NURS 317 Unit 6 Pharm Chapter 16 Flashcards
NSAIDs have antiinflammatory, antipyretic, and analgesic properties.
A) TRUE
B) FALSE
A) TRUE
Rationale:NSAIDs are used to reduce inflammation, lower fever, and also have analgesic properties. They can also be used to treat dysmenorrhea.
Rheumatoid factor (RF) interacts with circulating IgG to form immune complexes that deposit in the joints precipitating an inflammatory reaction.
A) FALSE
B) TRUE
B) TRUE
Rationale:Clients with rheumatoid arthritis have high levels of rheumatoid factor (RF), an antibody to immunoglobulin G (IgG). RF interacts with circulating IgG to form immune complexes, which tend to deposit in the synovial fluid of joints, as well as in the eye and other small vessels.
A client experiences intense knee pain due to arthritis and the use of a hyaluronidase derivative is being considered. What assessment finding must be considered?
A) The client’s adherence to previous medication regimens
B) Whether the client is comfortable having an injection into the knee joint
C) Allergies to shellfish or diagnostic contrast solution
D) The client’s expectations for future mobility
B) Whether the client is comfortable having an injection into the knee joint
Rationale:Hyaluronidase is injected directly into the knee once a week for 3 weeks to relieve arthritis pain in the knee when unresponsive to conventional treatment. Adherence is less of an issue because of the infrequent administration. An allergy to shellfish or contrast dye is not a contraindication. The client’s expectations must be assessed, but this would not be as significant an issue as the delivery method.
A parent has sought care from the nurse practitioner to treat a child’s fever. The nurse practitioner is most likely to recommend what drug?
A) Ibuprofen
B) Naproxen
C) Indomethacin
D) Acetaminophen
D) Acetaminophen
Rationale:Acetaminophen is the most frequently used drug for managing fever and pain in children. Ibuprofen and naproxen are both effective treatments for pain and fever in children, but they are not the most commonly used medications. Indomethacin is not indicated for fever control.
The nurse has conducted a health education session for new parents. After learning about the safe and effective use of antiinflammatories, which statement by the parents indicates effective teaching?
A) “We need to read the labels carefully for the ingredients and dosages.”
B) “We can temporarily give our child extra doses of acetaminophen if we need to do so.”
C) “We need to give the drug on an empty stomach or 2 hours after meals.”
D) “We should use aspirin if our child develops symptoms of the flu.”
A) “We need to read the labels carefully for the ingredients and dosages.”
Rationale:Antiinflammatory agents can be found in a number of combination products to treat pain, cold, flu, and nasal congestion. It is important for parents to read the label of each medication carefully to avoid overdosing the child with multiple products containing the same antiinflammatory agent. Children are more susceptible to the GI and CNS effects of these drugs so the drugs should be given with food or meals. Aspirin for flu-like symptoms in children is to be avoided due to the increased risk for Reye syndrome. Acetaminophen is the most commonly used antiinflammatory drug for children. However, parents need to be cautioned to avoid overdosage, which can lead to severe hepatotoxicity.
A client has been given acetaminophen to reduce a fever. How will this be achieved?
A) Acting directly on thermoregulatory cells in the hypothalamus
B) Reducing inflammation by inhibiting prostaglandins
C) Causing vasodilation, allowing heat to be expelled from the body
D) Increasing fluid reabsorption in the kidney to reduce fever
A) Acting directly on thermoregulatory cells in the hypothalamus
Rationale:Acetaminophen functions by acting directly on thermoregulatory cells in the hypothalamus to reduce fever. It does not impact kidney function, has no effect on vasodilation, and is not an antiinflammatory medication.
A client’s care provider has recommended the use of acetaminophen to treat the client’s pain. What should the nurse teach the client about the safe and effective use of acetaminophen?
A) Avoid drinking grapefruit juice with acetaminophen.
B) Avoid excessive doses because there is no antidote.
C) Avoid taking more than 4,000 mg in any 24-hour period.
D) Take the medication with food to prevent GI upset.
C) Avoid taking more than 4,000 mg in any 24-hour period.
Rationale:Clients should avoid taking more than 4,000 mg of acetaminophen daily to avoid hepatic damage. Acetylcysteine is an antidote for overdose, and there is no need to avoid grapefruit juice. GI upset is rare, so there is no particular need to take it with food.
