Drugs for Pain Opiods and Headaches-pharm

Use of opioids in children children are left

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Unformatted text preview: ular and subcutaneous – Intravenous – Epidural and intrathecal Time Required to Produce Maximal Respiratory Depression with Opioid Analgesics Route of Administration • IV • IM • SC Approximate Times • Within 7 minutes • Within 30 minutes • Within 90 minutes Goals of Therapy • Remove the cause and alleviate suffering by using the least toxic, most effective drug, and the one with the least amount of sedation. Use of Opioids in Children • Children are left untreated or are inadequately treated for pain • Pain assessment in children is more difficult • Consider giving children medications for pain in same circumstances as an adult • Approach to child should be individualized • Growth and developmental characteristics of various ages of children should be understood • Assessment tools that meet developmental age of child (pain faces, stick figures, thermometer diagram) should be used • Listen to parents, family members, and guardians about child’s behavior when he or she is in pain** Use of Opioids in the Older Adult • • • • • • • • Dosage and dosing intervals are required (start slow and go slow) Observe for enhanced medication responses Older adults have multiple medical problems and take numerous medications Multiple assessment skills should be used Height, weight, and body surface area are not accurate measurements for analgesic dosing in the older adult Communicate, remembering cultural, physiologic, and psychological differences Assessments should be adapted to meet the needs of the older adult Some analgesics are inappropriate for the older adult Selected Nursing Diagnoses Related to Opioid Therapy • Ineffective airway clearance related to cough reflex suppression • Ineffective breathing pattern: hypoventilation related to CNS depressant effects of drug • Risk for deficient fluid volume related to nausea and/or vomiting • Constipation • Urinary retention • Risk for injury related to sensory/perceptual alterations Nonpharmacologic Adjuncts to Analgesic Therapy • Relaxation techniques: rhythmic breathing, counting, and purposeful relaxation of muscle groups • Acupuncture • Meditation • Cognitive behavioral therapy • Guided imagery • • • • Therapeutic touch Biofeedback Hypnosis Distraction: music, television, visiting with friends, working on a project • Support groups, prayer, and pastoral counseling Critical Thinking Questions Mrs. K., aged 58, has had surgery to remove a tumor from her back. She asks you for pain medication. On assessment she states that her pain is an “8” and that her pain is located in the incision area. You give her Morphine Sulfate. 1. 2. What type of pain is she experiencing? Severe Within an hour of receiving MS, the patient complains that her skin feels “itchy” but she cannot find any hives. What do you tell her? 1. This is a side effect. She might have histamine releases. You could give her lotion. You could give benadryl for itching....
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This document was uploaded on 03/25/2014.

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