Combined Exam Review bundle for NUR2356 \/ NUR 2356 Multidimensional Care I \/ MDC 1. |Contains Exam 1 Review, Exam 2 Review and Exam 3 (Final Exam) Review.|<\/p>\n\n\n\n
NUR 2356 Multidimensional Care I
MDC 1 Exam 1 Review<\/p>\n\n\n\n
NUR 2356 Multidimensional Care I
MDC 1 Exam 2 Review
Pain
\u25cf Will be subjective and individualized per patient. May be unpleasant to various degrees.
\u25cf Different patients may need different treatments
\u25cf Many units will use the same classes of pain medications and methods to manage, but
the patient’s goal for pain relief may be different.
\u25cf Always respect one’s pain level! 5th vital sign!
\u25cb Types of Pain:
\u25a0 Acute Pain: associated w\/ injury, medical condition, surgery. Lasts hours
to a few days, but not longer than 6 months.
\u25a0 Chronic Pain: associated w\/ long term or chronic illnesses, can continue
for months or years and may go into positions of exacerbations and
remission.
\u25a0 Cancer Pain: caused from
\u25a0 tumor progression, pathological processes,
\u25a0 invasive procedures, chemotherapy and drug toxicities, infection and
physical limitations.
\u25a0 Idiopathic Pain: chronic or acute pain without an identifiable cause. Take
this pain seriously!
\u25a0 Somatic Pain: From ligaments, tendons, nerves, blood vessels and
bones, often from fractures or sprains that cause the pain.
\u25a0 Visceral Pain: From deep internal disorders or diseases such as in the GI
system like cramps and stomach pain.
\u25a0 Cutaneous\/ Burning Pain: from damage or pain or inflammation on the
skin surface. Can be intense with movement and when completing ADLs,
often from touching a hot surface.
\u25a0 Radiating Pain: pain that starts at an origin and can extend or move to
other locations.
\u25a0 Referred Pain: pain that occurs in another area that is distal from the true
site of pain origin. Like Jaw pain with a patient with an MI.
\u25a0 Phantom Pain: AMPUTATIONS! Pain perceived from an area that is
surgically or tragically removed. It WILL be REAL! Often in the person’s
brain, so we need to give pain medications and
\u25a0 non-pharmacological interventions to keep the patient comfortable.
\u25a0 Neuropathic Pain: From an injury that impairs the nerve messaging
system to multiple nerves. Often results in numbness and tingling.
\u25a0 Intractable Pain: pain that cannot be relieved.
\u25cf Assessment
\u25a0 Remember: to always note the client’s developmental level, cognitive
disabilities, culture, and gender when assessing pain.<\/p>\n\n\n\n
\u25a0 Always try to ask the patient about their pain and their goals for pain.
More information= better result.
\u25a0 GOAL: treat the pain before it becomes severe
\u25a0 Ask the client to describe the pain in terms of timing, location, severity,
quality, aggravating and precipitating factors, and relief measures, that
affect their life.
\u25cf PQRST
\u25cb P= Provoking Factors: what makes the pain worse, what
makes the pain better. What causes the pain.
\u25cb Q= Quality: how the pain feels (sharp, dull, stabbing,
throbbing)
\u25cb R=Region\/ Radiate: where is the pain located and\/or does
it move or expand to other tissues.
\u25cb S=Severity: how intense is the pain (0-10)
\u25cb T=Time: when did the pain start, how long have you had it,
intermittent or constant.
\u25a0 Use a numeric scale, faces scale, visuals to assess.
\u25a0 If not able to tell you about pain: use FLACC Scale, CRIES
\u25a0 Look at nonverbal behaviors like grimacing, positioning, guarding,
movement in the bed, arms and limbs, etc.
\u25cf Interventions
\u25cf Non-pharmacological
\u25cf Hot\/ Cold Therapy: helps to constrict and dilate blood vessels,
reduce swelling and inflammation, and soothe pain.
\u25cb May need an order for use
\u25cb Includes warm compresses, warm water, heated blankets,
thermal pads, hot tubs, and whirlpool baths. Cold packs,
ice bags.
\u25cb Monitor temp to prevent skin from burning.
\u25cb Keep on for a certain amount of time.
\u25cb Remove the source if one has problems with sensation or
discomfort.
\u25cf Cutaneous Stimulation: refocuses the attention to tactile stimuli
rather than pain.
\u25cb Reduces muscle pain
\u25cb Acupressure
\u25cb Uses hot and cold therapy, therapeutic touch.
\u25cb May need an order.
\u25cb Massage: helps to decrease pain in the back, shoulder,
hands and feet.
\u25a0 Do not use one who has PVD or calf swelling, or in
the neck.
