Chapter 11

Question 1

What are analgesics?

Answer 1

Medications that relieve pain without causing loss of consciousness. “Painkillers”

Question 2

What is nociception?

Answer 2

the neural processes of encoding and processing noxious stimuli.

Question 3

Acute pain is

Answer 3

sudden onset

usually subsides once treated

Question 4

Chronic pain is

Answer 4

persistent or recurring
lasting 3-6 months or longer
often difficult to treat

Question 5

Tissue injury causes the release of:

Answer 5

bradykinin
histamine
prostaglandins
serotonin

Question 6

The body has 2 endogenous neurotransmitters:

Answer 6

enkephalins

endophins

Question 7

Pain transmission are produced by the body to _____ ____

Answer 7

fight pain

Question 8

Pain transmission bind to _____ _________

Answer 8

opiod receptors

Question 9

Rubbing a painful area with massage or liniment stimulates large _______ ______

Answer 9

sensory fibers

Question 10

Rubbing a painful area results in:

Answer 10

recognition of pain reduced

same pathway used by opiates

Question 11

Opioid ceiling effect is

Answer 11

Drug reaches a maximum analgesic effect & analgesia does not improve, even with higher dose

Question 12

Pentazocine is a

Answer 12

partial agonist

does not have a ma response to opioid

Question 13

Nalbuphine is a

Answer 13

partial agonist

does not have a ma response to opioid

Question 14

Opioid analgesics are

Answer 14

pain relievers that contin opium, derived from the opium poppy or chemically related to opium

Question 15

Narcotics are

Answer 15

very strong pain relievers

they are opioid

Question 16

Opioid analgesics MOA

Answer 16

Three classifications based on their actions:
Agonist
Partial agonist
Antiagonist

Question 17

What does an agonists do:

Answer 17

binds to an opioid pain receptor in the brain, causing an analgesic response

Question 18

What does an agonists-antagonists do:

Answer 18

Binds to a pain receptor, causing a weaker neurologic response than a full agonist.

Question 19

Agonists-antagonists is also called ____________ or ________________

Answer 19

partial agonist or mixed agonist

Question 20

What does an antagonists do?

Answer 20

Reverse the effect of these drugs on pain receptors

Question 21

Antagonists bind to a pain receptor and exert __ ________

Answer 21

no response

Question 22

Antagonists are also known as ___________ ___________

Answer 22

competitive antagonists

Question 23

3 primary opioid receptors

Answer 23

Mu
Kappa
Delta

Question 24

Main use for an opioid analgesics:

Answer 24

to alleviate moderate to server pain

Question 25

Opioids are also used for:

Answer 25

Cough center suppression
Treatment for diarrhea
Balance anesthesia

Question 26

You should not use opioid analgesics if

Answer 26

known drug allergy

severe asthma

Question 27

Use extreme caution taking opioid analgesics if

Answer 27

respiratory insufficiency
elevated intracranial pressure
morbid obesity
sleep apnea
paralytic ileus

Question 28

Opioid analgesics adverse effects are:

Answer 28

Euphoria
CNS depression - leads to respiratory depression & most serious adverse effects
Nausea and vomiting
Urinary retention
Diaphoresis and flushing
Pupil constriction (miosis)
Constipation
Itching

Question 29

Opiates - Opioid tolerance is

Answer 29

a common physiologic result of chronic opioid treatment

Question 30

Opioid tolerance results:

Answer 30

larger dose of opioids is required to maintain the same level of analgesia

Question 31

Opioid physical dependence is

Answer 31

physiologic adaption of the body to the presence of an opioid

Question 32

Opioid tolerance and physical dependence are expected with ____-____ opioid treatment and should not be confused with psychologic dependence

Answer 32

long-term

Question 33

Opioid psychologic dependence is a

Answer 33

pattern of compulsive drug use characterized by a continued craving for an opioid and the need to use the opioid for effects other than pain relief

Question 34

When assessing a patient for adverse effects related to morphine sulfate, which effects would the nurse expect to find?

Answer 34

Decreased peristalsis
Delayed gastric emptying
Urinary retention

Question 35

A patient needs to switch analgesic drugs secondary to an adverse reaction to the present regimen. The patient is concerned that he will not receive an effective dose of a new drug to control pain. The nurse responds based on knowledge that potencies of analgesics are determined using an equianalgesic table comparing doses with that of

Answer 35

morphine.

Question 36

A patient is admitted to the psychiatric unit for treatment of narcotic addiction. The nurse would anticipate administration of which medication?

Answer 36

Methadone

Question 37

A patient has been admitted after overdosing on acetaminophen (Tylenol), with a total ingested dose of 14 g over a period of 1 hour. The nurse plans to monitor this patient for development of which of the following signs and symptoms related to the overdose?

Answer 37

Acute hepatic necrosis

Question 38

While admitting a patient for treatment of an acetaminophen overdose, the nurse prepares to administer which of the following medications to prevent toxicity?

Answer 38

acetylcysteine (Mucomyst)

Question 39

Massage therapy is ordered as adjunct treatment for a patient with musculoskeletal pain. The patient asks the nurse how “rubbing my muscles” will help the pain go away. The nurse responds based on the knowledge that

Answer 39

massaging muscles activates large sensory nerve fibers that send signals to the spinal cord to close the gate, thus blocking painful stimuli from reaching the brain.

Question 40

When assessing for the most serious adverse reaction to a narcotic analgesic, the nurse is careful to monitor the patient’s

Answer 40

respiratory rate.

Question 41

Which medication is used to treat a patient suffering from severe adverse effects of a narcotic analgesic?

Answer 41

naloxone (Narcan)

Question 42

A patient admitted to the hospital with a diagnosis of pneumonia asks the nurse why she is receiving codeine when she does not have any pain. The nurse’s response is based on knowledge that codeine also has what effect?

Answer 42

Cough suppressant

Question 43

In monitoring a patient for adverse effects related to morphine sulfate, the nurse assesses for stimulation of

Answer 43

chemoreceptor trigger zone.

Question 44

The nurse is preparing to administer an injection of morphine to a patient. Assessment notes a respiratory rate of 10 breaths/min. Which action will the nurse perform?

Answer 44

Notify the physician and delay drug administration

Question 45

A patient receiving narcotic analgesics for chronic pain can minimize the gastrointestinal (GI) side effects by

Answer 45

increasing fluid and fiber in the diet.

Question 46

The nurse teaches a patient prescribed the fentanyl (Duragesic) transdermal delivery system to change the patch at what interval?

Answer 46

Every 72 hours

Question 47

The nurse plans pharmacologic therapy for a patient with pain based on the knowledge that

Answer 47

pain relief is best obtained by administering analgesics around the clock.

Question 48

In developing a plan of care for a patient receiving morphine sulfate, which nursing diagnosis is a priority?

Answer 48

Impaired gas exchange related to respiratory depression