Pain

Question 1

Acetaminophen (PO)

Tylenol

Answer 1

Indication: Mild pain, Fever

Contraindications: Severe hepatic impairment, Active liver disease

Side Effects: Nausea, vomiting

Adverse Reactions: Hepatic impairment, Renal failure, Toxic epidermal necrosis

Nursing Considerations: When calculating daily dose, consider other medications containing acetaminophen, Lower doses for patients with hepatic impairment

Patient Teachings: Take exactly as directed, Notify HCP if fever > 3 days, Discontinue and notify HCP if rash occurs

Question 2

Acetylsalicylic acid (PO)
(Aspirin)

Answer 2

Indication: mild pain, fever, inflammatory disorders, prophylaxis for heart attacks

Contraindications: previous sensitivity to aspirin, cross-sensitivity to other NSAIDS, bleeding disorders

Side Effects: Nausea, vomiting

Adverse Reactions: GI bleeding, anaphylaxis, tinnitus

Nursing Considerations: Scheduled doses for inflammatory conditions, Monitor for hypersensitivity reactions, Monitor serum levels >400mcg/mL

Patient Teachings: Consult HCP if tinnitus occurs, or if fever exceeds 3 days, Take with food or water, sit upright for 15-30 min to reduce GI effects

Question 3

Ibuprofen (PO)

Answer 3

Indication: Pain, Inflammation, Fever

Contraindications: Hypersensitivity, Concurrent use of other NSAIDs, Active GI bleed or ulcers

Side Effects: Nausea, vomiting

Adverse Reactions: HF, MI, Stroke, GI bleeding

Nursing Considerations: Assess pain before and 1-2 hours post-administration, Assess for S/S of GI bleeding

Patient Teachings: Take exactly as directed, Avoid drinking alcohol, Take with food, Contact HCP if symptoms persist beyond 10 days or become worse

Question 4

Oxycodone (PO)

Answer 4

Indication: Moderate to severe pain

Contraindications: Hypersensitivity, Respiratory depression, acute or severe bronchial asthma

Side Effects: Nausea, vomiting

Adverse Reactions: Respiratory depression, Bradycardia, Hypotension

Nursing Considerations: Assess vitals (BP/pulse/RR) before and periodically throughout therapy, assess for risk of opioid addiction, abuse or misuse before administration

Patient Teachings: instruct patient on when and how to take medication, do not share medication with others, advise patient that this medication has abuse potential

Question 5

Fentanyl patch (Topical)

Answer 5

Indication: Moderate to severe chronic pain

Contraindications: Hypersensitivity, Respiratory depression, acute/ severe bronchial asthma

Side Effects: Nausea, vomiting

Adverse Reactions: Respiratory depression, Bradycardia, Hypotension

Nursing Considerations: Assess BP/RR/pulse before and throughout therapy , assess risk for opioid addictions use or misuse prior to administration

Patient Teachings: instruct how and when to take pain medication, Instruct on proper application and disposal of patch, Avoid water (patch may not stick)

Question 6

Lidocaine patch (Topical)

Answer 6

Indication: Pain due to post-op neuralgia

Contraindications: Hypersensitivity, 3rd-degree Heart block, Wolf-Parkinson-White Syndrome

Side Effects: Nausea, vomiting

Adverse Reactions: Seizure, Cardiac arrest

Nursing Considerations: Monitor ECG continuously, BP and RR during therapy, monitor for pain throughout therapy

Patient Teachings: Explain purpose of patch to patient, Instruct on proper administration/ disposal of patch, Avoid water to ensure the patch sticks