Exam 1 - Review Packet Flashcards
Goldstein
Organize these pain medications from weakest to strongest
- Ibuprofen
- Ketorolac
- Tramadol
- Codeine
- Morphine
- Hydromorphone
- Fentanyl
Name 5 adverse effects of systemic steroids
- Immunosuppression
- Hyperglycemia
- Hypertension
- Bone density weakness
- Weight gain
- Mood disorder
What is common practice in prescribing to address the danger of systemic steroids?
Give medication as localized as possible, i.e: rash > cream, lungs > inhaler
Name 2 conditions that opioids are used to treat besides pain.
Cough, diarrhea
What is the most common side effect of opiods?
Euphoria
What is the second most common side effect of opioids?
Constipation
Name 4 recommendations to address this
- Fiber
- Fluids
- Activity
- Stool softener
Name 3 types of pain
- Neuropathic
- Visceral
- Chronic
- Acute
Which one is treated different from the others?
Neuropathic - treated with adjuvant therapy
A patient is dehydrated and receiving fluids. The order is to give 1500ml over one hour, followed by 250ml an hour. The 1500 is referred to as the ___ dose, and the hourly rate is referred to as the ____ dose.
loading, maintenance
What is the relationship between titrate and taper?
They are opposites!
Titrate - increases medication dose
Taper - decreases medication dose
What medication routes are always systemic?
IV, PO, IM, rectal, subcutaneous
What is the primary indication for administering Nalozone?
Respiratory depression related to opioid use
Think about how a metformin question can be on our exam
Classic medication for diabetes, HBP spikes insulin, steroids cause HBP
How would you address a concern for addiction relating to a prescribed opioid?
Therapeutic communication, patient education
What safety education would you provide to a patient taking CAMs?
- Tell the patient to take it as prescribed on the bottle
- Tell patient to beware where they get it and to only get it from reputable source
- Educate us/providers on what they are taking (it’s important!)
What is the relationship between duration and half-life?
Same thing!
Duration - how long the drug effect lasts
Half-life - level of drug in blood drops by half
Name 2 prescription drug classes that can be used for an acute migraine?
- Serotonin 5-HT agonist
- NSAIDs
What OTC options are available for migraines?
NSAIDs, Tylenol
What drug class is most effective for inflammation?
SAIDs (steroids)
What drug is related to Reye’s syndrome?
Asprin
Why is this disease uncommon today?
Education not to be given to children under the age of 18
What does synergism mean?
Where 2 things work well together - more than the sum of their parts (1+1=3)
What is the difference between black-box-warning and contraindication?
BBW: Highest level of warning, you can still proceed with caution
Contraindication: Do NOT proceed, this is a no go!
What is the highest priority nursing assessment for the patient that is treated with an opioid?
Respiratory assessment
Name 2 opioids that are available PO only?
Vicodin, Oxycodone, Percocet
What medication this module can cause ringing in the ears?
Aspirin
What is the goal in pain relief?
Patient to reach tolerable pain/decreased pain
Can a patient that is allergic to Naproxen take Ibuprofen?
NO. SAME DRUG CLASS.
What is the highest priority question to ask when a patient reports that their medication is not working?
“Please tell me how you’re taking your medication?
How should a nurse address a patient refusing their prescribed medication?
Therapeutic communication, patient education
Name the 2 most significant differences between Acetaminophen and NSAIDS
Acetaminophen: anti-inflammatory, non nephrotoxic (hepatotoxic)
NSAIDS: inflammatory, nephrotoxic
Name 3 patient teaching points for someone prescribed morphine via a PCA pump?
- Medication is set to a fixed interval
- Push at anytime
- Will not OD, safe to use
Contact nurse at anytime
Match them up (IBU, Keto, Indo, Ace, Cel)
Ibuprofen: most commonly used NSAID
Ketorolac can be given IV/IM/PO
Indomethacin: by RX only
Acetaminophen: does not belong on this list
Celecoxib: does not block cyclooxygenase (COX1)
Why can some medications not be crushed up for the patient?
Enteric coded, sustained/extended release > you want to protect patient from stomach discomfort
What are 2 types of withdrawal a patient may experience with opioid addiction?
Physical & psychological withdrawl
Which withdrawal is treated with Methadone or Buprenorphine?
Physical, also know as medication-assisted therapy
Which withdrawl type is treated with therapy or narcotics anonymous?
Psychological withdrawl
What would you expect when giving Naloxone to a patient that has no opioids in their system?
NOTHING