Gold compounds are commonly used as first-line therapy for the treatment of rheumatoid arthritis.
A) FALSE
B) TRUE
A) FALSE
Rationale:Gold compounds are used for a client with rheumatoid arthritis who does not respond to the usual antiinflammatory agents and the conditions worsen despite weeks or months of standard pharmacologic treatment.
A client is receiving auranofin as treatment for rheumatoid arthritis. The nurse should expect this drug to be given by which route?
A) Intramuscular
B) Subcutaneous
C) Oral
D) Intravenous
C) Oral
Rationale:Auranofin is administered orally. Aurothioglucose and gold sodium thiomalate are given IM. Auranofin is not given via the subcutaneous, intramuscular, or intravenous routes
A client with acute joint inflammation tells the nurse, “I’ve been taking acetaminophen as it’s ordered on the bottle, but my swelling and inflammation doesn’t seem to be getting better.” What should the nurse teach the client?
A) “Acetaminophen’s only clinical use is for pain treatment.”
B) “It takes some people a few weeks to feel a difference.”
C) “Keep taking it as ordered, and watch for any signs of bleeding.”
D) “Acetaminophen has no effect on inflammation.”
D) “Acetaminophen has no effect on inflammation.”
Rationale:Acetaminophen has antipyretic and analgesic properties, but no antiinflammatory properties. Acetaminophen does not increase a person’s risk for bleeding. Relief of pain and fever occurs quickly.
A client is alarmed to be prescribed celecoxib, stating, “I heard on TV that celecoxib causes heart attacks.” How should the nurse best respond?
A) “A final decision from the FDA on whether celecoxib is safe will be released in a few years.”
B) “As long as you take your heart medications, you’ll be fine.”
C) “That was a scare that was entirely created by the media.”
D) “This drug hasn’t been definitively proven to be unsafe, so it’s still available.”
D) “This drug hasn’t been definitively proven to be unsafe, so it’s still available.
Rationale:Celecoxib remains on the market despite a 2 to 3 times increase in CV events because further research called into question these findings and the drug continues to be monitored. There is no promise of when or if a final decision will be released by the FDA. The media played a role in the public response, but it did not wholly create the controversy.
Which conditions would contraindicate the use of gold salts? Select all that apply.
A) Uncontrolled diabetes
B) Hypertension
C) Blood dyscrasias
D) Asthma
E) Cardiac arrhythmias
A) Uncontrolled diabetes
B) Hypertension
C) Blood dyscrasias
Rationale:Gold salts are contraindicated in the presence of severe diabetes, congestive heart failure, severe debilitation, renal or hepatic impairment, hypertension, blood dyscrasias, recent radiation treatment, history of toxic levels of heavy metals, and pregnancy or lactation. Gold salts are not contraindicated in the presence of asthma or cardiac arrhythmias.
A client has developed a fever. What aspect of the client’s health history would contraindicate the safe and effective use of acetaminophen?
A) The client had an allergic reaction to penicillin during a previous admission.
B) The client has hepatitis C and abuses alcohol.
C) The client’s most recent hospital admission was because of seizures, which were treated with benzodiazepines.
D) The client was prescribed diclofenac for back pain and did not experience pain relief.
B) The client has hepatitis C and abuses alcohol.
Rationale:Liver disease and alcoholism contraindicate the use of acetaminophen. An allergy to penicillin would not pose a problem. Similarly, a history of seizures, benzodiazepine use, and diclofenac would not rule out the use of acetaminophen.
A client with rheumatoid arthritis is relieved to have less pain and inflammation since a change in medications. The nurse is aware that the new medication inhibits phagocytosis and prevents the release of lysosomal enzymes. What medication classification is this client receiving?
A) Salicylates
B) DMARDs
C) Gold salts
D) NSAIDs
C) Gold salts
Rationale:Gold salts inhibit phagocytosis. NSAIDs inhibit prostaglandin synthesis. Salicylates block prostaglandin activity. DMARDs act by a variety of mechanisms to address inflammation but do not inhibit phagocytosis.
A child with juvenile arthritis has been prescribed auranofin 0.125 mg/kg/day PO. The client weighs 88 lbs. How many milligrams of auranofin should the nurse administer each day?
____________mg
5 mg
A child with juvenile arthritis has been prescribed auranofin 0.125 mg/kg/day PO. The client weighs 88 lbs. How many milligrams of auranofin should the nurse administer each day?
mg
