Test 2 Flashcards

Question

4 phases of wound healing

Answer 1

1. Vascular Response: vessels constrict to keep bacteria out and stop bleeding, fibrin meshwork, platelet aggregation. 2. Inflammatory response: helps to limit bacterial effects and setup environment for tissue repair. 3. Proliferative Phase: Collagen deposition, epithelialization, granulation tissue depostition, form new blood vessesls. 4. Maturation Phase (longterm phase): Remodel scar, up to 1 yr or longer, capillaries begin to disappear, scar thins and turns white.

Answer 2

1. Primary: Surgical incision healing 2. Secondary: Heals from inside out; left open 3. Tertiary: A primary that opened up or got an infection

Answer 3

1. Cutaneous: skin and subcut tissue; localized; sharp, stinging. Specific part of body. 2. Somatic: Less receptors; not as localized; not sharp; muscles, bones, ligaments; dull; poorly localized. 3. Visceral: Deep; pain of body organs; dull, defuse, vague pain. Ex Cholecystitis, Appendicitis. 4. Referred Pain: Related w/ visceral, organ has no pain sensors; transfers pain to another part body. Ex: Jaw pain from heart attack. 5. Phantom Limb Pain: Amputations, continue to sense pain after nerve severed. 6. Neuropathic: caused by damage to nerve fibers; numbness, burn, stab/pin & needles. Ex. Diabetics.

Answer 4

Increasing the dose beyond an upper limit provides no greater analgesia. Ex: Aspirin, Tylenol, NSAIDS. No ceiling on Opioids

Answer 5

Tolerance occurs when the person no longer responds to the drug in the way that person initially responded.

Answer 6

Physical dependence is an expected physiologic response to ongoing exposure to pharmacologic agents, manifested by a withdrawal syndrome that occurs when blood levels of the drug are abruptly decreased

Answer 7

A Psychological dependence. A complex neurobiologic condition characterized by aberrant behaviors.

Answer 8

When pain breaks through before next scheduled dose. Utilize a different drug to get the person by. Ex: alternating tylenol and motrin.

Answer 9

A dose of one analgesic that is approximately equivalent in pain relieving effects to a given dose of another analgesic.

