and lipid as energy sources, with the addition of electrolytes, minerals, trace elements, vitamins, and water.

What is the Valsalva maneuver used for?

To prevent air from entering a line.

When using PN therapy, how often should blood sugars be checked?

Every 6 hours for the first 48 hours, then checked daily.

What is the ideal method for PN?

Central venous catheter which allows for a higher concentration of nutrients.

How should medications be passed on someone with a central line used for PN?

Use an alternative IV line and do not obtain blood samples or CVP readings through the PN port.

Should PN infusion be interrupted?

No, never.

When should CPN tubing be changed?

Every 24 hours or immediately if it become contaminated or soiled.

How often should you check on a PN patient?

-Check flow rate every hour

-Monitor I/O every 8 hours

-Check BS every 6 hours