Pain and Comfort

Question 1

Side effects of Morphine:

Answer 1

Urinary retention
Nausea
Dysphoria (restlessness, anxiety, depression)
Euphoria
Respiratory depression/dizziness/sedation

Physical and psychological dependance
Hallucinations
Itching
Tolerance

Question 2

Morphine BB warning:

Answer 2

IV- monitor ECG, Vitals, and LOC closely

Question 3

Naloxone:

Answer 3

Minimal adverse effects
-Administer for RR <10 breaths/min
-Be prepared for combativeness
-Vomiting
-Anxiety and irritability
-Hypertension
-Hyperventilation

Question 4

What drug is used for treatment of opioid dependence?

Answer 4

Methadone:
-Avoids withdrawal symptoms

Question 5

Tramadol:

Answer 5

Is now a schedule IV drug in all 50 states
-Centrally acting analgesic
-Adverse: CNS, GI, CV effects

Question 6

What are triptans (sumatriptan-Imitrex) used for?

Answer 6

Constrict intracranial vessels to abort migraines.

Question 7

Triptans adverse effects:

Answer 7

-Dizziness, drowsiness
-Flushing, or warm sensation
-Decreased carotid blood flow (decreased LOC, seizures)
-Serotonin Syndrome

Question 8

Nursing Implications for triptans (Sumatriptan (Imitrex)):

Answer 8

-Assess pain before and after administration
-Education patients on Auras
-Educate to take at the onset of an aura (can take about 20 minutes)
-CONTRAINDICATED for pts. w/ CVD or CAD, Stroke, HPTN, MI, angina
-Monitor for LOC and seizures
-S/S or serotonin syndrome

Question 9

Signs and symptoms of serotonin syndrome

Answer 9

-Fever, tremors, tetany, shock sensations
-SSRI, SNRI, Tricyclic, MAOI’s, St. Johns Wort

Question 10

Ergot alkaloids:

Answer 10

-Promotes vasoconstriction
-Terminates migraines
-GI upset, weakness in the legs, myalgia, numbness and tingling in fingers and toes, angina-like pain, tachycardia