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
What is the standard lockout interval for most morphine patient-controlled analgesia (PCA) programs?
Answer: 5–10 minutes
A 5–10 minute lockout interval is standard for IV morphine PCA, allowing time to assess the effect of each demand dose before another can be delivered.
Which sedation assessment tool was specifically developed to monitor opioid-induced sedation in patients receiving IV analgesic infusions?
Answer: Pasero Opioid-induced Sedation Scale (POSS)
The Pasero Opioid-induced Sedation Scale (POSS) was specifically designed to assess sedation in patients receiving opioids and guides nursing interventions based on sedation level.
When programming a PCA pump, which set of parameters must ALL be verified to ensure safe analgesic delivery?
Answer: Maximum dose limit, lockout interval, and demand dose
Safe PCA programming requires verification of the demand dose, lockout interval, and maximum dose limit together to prevent inadvertent opioid overdose.
A patient receiving IV morphine via PCA has a respiratory rate of 8 breaths/min and is difficult to arouse. What is the priority nursing intervention?
Answer: Administer naloxone and notify the physician
Respiratory depression with decreased consciousness requires immediate administration of naloxone (opioid antagonist) and physician notification, as this is a life-threatening emergency.
What is the primary pharmacokinetic advantage of IV patient-controlled analgesia over nurse-administered as-needed opioids?
Answer: More consistent serum drug levels with less peak-and-trough sedation
PCA maintains more stable serum opioid concentrations by allowing small frequent doses, reducing the wide peaks and troughs seen with traditional as-needed intramuscular or IV bolus dosing.
Which route of opioid administration provides the fastest onset of analgesia in acute pain management?
Answer: Intravenous
The intravenous route provides the fastest onset of opioid action because the drug enters systemic circulation immediately without absorption barriers.
A patient's family member repeatedly presses the PCA button when the patient is asleep. This practice is called 'PCA by proxy' and is dangerous primarily because:
Answer: It bypasses the patient's own sedation response, which normally prevents self-overdose
The safety of PCA relies on the patient being awake enough to press the button; a sedated patient will not self-dose, but PCA by proxy removes this intrinsic safety mechanism, risking overdose.