\u25cf TENS: the application of a device that gives a mild electric current
over areas of pain to block the impulses.<\/p>\n\n\n\n
\u25cb Do not use this with a client with a pacemaker
\u25cf Binders, slings and supportive devices:
\u25cb Various objects that can ease the pain when there is
musculoskeletal injury, pain or other process where one is
immobile.
\u25cb Includes elevation to reduce swelling by using pillows to
relieve pain.
\u25cb Teach patients how to use it.
\u25cf Relaxation: use of different strategies to decrease tension, anxiety,
increase sleep and control.
\u25cb Use of breathing techniques, yoga, etc
\u25cb Teach to use before pain is severe.
\u25cf Distraction: takes the patients mind off of the pain with sensory
engagement
\u25cb TV, books, newspaper, coloring
\u25cb Muscle Therapy and pet therapy are often ordered to help
someone relax and reduce pain.
\u25cf Guided Imagery: using the imagination to create a relaxing effect
with deep breathing.
\u25cb Usually of places the person loves
\u25cf Biofeedback: involves adjusting and controlling the body’s
feelings, thoughts and responses from stimuli.
\u25cf Pharmacological
\u25cf Non-Opioids
\u25cb NSAIDS
\u25a0 Ex: aspirin, ibuprofen.
\u25a0 Helps to relieve minor aches, pains, fevers.
\u25a0 Contraindicated w\/ gastric irritation or PUD or
allergy
\u25a0 Bleeding is a big concern- have to report if vomiting
or pooping blood.
\u25a0 Take these meds w\/ food to reduce gastric or
stomach irritation.
\u25a0 Can amplify effects of anticoagulants
\u25a0 Hypoglycemia if used with a oral antidiabetic
\u25a0 Toxicity w\/ CCB
\u25a0 Adverse effect: gi upset and bleeding
\u25cb Acetaminophen
\u25a0 Ex: tylenol
\u25a0 Helps to relieve minor aches, pains, fevers.
\u25a0 Do not use w\/ hepatic or renal disease clients,
alcoholism, or hypersensitive (allergy).
\u25a0 Assess for liver dysfunction<\/p>\n\n\n\n
\u25a0
\u25a0
\u25a0
\u25a0
\u25a0
\u25cf Opioids:
\u25a0
\u25a0
\u25a0
\u25a0
\u25a0
\u25a0
\u25a0
\u25a0
\u25a0
\u25a0
\u25a0
Monitor for hepatic damage such as N,V,D, ABD
pain.
Monitor liver function labs
Teach clients that self medication should not be
used 10 days post d\/t hepatotoxicity.
Antidote is acetylcysteine!
Adverse effect: liver damage (hepatotoxicity)
These medications suppress pain but can also
suppress respiration and coughing as they act on
the respiratory systems.
Tolerate low doses first before advancing to higher
doses. IV best route.
Administer before pain gets bad.
Teach about physical dependence.
Take BP, RR,HR, do not use low RR, low HR and
Low BP.
LIsten to the lungs and monitor LOC.
Safety precautions: falls.
Monitor I\/O and take medication with a snack.
Do not do activities like driving if taking the
medication.
Assess for its effect after given.
Opioid antidote is naloxone and it should be on
hand.
\u25cb Codeine:
\u25a0 Used as a cough suppressant
\u25a0 Can cause constipation
\u25a0 Ex: hydrocodone\/ oxycodone
\u25cb Hydromorphone:
\u25a0 Concern: respiratory depression
\u25a0 Can make one drowsy, dizzy, and have orthostatic
hypotension
\u25a0 Monitor vital and RR
\u25a0 Assist the client when getting up, get up slowly to
prevent one from falling.
\u25cb Morphine
\u25a0 Used to ease moderate to severe pain
\u25a0 Concern: respiratory depression
\u25a0 Adverse effects: orthostatic hypotension, urinary
retention, constipation, pupil constriction, N,V.
\u25a0 Do not use it with patients with severe respiratory
disorders, head injuries, renal disease, seizure
activity, increased ICP.
<\/p>\n","protected":false},"excerpt":{"rendered":"
Combined Exam Review bundle for NUR2356 \/ NUR 2356 Multidimensional Care I \/ MDC 1. |Contains Exam 1 Review, Exam 2 Review and Exam 3 (Final Exam) Review.| NUR 2356 Multidimensional Care IMDC 1 Exam 1 Review NUR 2356 Multidimensional Care IMDC 1 Exam 2 ReviewPain\u25cf Will be subjective and individualized per patient. May be […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-114725","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/114725","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=114725"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/114725\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=114725"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=114725"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=114725"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}