Pain, decreased response

Evaluating and recording die patient s response to the drug (when applicable). Evaluation may include such facts as relief of pain, decrease in body temperature, relief of itching, and decrease in the number of stools passed. 

Accidental exposure of a pilot during a fuel leak to JP-4 at levels estimated to be between 3000 and 7000 ppm produced signs of neurological intoxication, but cardiovascular and pulmonary function appeared normal on clinical examination. The pilot had a staggering gait, mild muscular weakness, decreased responsiveness to painful stimuli, and slight slurring of speech. The effects were not evident 36 hours after exposure. 

Human Papillomavirus (Types 6, 11, 16, 18) Recombinant Vaccine (Gardasil) [Vaccine] Uses Prevent cervical CA, precancer-ous genital lesions, and genital warts d/t HPV types 6, 11, 16, 18 in females 9-26 y Action Recombinant vaccine, passive humoral immunity Dose 0.5 mL EM initial, then 2 and 6 mo observe for 15 min after, keep seated or lying down Caution [B, /-] Disp Inj SE Site Rxn (pain, erythema, swelling, pruritus), fever, fainting w/ administration Interactions W/ immunosuppressants, may get decreased response EMS Convulsive syncope (fainting associated w/ Sz -like activity) OD Unlikely... 

How it works Binds with opioid receptors within CNS, altering processes affecting pain perception, emotional response to pain. Decreases intestinal motility by local and central actions. 

The pain relief model described in Section 25.3.1.1 was implemented with the parameter values presented in Table 25.2. In this example, it is assumed that the placebo effect decreases monotonically with time, by setting the placebo onset rate (a) to zero. The negative values of the baseline placebo effect values (j3 s) indicates that the probability of a high pain relief response is less than that of a lower pain relief score. 

Acetaminophen (Tylenol and others) Possible decreased pain-relieving effect (increased metabolism) Monitor pain-relieving response... 

The symptoms of opiate withdrawal can be severe. It starts 8-12 hours after the last dose. The initial symptoms are lacrima-tion, yawning, and sweating. This is followed by restlessness, weakness, and chills. The first phase of withdrawal may last a week. The other symptoms during this period include nausea, vomiting, muscle pain, involuntary movements, hyperthermia, and hypertension. This is soon followed by a secondary phase of abstinence, which may continue for a prolonged period of 6-7 months. The symptoms of such protracted abstinence include hypotension, bradycardia, hypothermia, mydriasis, and decreased responsiveness to carbon dioxide. 

The mechanism by which gabapentin exerts its analgesic action is unknown. It has been shown in animal models to prevent allodynia (pain-related behavior in response to a normally innocuous stimulus) and hyperalgesia (exaggerated response to painful stimuli). Particularly, gabapentin has been shown to attenuate pain-related responses in several animal models of neuropathic pain (diabetes, spinal nerve ligation, spinal cord injury, acute herpes zoster infection) and also decreases pain-related responses after peripheral inflammation. However, gabapentin did not alter immediate pain-related behaviors in animal models. 

The nurse evaluates the patient daily for a response to therapy, such as a decrease in temperature, the relief of symptoms caused by the infection (such as pain or discomfort), an increase in appetite, and a change in the appearance or amount of drainage (when originally present). Once an infection is controlled, patients often look better and even state that they feel better. It is important to record these evaluations on the patient s chart. The nurse notifies the primary health care provider if signs and symptoms of the infection appear to worsen. 

The expected outcomes for the patient may include an optimal response to therapy (which includes a decrease in pain), management of common adverse reactions, and an understanding of the therapeutic regimen. 

The nurse notifies the primary health care provider immediately if eye pain increases or if it has not begun to decrease 3 to 4 hours after the first dose. If the patient has acute closed-angle glaucoma, the nurse checks the pupil of the affected eye every 2 hours for dilation and response to light. 

The nurse takes vital signs every 4 to 8 hours, depending on the patient s condition. The nurse evaluates the patient s response to drug therapy based on original assessments. Responses that may be seen include a decrease in pain, an increase in appetite, and a feeling of well-being. 

The nurse assesses the patient s response to therapy. For example a decrease in pain or inflammation should occur. The nurse examines the outer ear and ear canal for any local redness or irritation that may indicate sensitivity to die drug. 

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