Chapter

10 Chapter
12

Analgesics -

pain meds table 12 .

2
pg165 :
Surgery levels &
purpose

Opiates
-

hydrocodone

Pg/24 non opiate

-

Mylend
anticonvulsants

tylenol/codeine
Corticosteroids
Table10 /
adjuvant other med (benzo, antidepressants
,

given
.
-

opiates releases stimulus ,

release prostaglanding

travels spinal cord to brain I t .

arrects the CNS

Demeral synthetic opiate (agonist)

↳ agonist : works with

antagonist : works against (block

opiates)
a
don't give to pts c :

bad Kidneys it
cannot excrete from
body
be awa re of type of
drug given
Hansdermal
Fentanyl (parenterally
, intraspinal ,
patch ,given
for
for surgy
postop
pain
IV , patch , PCA pump (pain reliefs

Patch : 48-72hrs ,
for chronic pain ,
make sure
you
take of old one

have
2 nurses witness you disposing of it
. Monitor resp status

check Vitals ,
check on them
frequently
how you administer
beware of
analgesics

pt education in PCA pumps important

non pharmacological : biofeedback ,

PT , distraction , heat cold
,

massage
. TENS unit

WHATS UP ? -
Pain assessment

Where ? How ?
Aggravating ? Timing? Severity? Useful data ?I t !
perception

Pt Education
-

Side effects
.

Constipation : NSAIDs \ Opiates (fluids

laxatives I ,
stool softeners)
digital stimulation)
Fatigue
·

Adverse
Effects

Mombor Vitals
,
RR

* monitor total acetaminophen levels. *

SBAR : Situation
, Background ,
Assessment, Recommendation

as you
go
about SBAR , think of ADPIE
 labs
equipment given , insurance approval ,

consent

consents are
good for 30 days ,
follow hospital policy
prehabilitation :
planned preop functional lifestyle prep to achieve best postop outcome
,
physical a

Factors influencing outcomes :

Age ,
Chronic disease emotional ,
.
responses Nutrition , Smoking/alcohol/drug
-

smoking to
abuse

long Capacity
((8) smokingzaghrs Privoases(
&

Davinci
-

>
- lithotripsy
 pg 1039

voluntary movement

6 muscles to move the

eye
4 rectus muscles

-side to side

2
oblique muscles
.

rotate eyeball
-

intervated by cranial nerves

#I -Ocular motor-control muscles in eye

_ -trocher
e

1039
py enhance facial expressions
eyebrows

Sli eyelashes -

help keep debris out of eye

Conjunctiva -
mucous membrane that lines inner surface of
eyelid a anterior surface of
eyeball
lacrimal
sac/glands :
produces tear

pg1038 Autonomic System : innervates convergence/assess alignment of each

Nervous to do
muscles in
eye eye

pglove E
vessels/nerves)
↓
sclera-white of
eye (blood PERLAA

cornea-sits over eye

(colored portion of
eye) allows light to go in eye/of blood vessels

iris-ring of colored eyes

. controls amount of light going into eye
retina-back of
eye
Optic never transmits signal to brain

vision involves the focusing of light rays on the retina a transmission of the subsequent nerve impulses to the visual area

of the cerebral corted

 presbyopia

elasticity
presbyopia-loss of in
eye
shellen Chart-visual
accity
Echart-letters is pointing (UFEM

Visual area -
located in occipital lobe in Cerebral Cortex

most common location lens.

in
Aging
-

hard time
seeing blue
green violet
-

, ,

red yellow can see it better

orange
-

, ,

Vitamin A-vision

drooping of eyelid
Weber test-tuning
fork on forehead

rinne test-turning fork on

bony prominence a next to car

ifpt have trouble hearing ,

check for was

- if is often
waxy ,
debrox
given
Conjunctivitis -

pink eye

Visualize a clock for blind people

glaucoma "eye:
pressure , optic nerve is
damaged, of are

different types of
glaucoma
Eve Trauma

Emergencies
:

foreign body -
vinse i Saline , Chemical 15-70 mins irrigation
burns

Abrasion

Laceration

penetrating wounds -

DO NOT REMOVE
Menieres Disease-fluid imbalance

Vertigo ,
tinnitus ,
hearing loss