ANALGESICS UNIT 2

Question 1

What is an Analgesic?

Answer 1

A pain medication

Question 2

Is a Nonopiod analgesic more Potent than an Option Analgesic?
A. YES
B. NO

Answer 2

B. NO
Less potent than opioid analgesics

Question 3

What are Non Opioid Analgesics used to relieve?
A. Pain from 0-1 only
B. No pain
C. Mild to Moderate Pain
D. Severe Pain

Answer 3

C. Mild to Moderate Pain

 Mild to moderate pain
 Effective for dull, throbbing pain of:
 Headaches, dysmenorrhea, minor abrasions
 Inflammation, muscular aches, pain
 Mild to moderate arthritis
 Action site
 Peripheral nervous system at pain receptor
sites

Question 4

Is Acetominophen an NSAID?
A. Yes
B. No

Answer 4

B. No

Acetominophen has antipyretic elements and treats pain. MILD TO MODERATE

Question 5

What is the MAXIMUM DOSE that patient can take when taking Acetaminophen?
A. 4000mg
B. 3g
C. 800g
D. 700mg

Answer 5

A. 4000mg =4g

Maximum dose
 4 g/day
 If taken frequently 2 g/day

Question 6

What is an Alert for taking Acetaminophen?
A. Can be toxic to the kidneys with minimal dosing
B. Can be toxic to the heart
C. Can be toxic to the liver if it has excess dosing ( hepatotoxicity)
D. Is not toxic to any organs if excess dosing occurs

Answer 6

C. Can be toxic to the liver if it has excess dosing ( hepatotoxicity)

Question 7

What are key thing to assess for in your patient when considering administering Acetaminophen?

Answer 7

Assessment
 Pain assessment
 Obtain a medical history of liver
dysfunction, alcohol use
 Other medications – some could contain
acetaminophen
 Vital signs

Question 8

Would you give a patient with history of liver failure or alcohol abuse Acetaminophen?
Assessment
A. No
B. Yes

Answer 8

A. No

Question 9

Nursing Interventions for Acetominophen

Answer 9

Nursing interventions
 Check liver enzyme tests for abnormalities.
 Teach patient to keep acetaminophen out of
children’s reach.
 Teach patient to avoid alcohol ingestion while
taking acetaminophen.
 Teach the maximum safe dose per day (4 grams)
 Seek medical attention if no relief in 10 days
 Check other medications for inclusion of
acetaminophen

Question 10

How do you know the effects of Acetaminophen was successful?

Answer 10

When the fever has gone down
when pain relief has been activated

Question 11

Is Morphine a non opioid analgesic or an opioid analgesic?

Answer 11

Opioid Analgesics

Question 12

What is Morphine used to treat ?
A. Moderate to Severe Pain, cough , and diarrhea
B. Mild to Moderate
C. Pain from a level to 0-5
D. No pain

Answer 12

A. Moderate to Severe Pain, cough , and diarrhea

Use
 Moderate and severe pain
 Antitussive & antidiarrheal effects

 Action
 Act on CNS to Suppress pain impulses
 Also Suppresses respirations and
coughing by acting on respiratory and
cough centers in the medulla

Question 13

What are Side Effects of Morphine?

Answer 13

Side effects
 Drowsiness, sedation, dizziness
 Confusion, depression, miosis (pupil
constriction)
 GI distress, constipation
 Urinary retention

Question 14

What are Adverse Effects of Morphine?

Answer 14

Adverse reactions
 Hypotension, bradycardia
 Psychological dependence
 Respiratory depression

Question 15

Which of the following drug would be reverse the respiratory depression in a patient who has just received Morphine IV?
A. Naloxone
B. Acetominophen
C. Lorazepam
D. Methylphenidate

Answer 15

A. Naloxone

Antidote
 Naloxone

Question 16

What are some instances would not use Morphine for a patient?

