Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Ellie-NUR 120 > Pain pt 2 > Flashcards

Pain pt 2 Flashcards

1
Q

what are some barriers to pain management

A

age
communication
cognitive impairment
mental health conditions
injury associated w/ pain
conditions associated w/pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are some factors that affect pain

A

culture, ethnicity
family, sex, gender, age
religious beliefs
environment, support people
anxiety, other stressors
past pain experience

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are some nursing interventions for pain

A

Establishing trusting nurse–patient relationship
Manipulating factors affecting pain experience
Initiating nonpharmacologic pain relief measures
Managing pharmacologic interventions
Complementary and alternative relief measures
Considering ethical and legal responsibility to relieve pain
Teaching patient about pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are some non-pharmacologic pain relief measures

A

distraction
humor
music
imagery
relaxation
cutaneous stimulation
acupuncture
hypnosis
biofeedback
therapeutic touch
animal-facilitated therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the 3 opioid receptors

A

mu
kappa
delta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are mu opioid receptors

A

stimulated by opioid drugs causing analgesia
also causes respiratory depression, euphoria, sedation, and physical dependance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are kappa opioid receptors

A

stimulated by opioid drugs causing analgesia
also causes sedation and psychotomimetic effects such as hallucinations and delusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are delta opioid receptors

A

no pharmacology effects when stimulated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is inflammation

A

Response to cellular damage and release of bradykinins, histamine, prostaglandins,
leukotrienes resulting in pain, inflammation, edema and the systemic response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is suppression of inflammation

A

The hypothalamus stimulates the pituitary gland to release ACTH which stimulates the
adrenal glands to produce cortisol which plays a role in suppressing inflammation and the
release of aldosterone which affects fluid balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are the 2 nonopioid analgesics

A

acetaminophen and NSAIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are some characteristics of nonopioid analgesics

A

can be used for acute or chronic pain
lack of dependence
less side effects
decreases inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are opioid/narcotic analgesics considered

A

controlled substaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are some characteristics of opioids/narcotics

A

used for visceral pain
drowsiness
respiratory depression
gi issues
constipation
high dependency rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are 2 examples of controlled substances

A

morphine and codiene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are the 2 inflammatory drugs

A

antihyperuricemics/uricosurics/urate lowering therapy
glucocorticoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what class are 1st gen NSAIDS

A

COX-1 inhibitors and COX-2 inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are 2nd gen NSAIDS

A

COX-2 inhibitors and acetaminophen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is a centrally acting NSAID

A

tramadol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are examples of 1st gen NSAIDS

A

aspirin and ibuprofen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the 2nd gen NSAID

A

celecoxib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the pharmacologic action of aspirin and ibuprofen

A

inhibit the action of COX-1 and COX-2 which stimulates the release of prostaglandins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are the adverse reactions w/ aspirin and ibuprofen

A

gastric upset
heartburn
nausea
gastric ulceration
bleeding tendencies
renal dysfunction
increased thromboembolic events
aspirin toxicity
Reye’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are the interventions for aspirin and ibuprofen

A

Monitor for signs of bleeding, such as dark stool, hematemesis, bruising
excessive bleeding from minor injuries such as shaving
Monitor I/O, BUN, Creatinine
Assess for signs of toxicity such as tinnitus, dizziness, headache.
Use acetaminophen instead of aspirin for children under 18 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

how do you administer aspirin and ibuprofen

A

swallow do not crush or chew enteric coated or sustained release, avoid alcohol, take with food, milk or water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are some contraindications of aspirin and ibuprofen

A

pregnancy
peptic ulcer disease
hemophilia
current diagnosis of chicken pox or flu
Older adults, smokers
alcohol use disorders
impaired kidney function
heart failure
hypertension
Helicobacter pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is a precaution of aspirin and ibuprofen

A

discontinue a week before surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are some interactions of aspirin and ibuprofen

A

use of aspirin with anticoagulants, glucocorticoids and alcohol increase risk for bleeding
Use with ACE inhibitors and angiotensin receptor blockers increase the risk of renal failure
Toxicity of lithium carbonate and methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is the class of celecoxib

A

COX-2 inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is the pharmacologic action of celecoxib

A

inhibit the action of COX-2 which stimulates the release of prostaglandins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what are the adverse reactions w/ celecoxib

A

renal dysfunction and increased risk of clots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what are the interventions for celecoxib

A

Monitor for signs of bleeding, such as dark stool, hematemesis, bruising
excessive bleeding from minor injuries such as shaving
Monitor I/O, BUN, Creatinine
Assess for signs of MI or stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

how do you administer celecoxib

A

2 hours before or after magnesium or aluminum- based antacids, take with food, milk or water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what are some contraindications w/ celecoxib

A

pregnancy
children under the age of 18
alcohol use disorders
impaired kidney or liver function
heart failure
hypertension
Helicobacter pylori
allergic to sulfonamides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what are the precautions w/ celecoxib

A

changes in weight gain, signs of fluid retention, such as edema and bloating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what are the interactions w/ celecoxib

A

furosemide and antihypertensive less effective.
warfarin and lithium toxicity
Glucocorticoids and alcohol bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what class is acetaminophen

A

nonopioid analgesic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what is the pharmacologic action for acetaminophen

A

inhibit the action of COX-1 and COX-2 but is limited to the CNS, therefore relieves pain and reduces fever but does have ant-inflammatory or anti-coagulant effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what are the adverse reactions w/ acetaminophen

A

liver damage with toxic doses and hypertension when taken daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what are the interventions w/ acetaminophen

A

Monitor for signs of overdose or poisoning such as abdominal discomfort, nausea, vomiting, sweating and diarrhea
Monitor blood pressure if taking on a regular basis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

how do you administer acetaminophen

A

do not take more than 4 g in 24 hours. Often is found in combination cold and flu products so be careful reading labels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what is a contraindication for acetaminophen