Answer 10

``` Opioid (Narcotics): strongest Narcotic agonist/antagonists: Moderate NSAIDS: Cox1 and Cox2 Prostaglandin synthesis inhibitors Salicylates Tylenol ```

Answer 11

Treatment that enhances existing med regimen; pharm agent added to a drug to increase the effect. Not designed for pain meds

Answer 12

Elavil- chronic pain

Answer 13

Valium - relieve muscle spasm

Answer 14

decrease inflammation

Answer 15

gabapentin (Neurontin) or pregabalin (Lyrica): neuropathic pain

Answer 16

Inflammation of gall bladder | S&S: Rt upper quad pain, referred pain; back or rt shoulder; epigastric pain; increased WBC; fever.

Answer 17

Presence of stones

Answer 18

Inflammation of bile duct

Answer 19

Located in the joint capsule @ head of femur.

Answer 20

Located outside of capsule where it meets acetabulum.

Answer 21

Stage 1: inflammatory stage: Form hematoma, helps stabilize fracture. 1-3 days. Stage 2: fibrocartilage formation, 3-14 days Stage 3: Callus formation, 2-6 weeks Stage 4: Ossification, 3 wks- 6 mo.

Answer 22

A process by which fat tissue passes into the bloodstream and lodges within a blood vessel.

Answer 23

Happens with a spica cast; cast around waist. Edema causes pressure against artery and intestines. leads to necrosis of the bowel.

Answer 24

- neurovascular assessment - assessment for areas of pain of "hot spots" under the cast - With hip spica: assess for SMA syndrome: nausea, vomiting, bloating.

Answer 25

1. Help reduce muscle spasms | 2. Help align bone

Answer 26

physiologic process by which information about tissue damage is communicated from the peripheral to the central nervous system (CNS)

Answer 27

o Transduction is the conversion of a mechanical, thermal, or chemical stimulus into a neuronal action potential. o Transmission is the movement of pain impulses from the site of transduction to the brain. o Perception occurs when pain is recognized, defined, and assigned meaning by the individual experiencing the pain. The brain is necessary for pain perception. o Modulation involves the activation of descending neurochemical pathways that exert inhibitory or facilitatory effects on the transmission of pain.

Answer 28

describing the onset, duration, characteristics, pattern, location, intensity, quality, and associated symptoms such as anxiety and depression. The patient’s beliefs, expectations, and goals for pain management are also assessed.

Answer 29

Pain medications generally are divided into three categories: nonopioids, opioids, and adjuvant (coanalgesic) drugs. o Mild pain often can be relieved using nonopioids o Moderate to severe pain usually requires an opioid. o Neuropathic pain often requires adjuvant drug therapy alone or in combination with an opioid or another class of analgesics. Treatment is typically augmented with adjuvant therapies including tricyclic antidepressants, antiseizure drugs, and α2-adrenergic agonists.

Answer 30

* Nonopioids are characterized by an analgesic ceiling, lack of ability to produce tolerance or dependence, and availability without a prescription. * Nonopioid pain medications include acetaminophen, aspirin, and NSAIDs. * NSAIDs are associated with a number of side effects including bleeding tendencies, gastrointestinal (GI) ulcers and bleeding, and renal and CNS dysfunction.

Answer 31

• Opioids are the strongest analgesics available. Opioids produce their pain-relieving effects by binding to receptors in the CNS, inhibiting the transmission of nociceptive input from the periphery to the CNS. • Common side effects of opioids include constipation, nausea, vomiting, sedation, respiratory depression, and pruritus. • Concerns about sedation and respiratory depression are two of the most common fears associated with opioids. o Sedation is usually seen in opioid-naive patients in the treatment of acute pain. o Patients most at risk for respiratory depression include those who are opioid naive, are elderly, have underlying lung disease, have a history of sleep apnea, or are receiving other CNS depressants.

Answer 32

* Adjuvant analgesic medications are used alone or in conjunction with opioid and nonopioid analgesics. They include antidepressants, anticonvulsants, α-adrenergic agonists, and corticosteroids. * Tricyclic antidepressants enhance the descending inhibitory system and are effective for a variety of pain syndromes, especially neuropathic pain syndromes. * Antiseizure drugs affect both peripheral nerves and the CNS, and are effective for neuropathic pain and prophylactic treatment of migraine headaches. * Clonidine (Catapres) and tizanidine (Zanaflex) are the most widely used 2-adrenergic agonists and may be used for chronic headache and neuropathic pain. * Corticosteroids, including dexamethasone (Decadron), prednisone, and methylprednisolone (Medrol), are used for management of acute and chronic cancer pain, pain resulting from spinal cord compression, and inflammatory joint pain syndromes. * Ketamine (Ketalar) is an NMDA receptor antagonist that is potentially useful for blocking mechanisms that lead to or sustain central sensitization.

Answer 33

Antiseizure drugs, tricyclic antidepressants, SNRIs, transdermal lidocaine, and α2-adrenergic agonists will be used for multimodal treatment when opioid analgesics alone do not control neuropathic pain

Answer 34

This period in the health care continuum includes the time before surgery (the preoperative period), the time spent during the actual surgical procedure (the intraoperative period), and the period after the surgery is completed (the postoperative period)

Answer 35

conduct the preprocedure verification, assess the patient, and mark the procedure site before transferring the patient into the OR for surgery. • Procedures such as inserting intravenous (IV) catheters and arterial lines and removing casts may occur here.

Answer 36

using adjunctive drugs to complement the induction, is the most common approach used for general anesthesia. • Nearly all routine general anesthetics begin with an IV induction agent.

Answer 37

o Administered by an endotracheal tube, a laryngeal mask airway, or a tracheostomy and enter the body via the lung alveoli. o Complications of inhalation anesthesia include coughing, laryngospasm, bronchospasm, increased secretions, and respiratory depression.

Answer 38

uses a local anesthetic and is injected near a central nerve (e.g., spinal) or group of nerves (e.g., plexus) that innervate a site distal to the point of injection. o Spinal and epidural anesthesia are types of regional anesthesia. o When spinal or epidural anesthesia is used, the patient can remain fully conscious, receive MAC, or choose general anesthesia

Answer 39

During a surgical time-out, the surgery team will stop all activities right before the procedure to verify the patient identification, surgical procedure, and surgical site. Proper identification will be accomplished by asking the patient to state name, birth date, and operative procedure and location. In addition, the surgical team will compare the hospital ID number with the patient’s own ID band and chart.

Answer 40

To reverse severe benzodiazepine-induced respiratory depression, the nurse would administer flumazenil

Answer 41

Naloxone would reverse opioid-induced respiratory depression.

Answer 42

Atelectasis, which occurs as a result of retained secretions or decreased respiratory excursion.

Answer 43

is almost exclusively seen in the older surgical patient and describes a decline in cognitive function (e.g., memory, ability to concentrate) for weeks and months after surgery.

Answer 44

Postoperative nausea and vomiting remain the most common postoperative complications. Risk factors that contribute to their development include gender (female), history of motion sickness or previous postoperative nausea and vomiting, anesthetics or opioids, and duration and type of surgery. treated with the use of antiemetic or prokinetic drugs. Oral fluids should be given only as indicated in the PACU

Answer 45

may be expected, regardless of fluid intake. This low output is caused by increased aldosterone and ADH secretion resulting from the stress of surgery, fluid restriction before surgery, and fluid loss through surgery, drainage, and diaphoresis.

Answer 46

Used in asthmatic patients because it promotes bronchodilation Used in trauma patients because increase HR and cardiac output

Test 2 Flashcards

(71 cards)