Pain, Agitation, and Delirium Management Flashcards
6 cards from real CCRN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Pain, Agitation, and Delirium Management flashcards as text
Which sedative agent is preferred for ICU sedation in patients at high risk for delirium due to its analgo-sedation properties?
Answer: Dexmedetomidine
Dexmedetomidine (an alpha-2 agonist) produces sedation without suppressing respiratory drive and is associated with lower rates of delirium compared to benzodiazepines.
According to the PADIS bundle, which approach should be used first when managing pain in ICU patients (analgesia-first strategy)?
Answer: Treat pain before titrating sedation
The analgesia-first (analgo-sedation) approach recommends treating pain first, as untreated pain is a major driver of agitation and over-sedation.
Which opioid is most commonly used for analgesia in mechanically ventilated ICU patients due to its titratability and short duration of action?
Answer: Fentanyl
Fentanyl is preferred in mechanically ventilated ICU patients due to its rapid onset, short duration of action, and ease of titration.
A patient with ICU delirium becomes agitated and attempts to remove his endotracheal tube. Which intervention should the nurse implement first?
Answer: Reorient the patient and address reversible causes
The first intervention for ICU delirium is to reorient the patient and identify/treat reversible causes such as pain, urinary retention, and sleep deprivation.
Which benzodiazepine is associated with the highest risk of ICU delirium and prolonged mechanical ventilation?
Answer: Lorazepam
Lorazepam has been identified in studies as an independent risk factor for transitioning to delirium in ICU patients, particularly due to its active metabolites and long half-life.
The CPOT (Critical-Care Pain Observation Tool) assesses pain using which four behavioral indicators?
Answer: Facial expression, body movements, muscle tension, and ventilator compliance/vocalization
The CPOT evaluates four domains: facial expression, body movements, muscle tension, and compliance with ventilator or vocalization in extubated patients.