17 Pain and Sedation Flashcards Preview

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Flashcards in 17 Pain and Sedation Deck (21)
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1
Q

Do children tolerate pain better than adults

A

no, pain tolerance increases with age.

2
Q

What does QUESTT stand for? this is to assist in remembering components of pain management.

A
Question the child
Use pain rating scales 
Evaluate behavior 
Secure parent’s involvement 
Take cause of pain into account
Take action and evaluate results
3
Q

What does the ABCDE approach of pain management stand for

A
Ask about pain and assess systematically
Believe patient and family
Choose appropriate pain-control options
Deliver interventions in timely, logical, and coordinated fashion
Empower or enable patient and family
4
Q

What is most important about pain assessment tools

A

use the same one consistently

5
Q

Three possible meds for neuropathic pain?

A

gabapentin, carbamazepine, pregalban

6
Q

Downsides of PRN dosing?

A

peaks and valleys, leads to undermedication, (by the clock is better), decreases trust with HCP,

7
Q

What is pseudoaddiction?

A

Pseudoaddiction is distress and drug seeking that can occur in the context of unrelieved pain, such as similar behaviors in addicts. The main factor of this syndrome is that sufficient pain relief eliminates aberrant behavior, especially seen in the sickle cell population.

8
Q

remember

A

big emphasis in slides on phys dependence vs addiction, implying that HCPs are overly cautious about addiction in children and should prescribe opiods for pain mgmt as necessary

9
Q

When to give IM pain meds

A

no need to ever give it. subQ may be acceptable in rare cases but usually not necessary

10
Q

requirement for meds given via epidural

A

preservative free solution to prevent CNS irritation

11
Q

What is associated with meperidine

A

rigors. not good pain control, works better for providing euphoria.

12
Q

When to taper opiods

A

if used for 1-3 weeks or longer, usually at 10-20% every other day

13
Q

Do not use this as pain management with sickle cell patients

A

cold - can worsen pain crisis

14
Q

What to do prior to a tricyclic antidepressant, such as amitriptyline?

A

EKG to rule out prolonged QT

15
Q

Onset of fentanyl? lasts?

A

less than 1 m, lasts 30-45 min

16
Q

Onset of IV hydromorphone? how long does it last

A

rapid onset but lasts 4-6 h

17
Q

What is the key to successful EOL care

A

family involvement

18
Q

acetaminophen and codein dose

A

0.5-1 mg/kg per dose PO 4-6 h

19
Q

Fentanyl pediatric vs adult dose

A

Peds .06 mg/kg q3-4h
Adult 7.5 mg q3-4 h

for IV .01-.02 IV q2h

20
Q

Hydrocodone dose

A

0.1-0.2 mg/kg per PO q4-6h

21
Q

How much more potent is hydromorphone (dilaudid) than morphine

A

5 times more