Analgesic/Antipyretic (CH 10)

Question 1

What is pain?

Answer 1

Signal sent to CNS; subjective and universal; use 1-10 scale for adults and cries chart for pediatrics

Question 2

Tissue injury releases….

Answer 2

bradykinin, histamine, prostaglandins, serotonin (all stimulate nerve endings)

Question 3

Gate theory

Answer 3

common and well-described theory of pain; analogy of a gate to describe how injured tissues are sensed in the brain

Question 4

A Fibers

Answer 4

Have a myelin sheath, are large fiber size, conduct quickly, are sharp and well localized

Question 5

C Fibers

Answer 5

Have no myelin sheath, are small in fiber size, conduct slowly and are dull and nonlocalized

Question 6

Endorphins

Answer 6

Lower pain threshold briefly

Question 7

Pain Management

Answer 7

Treats the cause, is safe, provides effective releif

Question 8

Analgesics

Answer 8

Relieve pain without loss of consciuousness

Question 9

Opiods

Answer 9

Provide relief by attaching to pain receptors

Question 10

Agonist

Answer 10

Combinen with opiod receptor to produce an analgesic response

Question 11

Alternate uses of opiods

Answer 11

Cough suppressant: depresses respiratory center

Diarrhea treatment: slows motility of the bowels

Question 12

Effects of Opiods

Answer 12

euphoria, NV, respiratory depression, urinary retention, diaphoresis and flushing, pupils constrict (miosis), constipation

Question 13

Nursing Implications of Opiods

Answer 13

Get thorough history, baseline vitals and assessment. Assess for potential contraindications and drug interactions. Watch first time users for 30-45 minutes. Take oral dose with food.

Question 14

Opiod Addiction

Answer 14

A pattern of compulsive druge use when the medication is not needed for pain. (Taper off medication)

Question 15

Opiate Antagonist

Answer 15

Nalaxone (Narcan). Binds to opiod receptors and prevets a response. Opiods will not work for up to 24 hours after due to this blockage

Question 16

ASA

Answer 16

Aspirin: interferes with synthesis of prostaglandins and chemical substances released from injured tissue

Question 17

ASA Adverse Effects

Answer 17

GI irritation and bleeding, tinnitus, Reye’s Syndrome (children)

Question 18

Acetaminophen Adverse Effects

Answer 18

overdose causes hepatic necrosis, long-term can cause nephropathy. Normal dose is 150mg/kg

Question 19

Acute overdose of Acetaminophen

Answer 19

Treated with Acetylcysteine (smells like rotten eggs); given orally, prevents the formation of hepatotoxic metabolites

Question 20

What is potentiation

Answer 20

two medications working together to provide therapuetic results

Question 21

What will the nurse teach the client when administering methadone?

Answer 21

that it has an extended duration of action

Question 22

What is one of the most important considerations before giving a client a PCA pump?

Answer 22

the clients ability to understand and follow directions

Question 23

What medication would the nurse question giving throuigh and epidural?

Answer 23

duramorph

Question 24

What medication should the nurse give if the client is allergic to aspirin?

Answer 24

Celebrex

Question 25

The nurse knows the max dose of Ibuprofen in 24 hours is...

Answer 25

3200 mg

Question 26

The nurse knows that this agent is most likely to aggrevate epilepsy and psychiatric disturbances

Answer 26

Indomethacin

Question 27

Drug addiction and Opiods

Answer 27

Do not undertreat pain because of a fear of client addiction

Question 28

IM analgesics

Answer 28

Avoid IM route with analgesics

Question 29

False positive

Answer 29

Aspirin can cause a fals positive reading for glycosuria

Question 30

High doses of Aspirin

Answer 30

can cause tinnitus and vertigo

Question 31

Children and Opiods

Answer 31

Children should be placed on a cardiopulmonary monitor when given parenteral morphine, hydromorphone or fentanyl

Question 32

FIbromyalgia clients

Answer 32

the use of MAO inhibitors and clients with uncontrolled narrow-angle glaucoma are contraindications of using Milnaciprian or Duloxetine

Question 33

Teaching for clients who take large doses of aspirin

Answer 33

Drop a tablet of apsirin into a glass of room temperature water. Brands that dissolve within one minute are recommended

Question 34

How long should methadone (Dolophine) be given?

Answer 34

10 days

Question 35

How long does it take for respiratory depression to occur?

Answer 35

30 minutes with morphine, 1 hour with meperidine

Question 36

What are the precautions for fentanyl pathces?

Answer 36

Only prescribed to opiod tolerant patients and they must wear them for at least 12-18 hours

Question 37

What medications should be delivered through an epidural?

Answer 37

bupivacaine, morphine, hydromorphone (Dilaudid), and fentanyl citrate

Question 38

Triptan precautions

Answer 38

Over the age of 18; do not take other headache medication or antidepressants within 24 hours of taking triptans