Answer 16

Contraindications
 Allergy
 CNS or respiratory depression, sleep apnea
 Increased intracranial pressure
 Head injury

DO NOT USE MORPHINE
 Other CNS depressants

Question 17

ASSESSMENT FOR PT ON MORPHINE

Answer 17

Assessment
 Vital signs
 Pain assessment
 Obtain drug history and check for drug
allergies.
 Assess medical history

Question 18

What class is Sumatriptan?

Answer 18

Anti-migraine

Question 19

What is Sumatriptan used for?

Answer 19

It is used for migraine headaches and cluster headaches

Characteristics of

Characteristics
 Unilateral throbbing pain
 Nausea, vomiting
 Light sensitivity

Question 20

What is the action of Sumatriptan and use

Answer 20

increases vasoconstriction of cranial arteries
BRINGS UP BLOOD PRESSURE IN BRAIN AND BODY

USE
Acute treatment of migraine and cluster headaches

Question 21

Contraindication of Sumatriptan

Answer 21

Contraindication
 Hypertension, Coronary artery disease, cerebral vascular
accident (stroke)
 Caution
 Smoking, obesity, older adults, seizures
nteractions
 Anti-depressant medications (both increase serotonin)

Question 22

Side effects of Sumatriptan

Answer 22

 Dizziness, drowsiness, flushing, fatigue
 GI Distress

Question 23

Adverse Effects of Sumatriptan

Answer 23

 Bradycardia
 Thromboembolism (clot)
 Elevated liver enzymes
 Suicidal ideation

Question 24

Should you take Sumatriptan as soon as you get a migraine or cluster headache?
A. Yes
B. No

Answer 24

A. Yes

Take as soon as symptoms appear

Question 25

Teaching Intervention for Sumatriptan

Answer 25

Take as soon as symptoms appear
 Can be taken other than oral route if nausea/vomiting
(N/V) present – also available in subcutaneous
injection and intranasally
 May have antiemetic ordered for N/V associated with
migraines
 Safety – get up slowly (dizziness drowsiness, blurred
vision possible side effects)
 Therapeutic response – Decreased pain

Question 26

The next day, the patient’s pain medication is changed from morphine sulfate to hydromorphone. Which statement regarding hydromorphone does the nurse identify as being true?

A. Hydromorphone must be administered intravenously.
B. Hypertension is a common side effect.
C. Physical dependence does not occur with
hydromorphone therapy.
D. Hydromorphone is more potent than morphine.

Answer 26

D. Hydromorphone is more potent than morphine.

Hydromorphone (Dilaudid) is a semisynthetic opioid
similar to morphine. The analgesic effect is
approximately six times more potent than morphine.

Question 27

The nurse assesses a patient receiving
morphine via a PCA pump. The patient
has a respiratory rate of 6 breaths/min.
The nurse anticipates administration of
which of the following drugs?

A. Naloxone
B. Sumatriptan
C. Nalbuphine
D. Hydromorphone

Answer 27

A. Naloxone

Naloxone is an opiate antagonist and an antidote for opioid analgesic overdoses. Sumatriptan (Imitrex) is used for the treatment of migraine headaches; nalbuphine HCl
(Nubain) and hydromorphone are opiates.

Question 28

The nurse identifies which of the
following as a common side effect of
morphine therapy?
A. Diarrhea
B. Hypertension
C. Urinary retention
D. Tachypnea

Answer 28

C. Urinary retention

Urinary retention, constipation, hypotension, and
bradypnea are common side effects of morphine.
Diarrhea, hypertension, and tachypnea are not
common side effects.

Question 29

A patient received morphine sulfate for
severe pain. The nurse assesses the
patient 20 minutes later. What is the best
indication that the medication has been
effective?

A. Patient verbalizes pain relief.
B. Patient has an increase in heart rate.
C. Patient is resting.
D. Patient has an increase in blood pressure.

Answer 29

A. Patient verbalizes pain relief.

ANS: A
 The best source for evaluation of pain is the patient.