Exam 1 CH 18

Question 1

Know what med a Dr. would prescribe for lower back pain, for a pt who is in excellent health.

Answer 1

Salicylates (Aspirin, Tylenol)

Question 2

Know another type of med that is used “ spastic discomfort” besides NSAIDs or salicylates.

Answer 2

Skeletal muscle relaxants (diazepam/Valium)

Question 3

Know what class of drugs would be prescribed for a pt w “severe muscle spasms”.

Answer 3

Skeletal muscle relaxants

Question 4

Know what med is used to tx “acute” gouty attacks.

Answer 4

Antigout meds (Prednisone)

Question 5

If a pt has a recent fall w injury, how much medication of NSAIDs would be necessary for the anti-inflammatory response?

Answer 5

Begin w high dose and increase meds as necessary.

Question 6

Know what med is “most potent” in stopping prostaglandin synthesis w decreased pain/inflammation

Answer 6

Aspirin

Question 7

Know what a pt can develop in the GI tract when taking both Aspirin and drinking alcohol.

Answer 7

GI bleeding

Question 8

Know what one of the “main” side effects in the ears is w aspirin use.

Answer 8

tinnitus

Question 9

When a pt is on Aspirin therapy, know what the nurse should instruct the pt on regarding the pts stools.

Answer 9

Pt will need to watch for bleeding and bruising and watch for bleeding in stools or black tarry stools and will have regular occult bleeding tests.

Question 10

In a pt diagnosed w “osteoarthritis”, know which med the pt would be started on initially.

Answer 10

aspirin, ibuprofen, acetaminophen

Question 11

Know why children should not be given aspirin for a fever, what syndrome can develop?

Answer 11

Increased risk for GI bleeding and Reyes syndrome may develop.

Question 12

What would a physician do if a pt is given higher doses of salicylates, pertaining to pt’s labs.

Answer 12

Order blood occult testing

Question 13

When an older adult is taking NSAIDs, know what the should be monitored for.

Answer 13

Peptic ulcers, bleeding, NSAID-induced hepatotoxicity, nephrotoxicity

Question 14

If a pt has pain, swelling and heat of a large toe, what does this indicate?

Answer 14

Gout

Question 15

Know why allopurinol is not used in the tx of an acute gouty attack.

Answer 15

Uricosuric agents do not have significant anti-inflammatory or analgesic properties and therefore are of little help during an acute episode of gout.

Question 16

If a gout pt’s creatinine clearance is less than 80 mL/min, what med is the pt started on?

Answer 16

Allopurinol

Question 17

If a pt is sent home from the ER w muscle relaxants and anti-inflammatory meds, what is the most important discharge teaching?

Answer 17

Not to stop taking it suddenly or increase dosage without the knowledge of the health care provider.

Question 18

When a pt is on allopurinol, continued gouty attacks can occur. Know what med can be used as a prophylactic.

Answer 18

Colchicine

Question 19

Know how a pt should take anti-inflammatory drugs correctly, if the pt forgets them.

Answer 19

If a dose is missed, it should be taken as soon as possible. If the pt remembers the missed dose close to the time when the next dose is to be taken, only the regular dose should be taken, and the missed dose should be skipped. An increased amount of medication should not be taken to make up for a missed dose.

Question 20

If a pt is taking “Hydroxychloroquine Sulfate”, know what the pt should be checked frequently for.

Answer 20

Ophthalmologic evaluation before beginning the drug and periodic checkups every 3-6 months. Close monitoring to detect methotrexate toxicity should be done, especially in pts w reduced renal function.

Question 21

Know what disease the med “methotrexate” is used for.

Answer 21

Used to tx various cancerous and psoriatic conditions. Severe cases of RA that are unresponsive to other tx.

Question 22

For a pt stopping muscle relaxants, how should the med be discontinued?

Answer 22

The drug should be discontinued by the health care provider. Taper down.

Question 23

Know what the most common complication of NSAID is.

Answer 23

Gastrointestinal upset.