Analgesic, Opioid, Anti-inflammatory Meds
About this set
Created by:
mlewellen on October 17, 2010
Subjects:
med/surg, pain, pain medications
Description:
Study guide answers
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57 terms
Terms | Definitions |
|---|---|
 What are 4 parts of the nurse's pain assessment? | 1. Location (where is the pain?) 2. Intensity (on a 0-10 scale) 3. Description or character of pain (e.g. stinging, dull, constant, intermittent, sharp, burning, deep or superficial?) 4. What are the relieving factors and intensifying factors? |
| Should objective signs of a patient's pain be documented? | Yes |
| What are 6 non-pharmacological nursing interventions that should be used to assist a patient to manage their pain? | 1. Spend time with the patient 2. Relaxation techniques 3. Distraction 4. Music 5. Exercise 6. Massage |
| What is the FLACC scale? | Uses OBJECTIVE data for pain assessment Used for children up to age 4 AND patients who are unresponsive |
| Narcotic analgesics, such as morphine, are useful in treating what type of pain? | Moderate to Severe |
| What is the oral Morphine dosage that is equivalent to Morphine 10 mg IV? | 30 mg |
| What is the only narcotic analgesic used to treat the pain of a myocardial infarction? | Morphine |
| Which of the narcotic analgesics is commonly used to treat a cough? | Codeine |
| How can the use of codeine to treat a cough cause serious respiratory issues? | It suppresses the cough that would otherwise bring up secretions, etc. that could obstruct the airway |
| What should the nurse ALWAYS assess before giving her patient morphine for pain? | 1. Their BP 2. Respiratory rate >>> NEVER give if respiratory rate is <10 3. Respiratory EFFORT 4. Pupillary response to light 5. Patient's ability to ambulate to the bathroom |
| What are the expected responses to the administration of Morphine? | Tidal volume increase followed by a decrease Hypotension Orthostatic Hypotension Drowsiness/sedation Pain relief Increased risk for falls Urinary retention |
| Morphine causes... | Respiratory depression and depression of the CNS |
| How do we adjust a dose of Morphine for an elderly patient? | Usually lower the dose. If you have a range, start on the lowest dose |
| Why is morphine contraindicated for a patient with increased ICP? | 1. Risk of worsening respiratory depression 2. Can prevent accurate patient assessment (e.g. LOC) |
| Why is it so important to turn, cough and deep breathe a post-op patient who is receiving IV morphine for pain? | The respiratory effects |
| What is the difference in drug dependence and drug addiction? | Drug dependence is a PHYSICAL problem Drug addiction is a PSYCHOLOGICAL problem |
| How is the best way to prevent withdrawal from morphine administration? | Gradually decrease the morphine over a period of time |
| Why are we not seeing meperidine prescribed for pain much anymore? | It's a CNS toxin and can build up |
| What are the steps when changing a fentanyl patch on a patient? | 1. Verify MAR with physician's orders 2. Apply gloves 3. Tear open the new patch (Do not cut!) 4. Apply the new patch 5. Hold the patch in place for 30 seconds 6. Date/Time the new patch 7. Remove the old patch 8. Fold the old patch in half with sticky sides together 9. Discard old patch down the toilet |
| Codeine is classified as a...? | Mild narcotic agonist |
| How can a patient receiving long-term narcoic agonist medication prevent constipation? | Fiber in diet or Metamucil; increased fluides; stool softener |
| How can the patient taking oral narcotics avoid the frequent nause a/w taking the med? | May need to take with food or milk |
| How does a narcotic agonist-antagonist work? | Has a combination effect on the body. Act as agonists at some receptors and antagonists at others. Talwin stimulates kappa receptors but also has weak antagonist effects at the mu receptors (Ithe primary morphine receptors) |
| Why do narcotic agonist-antagonists not cause as much respiratory depression? | Because of their antagonist actions |
| What are the effects of smoking for a patient receiving Talwin for pain relief? | There is a 40% increase in metabolism of Talwin.....requiring higher doses for pain relief |
| What is the drug of choice for opioid induced respiratory depression? | Naloxone (Narcan) |
| By which route is Narcan administered? Results would be expected in.... | Can be administered IM or SubQ, but in case of opioid-induced respiratory depression, IV route is preferred Results would be expected in 1 to 2 minutes! |
| After administration of Narcan, the nurse expects to see what 2 things? | 1. Decreased respiratory depression 2. Reverses analgesia |
| In which patients would Aspirin be contraindicated? | - Known allergy to aspirin - Patients with lotting abnormalities - Patients with bleeding gastric ulcers - Patients with acute renal failure - Patients with active hepatitis - Patients under the age of 16 - Patients scheduled for surgery within 1 week - Patients with asthma |
| What is the daily dose of aspirin often taken for prevention of TIA or CVA? | 81 mg daily |
| What are the signs of salicylism? | Headache GI distress |
| How is salicylism treated? | By stopping the aspirin therapy |
| How is salicylate poisoning treated? | Gastric lavage, administration of activated charcoal and life support |
| What is the lethal dose of aspirin for an adult patient? | 10 - 30 grams |
| What is one way to decrease gastrointestinal distress while taking aspirin? | Take with food or milk |
| What is the antidote for salicylate poisoning? | There isn't one! |
| How may NSAIDs lead to increased blood pressure? | Retention of H2O and Na+ which increases BP |
| What patient teaching is appropriate for a patient receiving NSAIDs for pain? | Teach signs of MI or stroke Teach to report: - unusual bruising - bleeding - tarry stools - blood in urine |
| Where is COX-1 present? | In all tissue |
| Where is COX-2 active? | At the sites of trauma or injury |
| What is the maximum daily dose of Ibuprofen? | 3200 mg |
| In what patient is Celebrex contraindicated? | A patient allergic to sulfa and aspirin |
| What is Acetaminophen useful in treating? | Mild pain Moderate pain Fever |
| What are the symptoms of acute acetaminophen toxicity? | Anorexia N & V Abdominal discomfort/pain RUQ pain Jaundice |
| What is the antidote for Tylenol overdose and how is it administered? | Acetylcysteine (Mucomyst) Given as quickly as possible IV |
| What type of patients are much more likely to develop renal or hepatic toxicity with long-term Tylenol use? | Elderly patients |
| What is the prototype Disease-Modifying Antirheumatic drug? | Methotrexate (Rheumatrex) |
| What are the most serious side effects of Methotrexate (Rheumatrex)? | Bone marrow suppression Hepatotoxicity Nephrotoxicity |
| What is the "rescue drug" for patients receiving Rheumatrex? | Vitamin B (Folic acid) |
| The major side effect of Rheumatrex of __________ can lead to altered production of red blood cells, white blood cells and platelets | Bone marrow suppression |
| A patient with possible bone marrow suppression should be carefully monitored for what? | * Weight loss * Signs of infection * Bruising * Bleeding |
| What is one way to avoid nephrotoxicity a/w administration of Methotrexate? | Drink plenty of water so it doesn't accumulate |
| What are the levels for hyperuricemia? | Uric acid level >6 in men and >7 in women |
| A diet high in what type of foods can cause hyperuricemia? | Meat products Seafood Alcohol Asparagus Mushrooms Spinach Peas |
| What is the anti-gout medication that should be taken at the first sign of a gout attack? | Colcichine |
| What is the anti-gout medication usually taken all the time to prevent attacks? | Allopurinol (Alloprim or Zyloprim) |
| What is Gabapentin (Neurontin) very useful in treating? | Diabetic neuropathy |
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