Non-opioid Pain Management

Question 1

Acetaminophen: Classification

Answer 1

Antipyretics

Nonopioid Analgesics

Question 2

Acetaminophen: Actions/ Indications

Answer 2

Used for mild pain, fever, moderate to severe pain with opioid analgesics

Question 3

Acetaminophen: Common Side Effects and Adverse Affects

Answer 3

STEVES-JOHNSON SYNDROME, HEPATOTOXICITY, fatigue, hypertension, constipation, rash, dyspnea

Question 4

Acetaminophen: When would you NOT give this drug?

Answer 4

Previous hypersensitivity, severe hepatic impairment/active liver disease

Use cautiously: hepatic or renal disease, alcoholism, malnutrition, pregnancy

Question 5

Acetaminophen: What do nurses need to know and do?

Answer 5

For adult not to exceed 3g in 24 hours for patients with hepatic/renal impairment

Pain scale prior to giving, thorough pain assessment

Assess: malnutrition, alcohol use

Question 6

Acetaminophen: Essential Patient Teaching

Answer 6

Advise patient to stop taking if a rash appears and to notify provider

Avoid alcohol, avoid taking other medication that contains acetaminophen to prevent toxicity

Question 7

Aspirin: Classification

Answer 7

Antiplatelet

Antipyretic

Nonopioid analgesics

Question 8

Aspirin: Actions/ Indications

Answer 8

Used for mild to moderate pain, fever, decrease platelet, inflammatory disorders

Question 9

Aspirin: Common Side Effects and Adverse Affects

Answer 9

GI BLEEDING, HYPERSENSITIVITY, epigastric distress, nausea

Question 10

Aspirin: When would you NOT give this drug?

Answer 10

Bleeding disorders

Use cautiously: History of GI bleeding, after 20 wk gestation

Question 11

Aspirin: What do nurses need to know and do?

Answer 11

Pain scale prior and pain assessment

Assess: asthma, allergies, monitor for signs of DRESS, fever

Question 12

Aspirin: Essential Patient Teaching

Answer 12

Take with food and water, sit up right for 15-30 minutes

Avoid 3 or more glasses of alcohol

Question 13

Ibuprofen : Classification

Answer 13

Antipyretics

Anti-rheumatics

Nonopioid Analgesics

Nonsteroid anti-inflammatory agents

Question 14

Ibuprofen : Actions/ Indications

Answer 14

Used for mild to moderate pain, fever, inflammatory disorders

Question 15

Ibuprofen : Common Side Effects and Adverse Affects

Answer 15

MYOCARDIAL INFARCTION, HEART FAILURE, STROKE, GI BLEEDING, headache, nausea, vomiting, constipation

Question 16

Ibuprofen : When would you NOT give this drug?

Answer 16

Active GI bleeding, ulcer disease, no chewable tablets for patients with phenylketonuria, history of recent MI, after 30wk gestation

Use cautiously: cardiovascular disease, renal or hepatic disease, chronic alcohol

Question 17

Ibuprofen : What do nurses need to know and do?

Answer 17

Pain scale and pain assessment

Monitor temperature

Asses for rhinitis, asthma, urticaria, rash, symptoms of GI bleed

Lab tests: BUN, serum creatine, CBC, liver function

Question 18

Ibuprofen : Essential Patient Teaching

Answer 18

Take after meals with water, sit for 15-30 mins upright

Avoid alcohol

May cause drowsiness

Consult provider if experiencing rash, itching, visual disturbances, cardiovascular events, shortness of breath

Question 19

Gabapentin : Classification

Answer 19

Analgesic adjuncts

Therapeutic anticonvulsants

Mood stabilizers

Question 20

Gabapentin : Actions/ Indications

Answer 20

Used for partial seizures, therapeutic neuralgia, restless leg syndrome

Unlabeled Use(s):

Neuropathic pain.

Prevention of migraine headache

Bipolar disorder.

Anxiety.

Diabetic peripheral neuropathy.

Question 21

Gabapentin : Common Side Effects and Adverse Affects

Answer 21

SUICIDAL THOUGHTS, STEVENS-JOHNSON SYNDROME, RHABDOMYOLYSIS, confusion, depression, dizziness, ataxia

Question 22

Gabapentin : When would you NOT give this drug?

Answer 22

Hypersensitivity, older people more susceptible to toxicity

Use cautiously: renal impairment, respiratory impairment, pregnancy,

Question 23

Gabapentin : What do nurses need to know and do?

Answer 23

Pain scale and pain assessment,

Monitor for signs of changed behavior, suicidal thoughts, depression

If administered with depressants, start at a low dose

Assess for seizures, neuropathic pain, migraine Prophylaxis, restless leg syndrome

Question 24

Gabapentin : Essential Patient Teaching

Answer 24

Risk of respiratory depression when taken with CNS depressants

Do not take within 2 hours of antacid

May cause dizziness and drowsiness

Notify provider if thoughts of suicide, panic attacks, being violent, unusual changes in behavior, or if become pregnant

Question 25

Toradol : Classification

Answer 25

nonsteroidal anti inflammatory agents

nonopioid analgesics

Question 26

Toradol : Actions/ Indications

Answer 26

Used for short-term management of pain (not to exceed 5 days total for all routes combined)

Question 27

Toradol : Common Side Effects and Adverse Affects

Answer 27

HEART FAILURE, MYOCARDIAL INFRACTION, STROKE, GI BLEEDING, HYPERSENSITIVITY, drowsiness, diarrhea, injection sight pain

Question 28

Toradol : When would you NOT give this drug?

Answer 28

Concurrent use with Probenecid increase risk of adverse affects

If patient has cerebrovascular bleeding, advanced renal impairment, Active or history of peptic ulcer disease or GI bleeding

Use cautiously: cardiovascular disease, coagulation disorders, safety not established in neonates

Question 29

Toradol : What do nurses need to know and do?

Answer 29

Pain scale 1-2 hr prior and after administering

Patients who have asthma, aspirin-induced allergy, and nasal polyps are at increased risk for developing hypersensitivity reactions.

Assess for rash periodically during therapy

Question 30

Toradol : Essential Patient Teaching

Answer 30

May cause drowsiness or dizziness

Caution patient to avoid the concurrent use of alcohol, aspirin, NSAIDs, acetaminophen, or other OTC medications without consulting health care professional.

Advise patient to consult health care professional if rash, itching, visual disturbances, tinnitus, weight gain, edema, black stools, persistent headache, or influenza-like syndrome