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Pharmocology > Comfort, Inflammation And Mobility (Exam 1) > Flashcards

Comfort, Inflammation And Mobility (Exam 1) Flashcards

1
Q

What is one of the first interventions should you take as a nurse when it comes to opioid tolerance clients?

A

Gradually increase the does of the medication
The body gets used to the medication more quickly

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2
Q

What is the other name for Acetaminophen

A

Tylenol

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3
Q

Define inflammation

A

Think of the body crying out for help
It’s a reaction to stressors
It is the tissue response to tissue injury

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4
Q

What are the chemical mediators of inflammation

A

Histamine
Kinins
Prostaglandin

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5
Q

What are infections

A

They are caused by microorganisms and are a result of inflammation

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6
Q

Are all inflammation caused by infections

A

No

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7
Q

What is the first mediator in inflammation

A

Histamine

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8
Q

What is the first mediator in the inflammatory process

A

Histamine

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9
Q

What does histamine do

A

In causes a dilation in the arteries and increase capillary permeability causing an increase in blood flow to the injured area

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10
Q

What is the side effect of activating histamine

A

Swelling

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11
Q

What do kinins do?

A

Increase capillary permeability and sensation of pain

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12
Q

What is the effect of prostaglandin

A

Vasodilation
Relaxation
Relaxation of smooth muscle
Increased capillary permeability
Makes cells get swollen and red

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13
Q

What are the 5 cardinal signs of inflammation

A

Redness
Swelling
Heat
Pain
Loss of function

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14
Q

What are signs of comfort for your patient

A

No pain
No signs of physical discomfort
Absence of emotional distress

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15
Q

What are signs that inflammation is being subsidized

A

Absence of edema
Normal WBC
No redness
No pain
Full functionality

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16
Q

Active vs passive range of motion

A

Active: patient does it by themselves
Passive: you help the patient

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17
Q

When it comes to making your patient comfortable and mobile what is the last resort and what is the first resort

A

Last resort is the medication
Go from invasive to noninvasive

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18
Q

For your patient to be free of pain and discomfort there should be?

A

Maintaining functionality
Effective communication
Well balance between psychological, spiritual activities and state

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19
Q

What can lead to the consequence of lack of comfort

A

Stress
Fear
Pain
Immobility

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20
Q

What is the most common reason patient seek healthcare

A

Pain

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21
Q

Acute pain

A

Minutes to hours
Less than 3 months

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22
Q

Chronic pain

A

Days to months
Persistent and reoccurring
Greater than 3 months

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23
Q

Somatic pain

A

Think skeletal
Skeletal muscles
Ligaments
Joints

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24
Q

Visceral pain

A

Think internal
Originates from organs and smooth muscle

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25
Q

Superficial pain

A

Originates from skin and mucous membrane

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26
Q

Vascular pain

A

Originates from vascular or peri vascular tissues
Migraines headache

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27
Q

Neuropathic pain

A

There is damage to the nerve
Unexplained or resulting from damage to peripheral or CNS nerve fibers by disease or injury

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28
Q

Phantom

A

Think amputation pain.
Patient feels pain where they had an amputation

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29
Q

Cancer pain

A

Occurs from pressure on nerves and organs
Blockage to blood supply
Metastasis to bone

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30
Q

Again what do prostaglandins do?

A

They increase swelling
Activate platelets
Protect kidney
Stomach lining

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31
Q

Prostaglandin

A

They can the inflammatory response= swelling and so forth

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32
Q

When are prostaglandin produced

A

When the cell is injured

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33
Q

Name some anti-prostaglandin

A

Aspirin
Acetaminophen
NSAIDS

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34
Q

Name the 2 pain scale

A

FLACC
Defense and veterans pain scale

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35
Q

What does NSAID stand for

A

Non steroidal anti inflammatory drugs

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36
Q

What do NSAIDS do

A

They inhibit prostaglandin. So they are anti inflammatory drugs

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37
Q

Name the first generation of NSAIDS that aspirin fall under

A

Salicylates

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38
Q

What is the most commonly used salicylates

A

Aspirin

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39
Q

Why would you administer aspirin

A

For mild to moderate pain

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40
Q

Aspirin is

A

Anti inflammatory
Anti platelet

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41
Q

Who is aspirin only given to

A

Adults only!!!!

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42
Q

What is the most important teaching about aspirin

A

Never ever ever give to children with a virus or flu symptoms
Causes Reye’s syndrome

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43
Q

Should you give aspirin to children?

