NSG 219 Week 6 Pharmacology actual questions with 100% correct answers + detailed explanations

enzyme COX - 1

if inhibited can decrease platelet function and cause kidney damage

enzyme COX - 2

if inhibited can decrease inflammation, fever, and pain

NSAIDS

nonsteroidal anti-inflammatory drugs

first generation NSAIDS

aspirin

ibuprofen

naproxen

idomethacin

diclofenac

ketorolax

meloxicam

second generation NSAIDS

celecoxib

therapeutic use of NSAIDs

Includes inflammation suppression

analgesia for mild to moderate pain

antipyretic (fever reduction)

dysmenorrhea

inhibition of platelet aggregation (aspirin)

can protect against CRC

side effects of NSAIDs

GI discomfort

long term use can lead to GI bleed and perforation

impaired kidney function

risk for heart attack and stroke

reyes syndrome

saliecylism

aspirin toxicity

respiratory depression

NSAID risk factors

age

smoking

alcohol use

peptic ulcer history

reyes syndrome

potentially serious or deadly disorder in children that is characterized by vomiting and confusion

aspirin toxicity

sweating

fever

acidosis

dehydration

coma

respiratory distress

first gen NSAID contraindications/precautions

pregnancy

PUD

bleeding disorders

hypersensitivity

vital infections in children

toradol

second gen NSAID contraindications / precautions

celecoxib + NSAID COX-2 = last resort

NSAID interactions

anticoagulants

glucocorticoids

alcohol= increases risk of bleeding

Ibuprofen and aspirin should NOT be taken together

ketorolac

OTC meds

a client has surgery scheduled, when should the pt stop taking aspirin?

a week before

IV ibuprofen infuse over

30 minutes

NSAIDs should be taken with

8oz of water/milk or food

acetaminophen

analgesic effect

antipyretic

acetaminophen toxicity

liver damage

acetaminophen limit

4 grams

acetaminophen antidote

acetylcysteine

acetaminophen contraindications

pregnancy

opioids

tx of severe pain

opioids are a

scheduled II narcotic

common opioids

morphine

hydrocodone

oxycodone

codeine

fentanyl

morphine route

oral

sq

im

iv

epidural

intrathecal

fentanyl route

IV

IM

transmucosal

transdermal

merperidine route

oral

sq

im

iv

codeine route

oral

sq

im

iv

methadone route

oral

sq

IM

oxycodone route

oral

rectal

hydromorphone route

oral

sq

im

iv

opioid complications

respiratory distress

constipation

orthostatic hypotension

urinary retention

cough suppression

sedation

biliary colic

N/V

triad

opioid triad

coma

depressed respiration

pinpoint pupils

can opioids be addictive?

yes

opioid interactions

CNS depressions

anticholinergic

antihistamines

tricyclic antidepressants

amphetamines

clonadine

dextromethorphan

Opioid Agonists

narcan

Agonist-Antagonist Opioids

tx of pain while reducing addiction

suboxone route

sublingual

Butorphanol route

IV, IM, nasal

nalbuphine route

IV, SQ, IM

buprenorphine route

IV

sublingual

transdermal

petazocine route

IV

IM

SQ

abstinence syndrome

a characteristic cluster of withdrawal symptoms that results from sudden decease in an addictive drug's level of usage

abstinence syndrome symptoms

cramping, hypertension, vomiting, fever, anxiety

agonist-antagonist opioid complications

sedations

resp. distress

dizziness

headache

CNS/alcohol

A nurse is preparing to administer an opioid agonist to a client who has acute pain.For which of the following manifestations should the nurse monitor as an adverse effect of this medication?

A. Urinary retention

B. Tachypnea

C. Hypertension

D. Irritating cough

a

A nurse is caring for a client who has end-stage cancer and is receiving morphine. The client's family member asks why the provider prescribed methyl naltrexone (Relistor). Which of the following responses should the nurse make?

A. "The medication will increase respirations."

B. "The medication will prevent dependence on the morphine."

C. "The medication will relieve constipation."

D. "The medication works with the morphine to increase pain relief."

c

A nurse is preparing to administer butorphanol(Stadol) to a client who has a history of substance use disorder. The nurse should identify which of the following information as true regarding butorphanol?

• A. Butorphanol has a greater risk for abuse than morphine.•

B. Butorphanol causes a higher incidence ofrespiratory depression than morphine.•

C. Butorphanol cannot be reversed with anopioid antagonist.•

D. Butorphanol can cause abstinence syndromein opioid-dependent clients

d

A nurse is planning to administer morphine IV to a client who is postoperative.Which of the following actions should the nurse take?•

A. Monitor for seizures and confusion with repeated doses.•

B. Protect the client's skin from the severe diarrhea that occurs with morphine.•

C. Withhold this medication if respiratory rate is less than 12/min.•

D. Give morphine intermittent via IV bolus over 30 seconds or less.

c

A nurse is reviewing the medication administration record for a client who is receiving transdermal fentanyl for severe pain. The nurse should identify that which of the following medications can cause an adverse effect when administered concurrently with fentanyl?

• A. Ampicillin•

B. Diazepam•

C. Furosemide•

D. Prednisone

b