Pain Management and Analgesic Infusion Therapy Flashcards
7 cards from real CRNI practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Pain Management and Analgesic Infusion Therapy flashcards as text
A patient receiving epidural analgesia develops sudden onset of severe back pain and lower extremity weakness. What is the priority nursing action?
Answer: Stop the epidural infusion and notify the physician immediately
Sudden back pain with lower extremity weakness suggests epidural hematoma or abscess, requiring immediate discontinuation and emergency evaluation.
When converting a patient from IV morphine to oral oxycodone, which principle guides the calculation?
Answer: Apply equianalgesic dose tables and adjust for incomplete cross-tolerance
Equianalgesic tables provide conversion ratios, and a 25–50% dose reduction accounts for incomplete cross-tolerance when rotating opioids.
A patient on a continuous opioid infusion has a respiratory rate of 8 breaths/min and is difficult to arouse. After stopping the infusion, what is the next step?
Answer: Administer naloxone and prepare for repeated dosing
Opioid-induced respiratory depression with sedation requires naloxone titration; repeated dosing may be needed because naloxone's duration is shorter than most opioids.
Which catheter tip position is considered optimal for thoracic epidural analgesia after major abdominal surgery?
Answer: T6–T10 to correspond to the surgical dermatome
Placing the epidural catheter at T6–T10 targets the thoracic dermatomes corresponding to the abdominal incision for optimal analgesia.
A nurse notices the PCA pump has delivered 48 mg of morphine in the past 4 hours against a prescribed maximum of 10 mg/hour. What should the nurse suspect first?
Answer: Pump malfunction or programming error
Delivery significantly exceeding the prescribed limit strongly suggests a pump programming error or malfunction that must be verified before other causes.
Which assessment finding best indicates that a patient's multimodal pain regimen is effective after total knee replacement?
Answer: Patient participates in physical therapy with pain rated ≤4/10
Functional pain goals — tolerating therapy with pain ≤4/10 — reflect effective multimodal analgesia better than complete pain elimination at rest.
A patient's intrathecal drug delivery system (IDDS) is scheduled for refill. The nurse notes the reservoir volume is lower than the calculated expected volume. What does this indicate?
Answer: Possible catheter dislodgement or drug leak requiring evaluation
Unexpected low reservoir volume suggests catheter malfunction, dislodgement, or leak, which must be evaluated to prevent underdosing or drug granuloma risk.