A

No. Especially if they have a virus or flu like symptoms
Reye’s syndrome

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44
Q

What might be a risk of giving aspirin to children

A

Reye’s syndrome

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45
Q

How can aspirin be harmful in high doses

A

It can be nephrotoxic
This is when it causes damage to the kidney

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46
Q

Impaired renal function and aspirin administration

A

The purpose of the kidney is to filter out the blood and help filter out the medication. If the kidney is not working there is filter issues. Causing a buildup in the blood of aspirin.
This is why we increase the blood level

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47
Q

If the kidney is t functioning well what happens to the dose of aspirin

A

It decreases

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48
Q

what are some adverse effects that can occur while taking aspirin?

A

hemorrhage
GI bleeding
hearing loss
Ryes syndrome
low level of WBC

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49
Q

What do you do if your patient start tp show signs of Reyes syndrome?

A

stop administering medication

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50
Q

You have a patient who is about to have a surgery. The patient informs you that they are currently taking NSAIDS. What should you do?

A

tell the doctors so they cancel the surgery

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51
Q

what can be a nursing intervention when you have a patient about to go in surgery?

A

ask the patient if they are currently on any NSAIDs
they should stop taking it at least 28-48 hours before

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52
Q

Salicylism

A

toxicity is associated with the chronic use
toxic levels of aspirin

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53
Q

what are signs and symptoms of salicylism

A

dizziness
vertigo
tinnitus
difficulty hearing
mental confusion
bronchospasm

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54
Q

what should you check when giving aspirin

A

CBC

55
Q

what is a contraindication of aspirin
(HINT: ASPIRIN IS A NSAID AND SALICYLATES)

A

hypersensitivity to NSAIDs or Salicylates

56
Q

What are some precautions to watch out for when administering aspirin

A

renal or hepatic disorder= increase risk of toxicity
GI bleeding or history
Head trauma

57
Q

who might be taking a high dose of salicylates

A

patients with arthritis
patients with chronic conditions

58
Q

normal therapeutic range for aspirin

A

15-30 mg/dl

59
Q

mild toxicity level

A

greater than 30 mg/dl

60
Q

severe toxicity

A

above 50 mg/dl

61
Q

name some nursing implications when administering ASPIRIN

A

observe signs for bleeding
asses therapeutic effect
severe overdose signs

62
Q

what are some signs for bleeding with aspirin

A

dark tarry stool
bleeding gums
petechiae

63
Q

how might you know that the patient has reached the therapeutic effect (ASPIRIN)

A

decrease pain, fever, inflammation

64
Q

how long after administration should you ask the patient

A

30

65
Q

what should you do if the patient is overdosing

A

gastric lavage
suction with ng
iv sodium bicarbonate
activated charcoal

66
Q

if the patient is overdosing on oral medication what should you do?

A

suction

67
Q

another name for acetaminophen is

A

tylenol

68
Q

what is acetaminophen used for

A

mild to moderate pain
reduce fever

69
Q

which medication is the drug of choice for children. why is that?

A

acetaminophen
they are less susceptible to liver toxicity

70
Q

when administering acetaminophen what’s important to note? (ROTATING
why?

A

its better to rotate with ibuprofen
because its better to control fever than monotherapy

71
Q

with a PRN pain medication what is important to note

A

that you must know how often the medication is being administered

72
Q

adverse reaction (ACETAMINOPHEN)

A

oliguria
hearing loss
elevated hepatic enzyme= affected kidney and liver

73
Q

what is oliguria

A

eliminating less than 30ml per hour urine

74
Q

hepatoxicity and renal failure (ACETAMIN)

A

take as directed as it can cause liver necrosis and overdose

75
Q

what lab work should you monitor with acetaminophen

A

CBC
CMP

76
Q

precaution of ACETAMIN

A

alcohol use disorder
renal/hepatic disease

77
Q

what is the maximum daily dose of acetaminophen for adults

A

4000mg’
4g

78
Q

ACETAMIN therapeutic serum level

A

10-20 mcg/mg

79
Q

ACETAMIN toxicity serum level

A

greater than 200 mcg/mg

80
Q

what are the late signs of acetaminophen toxicity

A

jaundice
vomiting
cns stimulation

81
Q

what do anti inflammatory agents do (MOA)

A

inhibit the synthesis of prostaglandin
affect the inflammation process

82
Q

Antipyretic

A

reduce fever

83
Q

Analgesic

A

reduce pain

84
Q

Anticoagulant

A

inhibit platelet aggregation
make the blood thinner

85
Q

What is ibuprofen MOA

A

they inhibit the synthesis of prostaglandin

86
Q

what is ibuprofen used for

A

decrease pain
decrease inflammation related to rheumatoid and osteoarthritis

87
Q

why is ibuprofen so commonly used with patients with arthritis

A

because they have alot of inflammation

88
Q

what ways are ibuprofen given

A

po
iv

89
Q

adverse effects of ibuprofen

A

hearing loss
gi bleeding
tinnitus
seizure
anaphylaxis
anemia
renal failure
thrombocytopenia
angioedema

