PCA: Patient Controlled Analgesia
Biggest risk for opioid patients? - ANS-Respiratory depression
Dilaudid - ANS-0.2 mg/ml in 30cc NS = 6mg
Fentanyl - ANS-10 mcg/ml in 30cc NS = 300 mcg
How does a PCA pump work? - ANS-*MD order- med, quantity, shipping mode
*nurse applications gadget- double verify
*patient and own family training
*patient presses button to acquire med
*lockout
Morphine Sulfate - ANS-1 mg/ml in 30cc NS = 30mg
Narcotics Side Effects - ANS-Nausea (Zofran)
Itching (Benadryl)
Drowsiness
Urinary Retention
Constipation (Miralax, Colace, Senna)
Hallucinations
Slow Breathing Rate
Oversedation!!
Obtunded - ANS-State of being unable to arouse with lively stimulation.
PCA Assessment and Documentation - ANS-Every hour x four then q 4 hours
RR, HR, B/P, Sedation Level, Pain Score
Boluses attempted/ delivered and total
Dose received
For modifications in dosage/ frequency, repeat q 1 hour x 4 then q 4 hours
PCA Delivery Modes - ANS-Continuous- rarely see this by myself on PCA
Bolus- handiest receive med when button driven
Both- frequently small amount non-stop with button bolus further
**All modes require NS infusing to push med through lines**
PCA Medications - ANS-Morphine Sulfate
Fentanyl
Dilaudid
Always have Narcan available
Biggest risk for opioid patients? - ANS-Respiratory depression
Dilaudid - ANS-0.2 mg/ml in 30cc NS = 6mg
Fentanyl - ANS-10 mcg/ml in 30cc NS = 300 mcg
How does a PCA pump work? - ANS-*MD order- med, quantity, shipping mode
*nurse applications gadget- double verify
*patient and own family training
*patient presses button to acquire med
*lockout
Morphine Sulfate - ANS-1 mg/ml in 30cc NS = 30mg
Narcotics Side Effects - ANS-Nausea (Zofran)
Itching (Benadryl)
Drowsiness
Urinary Retention
Constipation (Miralax, Colace, Senna)
Hallucinations
Slow Breathing Rate
Oversedation!!
Obtunded - ANS-State of being unable to arouse with lively stimulation.
PCA Assessment and Documentation - ANS-Every hour x four then q 4 hours
RR, HR, B/P, Sedation Level, Pain Score
Boluses attempted/ delivered and total
Dose received
For modifications in dosage/ frequency, repeat q 1 hour x 4 then q 4 hours
PCA Delivery Modes - ANS-Continuous- rarely see this by myself on PCA
Bolus- handiest receive med when button driven
Both- frequently small amount non-stop with button bolus further
**All modes require NS infusing to push med through lines**
PCA Medications - ANS-Morphine Sulfate
Fentanyl
Dilaudid
Always have Narcan available
