Review of Pain, Sleep, Medications, Diagnostic Tests, and Admission/Discharge

Flashcards based on lecture notes about pain, sleep, medications, diagnostic tests, and patient admission/discharge.

What is meant by 'quality' of pain?

The discomfort, what it feels like

What is radiation of pain?

Does the pain go from one spot to another?

What does severity of pain describe?

Describes how bad the pain is

What does timing of pain refer to?

How often the pain is happening

What are some of the pain scales used?

Numeric scale, faces pain scale

How can you tell if someone is in pain?

A person's number on the pain scale, their facial expressions, and their vitals

What does TENS do?

Stimulates the muscles

Name some non-pharmacological pain relief methods besides TENS.

Acupuncture, hydrotherapy, biofeedback, distraction, heat and cold, guided imagery

What is the most common side effect of narcotic pain medications?

Constipation

What are some interventions for constipation related to pain medication?

Increase fluids, stool softeners, suppositories, enemas

How should a fentanyl pain patch be disposed of at home?

Wrap in a bio bag and dispose of it in a trash can that is not accessible

What are the two stages of sleep?

REM and non-REM

What do vital signs look like during non-REM sleep?

Vital signs are lower

What do vital signs look like during REM sleep?

Vital signs are pretty normal

How many times do you cycle through REM and non-REM sleep a night?

Five to six times

How much sleep does a newborn need?

10-14 hours

How much sleep does a school-age child need?

10-11 hours

What things can patients bring from home to help them sleep in the hospital?

Blankets, pillow, CPAP, white noise machine

What is narcolepsy?

Recurrent, uncontrollable episodes of falling asleep

What are two names of drugs?

Generic and brand/trade

Who is the last check for medication?

Nurse

What would you do if you noticed a discrepancy with controlled substances every time another nurse was working?

Report it to charge nurse.

What are the four parts of pharmacokinetics (ADME)?

Absorption, distribution, metabolism, excretion

Where are medications excreted from?

Kidneys and bladder

How does poor kidney function affect medications?

It would affect how those medications get excreted.

Besides IV, what is one of the fastest ways for drugs to be absorbed?

Inhaled

What is the primary effect of Benadryl?

Decrease any allergic reaction

What is a secondary effect of Benadryl?

Sleepiness

What are the pharmacodynamics?

Onset, peak, and duration

What is a black box warning?

Medication has some pretty nasty side effects, but benefits outweigh the harm

Name some routes for administration of medication.

Topical, transdermal, oral, parenteral, mucous membranes.

What are the three different oral routes of medication administration?

Swallowing, sublingual, and buccal

What does parenteral mean?

Under the skin, in the muscle, or in the IV

Where does an intercardiac injection go?

In the heart

Where does an intravenous injection go?

In a vein

Where does an epidural injection go?

In the spinal column

What are the six rights of medication administration?

Right patient, right drug, right dose, right route, right time, right documentation

What are you going to do if a patient says, I've never taken this before?

Don't give it and check the order

What types of medications do you need to double-check for?

Insulin and narcotics

What do we say instead of noncompliant?

Non-adherent

What is a medication reconciliation?

A list of all their current medications

What order means, now you need to get it up here now?

Stat

What is a renewal medication order?

The doctor has to approve it

What are protocols?

It's usually an order set.

What is a unit dose system?

Prepackaged, pre-labeled, pre-shipped from the pharmacy

Where are controlled substances stored?

Locked up behind two locks

When measuring an oral medication in liquid form, how do you check to make sure you have the right amount?

Meniscus at eye level

How do you instill eye drops?

Pull down the lower lid and put the drops in the lower conjunctival sac, don't touch the eye with the dropper

How do you position the ear for eardrops in an adult?

Up and back

How do you position the ear for eardrops in a child?

Down and back

What will help you get good delivery of medication from an inhaler?

Use the spacer

When inserting a rectal suppository, which end goes in first?

Pointed end

Which finger do you use to insert a rectal suppository?

Index finger

If you have five crushable medications to administer via feeding tube, how do you administer them?

One at a time with 30 mL water flushes in between each

If someone's on continuous suction while administering medication via feeding tube, how long do you turn off the suction for?

Turn it off for 30 minutes

How should the head of the bed positioned during/after medication administration via the feeding tube?

Raise it 30 degrees for 30 minutes to an hour

When do you report medication errors?

As soon as they happen

What needs to be on the label of a syringe after drawing up medication?

Medication, patient name, and dose

What areas do you want to avoid when giving an injection?

Hairy areas, blood vessels, or nerves

What size syringe and gauge is used for intradermal injections?

5/8 inch and 25 to 29 gauge

What degree do you hold the needle for an intradermal injection?

5 to 15 degrees

What is the maximum amount you can inject subcutaneously?

1 mL

What angle can you hold the needle for a subcutaneous injection?

45 to 90 degrees

How are you holding the needle for an intramuscular injection?

90 degrees

How are you going to prevent needle sticks after injection?

Drop it like it's hot into the sharps container