90
Q

what might Ibuprofen cause

A

renal impairment which increases BUN and Creatinine

91
Q

what should you check before administering ibuprofen

A

BUN
CREATINE

92
Q

what do you do if the BUN AND CREATNINE is high

A

do not administer

93
Q

Nursing implications for IBUPROFEN

A

decreased pain, inflammation and fever
assess for bleeding and dyspepsia
assess for rash and bronchospasm
administer at mealtime with food
monitor vitals

94
Q

why do you administer ibuprofen with food

A

to prevent GI upset

95
Q

what does the rash and bronchospasm tells us with ibuprofen

A

that they cannot breathe

96
Q

can you give patient ibuprofen who has had recent asthma attack? Why?

A

no
Because it may cause bronchospasms

97
Q

what is dyspepsia

A

discomfort in upper abdomen

98
Q

which route is ketorolac mostly used

A

IV

99
Q

why would you administer ketorolac

A

short term pain management
5 days or less

100
Q

What is ketorolac mostly used for?

A

Short term pain
5 days or less

101
Q

What is the other name for ketorolac

A

Toradol

102
Q

What should you monitor with ketorolac?
How do you monitor it?

A

Monitor renal function
By assessing urine output and serum creatinine levels

103
Q

Who would you not administer ketorolac to

A

A patient with renal problems

104
Q

What might ketorolac cause

A

Dizziness
Headache
Dyspepsia
Nausea

105
Q

Why is NAPROXEN usually given ?

A

Mild pain
Mild fever
Osteoarthritis

106
Q

What is the most common risk when taking naproxen

A

Gi bleeding
Gi upset

107
Q

What should you instruct a patient to look for who is taking NAPROXEN

A

Black tarry stool ( gi bleed)
Abdominal pain (gi upset)

108
Q

What are some things that NAPROXEN cause

A

Dizziness
vomiting
Nausea
Elevated hepatic enzyme
Tinnitus
Gi bleeding
Ulcer
Perforation

109
Q

Most medications for severe pain is given what route?

A

Intravenous (IV)

110
Q

Give an example of an opioid agonist

A

Morphine

111
Q

What is the main reason opioid agonist are taken

A

Moderate to severe pain

112
Q

What routes are morphine given

A

PO
IV
IM

113
Q

Which route is faster when giving morphine

A

IV

114
Q

What are the main uses of morphine

A

Acute pain
Chronic pain
Severe pain

115
Q

What are some other effects of morphine

A

It relaxes your body so it promotes sedation, decrease anxiety, decreases the amount of anesthesia required

116
Q

Who should you be cautious with using MORPHINE

A

Older adults

117
Q

How should you give MORPHINE

A

Start low and go slow

118
Q

What are some adverse effects of MORPHINE

A

Orthostatic hypotension
Bradycardia
Tachycardia
Respiratory depression

119
Q

Side effects of MORPHINE

A

Myosin’s
Out of it
Respiratory depression
Pneumonia
Hypotension
Infrequency
Nausea
Emission: vomiting

120
Q

How can morphine affect the CNS effects

A

Depresses the CNS
Respiratory depression
Decreased physical and mental activity

121
Q

Who should be cautious with when giving morphine

A

Older adults

122
Q

How can morphine affect the gi system

A

Nausea
Vomiting
Constipation

123
Q

What does morphine do to the GI system motility

A

It slows the motility causing constipation
Those who are not ambulatory are more likely to cause constipation

124
Q

What are the contraindications when taking morphine

A

Respiratory depression
BPH

125
Q

What is the precaution when taking morphine

A

If you have respiratory insufficiency

126
Q

How do you assess the therapeutic effect of morphine

A

Decreased in pain without the adverse effects

127
Q

What are some withdrawal symptoms of morphine

A

Restless
Sweating
Dilated pupil and watery eyes
Diarrhea
Nausea
Vomiting
Muscle pain
Anxiety

128
Q

What do you give to a patient who is having overdose for morphine?

A

Naloxone

129
Q

Why do you give NALOXONE for morphine overdose

A

Because it reverses the severe respiratory depression

130
Q

Name a opioid antagonist

A

Naloxone

131
Q

What is another name for Naloxone

A

Narcan

132
Q

How does Naloxone work

A

It reverses analgesia and the CNS and respiratory depression
It decreases the substance use disorder
Used for overdoses

133
Q

How do opioid antagonists work

A

It prevents opioid from binding to receptor sites and displace opioids that are already bound

134
Q

What are the adverse effects of opioid antagonist

A

Tremors
Drowsiness
Sweating
Nausea
Vomiting
Hypertension

Pharmocology (14 decks)

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