CNS Drugs - Part 1 Q&A

The nurse sees that one of the analgesic meds listed for a patient is acetaminophen (Tylenol), a COX inhibitor analgesic agent. Which assessment is most important related to this drug?

1. Blood pressure

2. History of hepatitis

3. History of chronic kidney disease

4. History of a bleeding disorder

5. Respiratory rate

6. Heart rate

The nurse sees that one of the analgesic meds listed for a patient is ibuprofen (Advil), a nonsteroidal anti-inflammatory (NSAID). Which assessment is most important related to this drug?

1. Blood pressure

2. History of hepatitis

3. History of chronic kidney disease

4. History of a bleeding disorder

5. Respiratory rate

6. Heart rate

A patient is on a continuous infusion of morphine. What interventions should the nurse implement? Select all that apply.

1. Monitor respiratory rate

2. Assess for paradoxical insomnia

3. Monitor level of consciousness

4. Assess the patient’s pain score from 0-10

5. Assess for peripheral edema

6. Assess the patient’s bowel patterns for constipation

A patient is receiving a new order for morphine IVP. During the first administration, the nurse will carefully monitor for signs and symptoms of an allergic, hypersensitivity reaction. Which of these assessment findings may be an indication of a hypersensitivity reaction? Select all that apply. (Choose 4.)

1. Erythema

2. Shortness of breath

3. Constipation

4. Rash

5. Itching

6. Urticaria

During medication therapy, the nurse will monitor closely for signs and symptoms of an anaphylactic reaction. Which of these assessment findings may be an indication of an anaphylaxis reaction? Select all that apply. (Choose 4.)

1. Wheezing

2. Jaundice

3. Pallor

4. Dyspnea

5. Tachycardia

6. Decreased respiratory rate

7. Hypertension

8. Shortness of breath

During medication therapy, the nurse will monitor closely for signs and symptoms of hypersensitivity and anaphylaxis reactions. Which of these assessment findings are most directly associated with an (a) anaphylactic reaction, (b) hypersensitivity reaction, or (c) not applicable to either? Match to the appropriate reaction.

1. Wheezing

2. Rash

3. Itching

4. Numbness & tingling

5. Urticaria

6. Dyspnea

7. Bradycardia

8. Increased respiratory rate

9. Hypertension

The nurse administers morphine 4mg IVP to a 19-year-old female with appendicitis. Ten minutes later she complains of her nose itching. Which are appropriate nursing interventions? Select all that apply.

1. Check for urticaria

2. Notify the HCP and request an order for diphenhydramine

(Benadryl), an antihistamine

3. Ask if she is having trouble breathing

4. Reassess in 30 minutes

5. Call the rapid response team to treat her anaphylactic

reaction.

6. Assess respiratory rate, O2 saturation and blood pressure

7. Reassure her that itching is a common side effect of morphine

Match the drug with its antidote!

Medication - 1. morphine, 2. acetaminophen, 3. benzodiazepines, 4. barbiturates, 5. NMBDs

Antidotes -

When a patient experiences severe respiratory depression from an opioid such as morphine, an opioid antagonist should always be given.

1. True

2. False

A patient in the Emergency Department c/o abdominal pain. The nurse enters the following statements into the chart:

1000: Patient reports pain 10/10

1015: Administered 2 mg of morphine IVP as ordered

1055: Patient to radiology for CT

1. How do you rate the documentation (1-3) where 1 is poor, 2 is average, and 3 is outstanding?

2. Is there additional information that you want to know? If so, describe.

An obese 78-year-old patient with a history of HTN and MI who uses CPAP at night for OSA presents to the ED at 2100 with lower leg pain sustained after tripping and falling down a flight of stairs. They have an obvious deformity to their right ankle and rates their pain as 10/10. The HCP writes orders. Documentation follows.

1. 2115: HCP order for hydromorphone (Dilaudid), an opioid, 2mg IVP x 1 stat

2. 2129: hydromorphone (Dilaudid), an opioid, administered

3. 2145: VS remain baseline, patient rates pain 2/10

4. 2230: The nurse tech calls RN to room. The patient has an O2 sat of 84%, snoring respirations, and cannot be aroused. The nurse notes that the patient’s CPAP machine is on the bedside table, not attached to the patient.

1. What happened? Why?

2. Describe missing assessments and documentation.