Pain meds is considered a fundamental topic since it doesn’t matter what entry level nursing field you go into, you will have to give pain meds and pain meds can be on the NCLEX! It’s a hot topic! Ouch! Hot!
Examples include:
- Maternity: for labor pain
- Psych: for headaches
- Pediatrics & Adult Health: for post-op pain and trauma (like a broken bone)
Nurses don’t have all day to look up content about pain meds. We just need to know the basics and then give them. My favorite way to study meds is through flashcards. Check out the ones my students use that I made with Brainscape.
Make sure a pain assessment is done first. Common pain assessments include:
- Location: where is the pain?
- Severity: how bad is it? Use a 0-10 scale or Wong-Baker faces scale
- Character: what does it feel like?
- Onset: when did it begin?
- Associated factors: are there other symptoms that occur with it? are their underlying factors or conditions?
- Pattern: what makes it better? makes it worse?
- What pain meds do you take?
- Do you use alternative therapies?
Common pain meds include:
1. NSAIDs: nonsteroidal anti-inflammatory drugs
- Mechanism of action: inhibits COX-2
- Indication: analgesic for mild to moderate pain and antipyretic to decrease fever
- Names: celecoxib, ibuprofen, indomethacin, ketorolac, meloxicam, naproxen, aspirin
Side effects/Adverse reactions and Nursing Considerations
- GI upset and bleeding (peptic ulcer disease)
- take with food and assess for bleeding/melena
- HF/CVA/MI (blood clots)
- assess for chest pain and difficulty speaking, one-sided weakness
- nephrotoxic
- assess BUN, creatinine and urine output
2. Opioids
- Mechanism of action: binds to opiate receptors in CNS
- Indication: for moderate to severe pain
- Names: codeine, fentanyl, morphine, oxycodone, oxymorphone, tramadol, hydromorphone, heroin (illegal)
Side effects/Adverse reactions and Nursing Considerations
- suppresses cough reflux
- encourage to turn, cough and deep breathe
- constipation
- encourage fluids, fiber, walking
- sedation
- check vital signs and implement fall precautions
- decreased blood pressure
- hold if BP <100/60
3. Acetaminophen
- Mechanism of action: inhibits prostaglandins
- Indication: analgesic for mild to moderate pain and antipyretic to decrease fever
- Names: acetaminophen!
Side effects/Adverse reactions and Nursing Considerations
- Hepatotoxic
- assess liver function: AST, ALT and bilirubin and hold if too high
- don’t give to those with hepatitis or cirrhosis
- limit to 4000 mg daily
- Antidote is acetylcysteine
Want to see all the pain med content in a nice table format? Then check out my NCLEX Nursing Nugget Pages book! You will love it for it’s need to know content and how organized it is. Here’s a sample below of the pain meds that can be on the NCLEX.
