Critical thinking pain

What is buprenorphine

A partial opioid agonist used for pain and opioid use disorder.

What are the BIG side effects of buprenorphine

Respiratory depression, sedation, nausea, constipation.

What should the nurse monitor with buprenorphine

Respiratory rate, sedation, pain, and bowel movements.

What should patients avoid with buprenorphine

Alcohol and other sedating/CNS-depressant medications.

What reversal drug should be available with buprenorphine

Naloxone.

What type of drug is fentanyl

A strong opioid analgesic.

What is the biggest danger of fentanyl

Respiratory depression/apnea.

What should the nurse continuously monitor with fentanyl

Pulse oximetry, respiratory rate, and sedation.

What must NEVER be applied to a fentanyl patch

heat

Why can't you put heat on a fentanyl patch

Heat can increase fentanyl absorption → overdose.

Who can use a fentanyl patch

Opioid-tolerant patients.

What antidote should be available for fentanyl overdose

Naloxone.

What is flumazenil

A benzodiazepine antidote.

What does flumazenil reverse

Benzodiazepine sedation/overdose.

What is the BIG danger of flumazenil

seizures

Why can a patient become sedated again after flumazenil

Flumazenil has a shorter half-life, so the benzodiazepine can outlast it.

What should the nurse monitor after flumazenil

Respirations, LOC, and seizures.

What emergency equipment should be available with flumazenil

Airway and resuscitation equipment.

What is gabapentin mainly used for

Nerve pain and partial seizures.

What are common side effects of GABAPENTIN

Dizziness, sleepiness, ataxia, and edema.

What major safety issue occurs with gabapentin + opioids

Increased risk of respiratory depression.

Should gabapentin be stopped suddenly

no

Why shouldn't gabapentin be stopped suddenly

It can cause rebound effects/seizures.

What organ function is especially important to monitor with gabapentin

Kidney/renal function.

What is hydrocodone

An opioid pain medication.

What is the biggest danger for MORPHINE

Respiratory depression.

What other common side effects occur for MORPHINE

Sedation, constipation, nausea, dizziness.

What should the nurse assess before and after hydrocodone

Pain, sedation, and respiratory rate.

What should you watch if hydrocodone is combined with acetaminophen

The patient's total daily acetaminophen dose.

What should patients avoid with hydrocodone

Alcohol and driving when sedated.

What type of drug is ibuprofen

An NSAID.

What is ibuprofen used for

Pain, inflammation, and fever.

What are the TWO big problems with ibuprofen

GI bleeding + kidney injury.

What stool finding could indicate GI bleeding

Black/tarry stool.

What vomit finding could indicate GI bleeding

Coffee-ground emesis.

What should the patient take ibuprofen with

Food or milk.

What should patients avoid taking with ibuprofen

Other NSAIDs.

What should the nurse monitor for IBUPROFEN

GI bleeding, renal function, and BP.

What type of drug is lorazepam

A benzodiazepine.

What is lorazepam used for

Anxiety, alcohol withdrawal, seizures, and sedation.

What are the major side effects for LORAZEPAM (Ativan)

Sedation, respiratory depression, dizziness, ataxia, confusion.

What happens if long-term lorazepam is stopped suddenly

Withdrawal and potentially life-threatening seizures.

What should patients NOT mix with lorazepam

Alcohol or other CNS depressants.

What should the nurse watch for in older adults

Falls, confusion, and oversedation.

What antidote may be used for benzodiazepine overdose

Flumazenil.

What type of drug is morphine

An opioid analgesic.

What is the BIGGEST danger for HYDROCODONE

Respiratory depression.

What other side effects should you remember of MORPHINE

Sedation, constipation, nausea/vomiting, itching, hypotension.

What should the nurse check before giving morphine

RR, sedation, pain, and BP.

What antidote should be available for Buprenorphine (Buprenex/Subutex)

Naloxone.

Why can morphine cause itching and low BP

It can cause histamine release.

Why is morphine considered high-alert

It has a high risk for serious medication errors/adverse effects, so dose and route should be double-checked per policy.

What is naloxone

An opioid antidote.

What does naloxone reverse

Opioid-induced respiratory depression and sedation.

What can happen when naloxone is given to an opioid-dependent patient

Acute opioid withdrawal.

Why must you continue monitoring after naloxone

Naloxone may wear off before the opioid, causing respiratory depression to return.

Can one dose of naloxone always be enough

No. More doses may be needed.

What should happen even if naloxone works

The patient should still receive emergency medical evaluation because respiratory depression can return.

What is dexmedetomidine used for

Sedation, especially in ICU/intubated patients.

What are the TWO biggest side effects of Dexmedetomidine

Bradycardia + Hypotension.

What should the nurse continuously monitor for DEXMEDETOMIDINE (Precedex)

Heart rate and blood pressure/cardiac status.

How is dexmedetomidine given

IV infusion.

Can dexmedetomidine be given as an IV bolus

no

What medication should be available for significant bradycardia

Atropine.

What is propofol used for

General anesthesia and deep sedation, including ICU sedation.

What are the BIGGEST dangers of Propofol (Diprivan)

Respiratory depression/apnea + Hypotension.

What must be continuously monitored in PROPOFOL

Respirations, oxygen saturation, BP, and cardiac status.

Who should administer propofol

Personnel trained in airway management with continuous monitoring.

What serious problem can occur with prolonged high-dose propofol

Propofol infusion syndrome.

What is important about the propofol IV setup

Use strict aseptic technique because the lipid emulsion can support bacterial growth.

What is the BIGGEST danger of acetaminophen

LIVER DAMAGE.

What is the healthy adult maximum daily dose in the card

4 grams/day.

What should you check before giving acetaminophen

ALL sources of acetaminophen the patient is taking.

Why do you need to check cold/flu medications

They may secretly contain acetaminophen.

What is the antidote for acetaminophen overdose

Acetylcysteine.

What should patients avoid while taking acetaminophen

Excessive alcohol use.

What organ should you think about whenever you see acetaminophen

LIVER.