Pain & Sedation

Nociceptive pain is our _____ pain that's r/t some kind of _______ or _____ pain

Functional pain is d/t an abnormal presence of or inappropriate activation of the ______ w/in the _______

Opiates are the mainstay of _____ & _____ acute pain. It works on our _______ receptors to inhibit ________

Morphine IV dose is _________ & continuous infusion dose is _______

Morphines duration is _____. It is assoc. w/ ______ & _______ release causing _____, _____, _____

Meperidine (Demerol®) is an opiate that has an active metabolite, _________, which is a ________. It's a poor choice for pt w/ ______ or hx of _______. Assoc. w/ ______ & _______

In most places, meperidine (Demerol®) for children is limited only to _________

Fentanyl can accumulate in the blood and cause a _______ effect or it can cause _______, meaning patients become _______ to it no matter how much you inc. the dose

Fentanyl has less _______ effects although is assoc with _________ & then chest wall rigidity when given to quickly

PCA is used to control moderate-to-severe _______ pain, _____ pain, and _______ pain

Ketorolac (toradol): Limit IV use to ____ days due to ADR’s

Etomidate (Amidate®) is an ultra short acting, non ______, _______ like compound that causes sedation. Not assoc. w/ _____ or ______

Etomidate (Amidate®) is associated with _____, _____, ____, _____

Lorazepam (Ativan®) IV dose: ______ mg/kg/dose Q____ hours

Lorazepam (Ativan®) has fewer _______ than other benzos, but it contains ______ that can be toxic to _____

Benzodiazepines potentiate ______ (neuro inhibitory transmitter) & have sedative, ________, ________ and anticonvulsant properties

Dexmedetomidine (Precedex) is a __________ with potent sedative and mild analgesic properties

Prior to procedure you need to obtain patients “AMPLE” history...This stands for

Pre-Sedation Evaluation includes ______, ______, & ______

Minimum Fasting Time Period for clear liquids is ____ hrs; Breast milk is ____ hrs; Formula/milk is ____ hrs; & Solid foods is _____ hrs

Depolarizing or agonist NMBA produces muscle paralysis through binding with ________, allowing for ________ and then paralysis

Non-depolarizing or antagonist NMBA produces muscle paralysis through ________ at the ________ receptor site and does not allow for _______

Most common nerves used for TOF are the _____ & _____ nerves

Desired number of elicited twitches w/ TOF is at least _____

Pediatric patients receiving sedation and/or analgesic agents greater than or equal to ___ days are at risk for withdrawal

Withdrawal is seen in 100% of pediatric patients receiving opioids or benzodiazepines for >___ days and will require a slow sedation taper

Assessment tools for withdrawal include neonatal assessment scale for infants <____ old and the Withdrawal Assessment Tool (WAT) for ______

Patients who have received opioids or other sedative agents for _____ days, benefit from switching from IV agents to ______

If s/s of withdrawal are observed during the weaning process, an IV dose of “rescue” morphine _______ mg/kg or lorazepam ______ mg/kg should be given

The most common adjunctive therapy to smooth sedation titration and minimize withdrawal is the use of _______

Iatrogenic risk factors of delirium: sleep deprivation, _______, _______, ______, and psychoactive meds

Long term outcomes of delirium: Inc. risk for psychological conditions (PTSD), _______, & _____

The neonatal infant pain scale tool evaluates _____, _____, & ______. It is used in patients < _______ & ranges from 0-7

Opioid analgesics work on ______ opioid receptors including ____, ____, & ____ receptors. The predominant receptor is _____

NSAIDs work by inhibiting _______, thereby blocking the production of ______ & _______

Signs of opioid overdose include respiratory depression, lethargy, ______, _____, _______ skin, and decreased level of consciousness