A

alcoholism

43
Q

what are the precautions w/ acetaminophen

A

anemia
immune suppression
liver/kidney disease

44
Q

what are the interactions for acetaminophen

A

increases risk of bleeding when also taking warfarin, if reduced absorption when taking cholestyramine

45
Q

what is the name of the centrally acting nonopioid

A

tramadol

46
Q

what is the class of tramadol

A

centrally acting nonopioid

47
Q

what is the pharmacologic action of tramadol

A

binds to selected opioid receptors and blocking
reuptake of norepinephrine and serotonin in the CNS

48
Q

what are the adverse reactions for tramadol

A

rare but include sedation and dizziness, headache, nausea and constipation. Seizures

49
Q

what are the interventions w/ tramadol

A

Monitor during ambulation, vital signs particularly respiratory rate, seizure activity and urinary retention.

50
Q

how do you administer tramadol

A

effects typically not felt until an hour after
administration. Swallow extended release do not chew or crush.

51
Q

what are the contraindications w/ tramadol

A

alcoholism
taking opioids or psychotropics
seizure disorders
respiratory depression
under the age of 12
liver or kidney disease
increased intracranial pressure

52
Q

what are the precautions for tramadol

A

avoid taking before driving or performing activities
Change positions slowly

53
Q

what are the interactions for tramadol

A

taking with MAOI’s increased risk for hypertensive crisis
increases effects of CNS depressant
taking with St. Johns wort increases its sedative effects.

54
Q

what is the opioid agonist

A

morphine

55
Q

what class is morphine

A

opioid agonist

56
Q

what is the pharmacologic action of morphine

A

mimics naturally occurring opioids, endorphins and enkephalins by binding with the mu receptors

57
Q

what are adverse reactions for morphine

A

respiratory depression and sedation
dizziness
lightheaded and drowsiness
Constipation
orthostatic hypotension
High potential for abuse

58
Q

what are interventions w/ morphine

A

Monitor vital signs particularly respiratory rate and oxygen saturation, If RR less than 12 hold medication and consider administering
naloxone
Monitor for constipation, urinary retention and dependance

59
Q

how do you administer morphine

A

orally
intramuscularly
intravenously
subcutaneously
rectally
epidurally
Have naloxone and resuscitation equipment readily available

60
Q

what are contraindications for morphine

A

pregnant women because it can cause newborn respiratory depression or neonatal withdrawal syndrome
Renal failure
increased intracranial pressure
biliary surgery

61
Q

what are the precautions for morphine

A

avoid taking before driving or performing activities. Change positions slowly

62
Q

what are the interactions for morphine

A

interact with CNS suppressants causing increased CNS suppression
Anticholinergics- increases risk for constipation and urinary retention
taking with MAOI’s increased risk for hyperpyrexic syndrome
taking with St. Johns wort increases its sedative effects

63
Q

what are the opioid agonist-antagonists

A

butorphanol and pentazocine

64
Q

what is the class of butorphanol and pentazocine

A

opioid agonist-antagonist

65
Q

what is the pharmacologic action of butorphanol and pentazocine

A

mu receptors antagonists and kappa receptor
agonists

66
Q

what are adverse reactions for butorphanol and pentazocine

A

respiratory depression and sedation
dizziness
lightheaded and drowsiness
headache
nausea
Increased cardiac workload

67
Q

what are interventions w/ butorphanol and pentazocine

A

ask if they are taking an opioid before administering as it can precipitate withdrawal symptoms
Monitor vital signs particularly respiratory rate and oxygen saturation. If RR less than 12 hold medication.

68
Q

how do you administer butorphanol and pentazocine

A

IM
IV
intranasally

69
Q

what are contraindications for butorphanol and pentazocine

A

Acute myocardial infarction
renal or liver disease
increased intracranial pressure
cardiac insufficiency
hypertension

70
Q

what are the precautions for butorphanol and pentazocine

A

avoid taking before driving or performing activities.
Change positions slowly

71
Q

what are the interactions for butorphanol and pentazocine

A

interact with CNS suppressants causing increased CNS suppression
If given with opioids will decease the effect of the opioid

72
Q

what is an opioid antagonist

A

naloxone

73
Q

what class is naloxone

A

opioid antagonist

74
Q

what is the pharmacologic action of naloxone

A

block opioid receptors reversing or
antagonizing the effects of opioids

75
Q

what are adverse reactions of naloxone

A

ventricular arrythmias and abstinence syndrome in opioid dependent including hypertension, vomiting and tremors

76
Q

what are interventions w/ naloxone

A

closely monitor for dangerous elevations in blood pressure and abnormal heart rhythms

77
Q

how do you administer naloxone

A

IM
IV
subcutaneous

78
Q

what are contraindications w/ naloxone

A

Acute myocardial infarction
renal or liver disease
increased intracranial pressure
cardiac insufficiency
hypertension

79
Q

what are precautions for naloxone

A

caution in use on cardiac irritability, head injury, with increased intracranial pressure, brain tumor, or seizures

80
Q

what are interactions for naloxone

A

will decrease the effect of opioids

81
Q

what drug is a antihyperuricemics/uricosurics/urate lowering therapy

A

allopurinol

82
Q

what class is allopurinol in

A

anti/gout/antihyperuricemics

83
Q

what is the pharmacologic action of allopurinol

A

inhibit the conversion of hypoxanthine and xanthine into uric acid and inhibit the reabsorption of uric acid by the kidneys promoting excretion

84
Q

what are adverse reactions of allopurinol

A

generally tolerated well but some may experience hypersensitivity syndrome, liver and kidney dysfunction, GI disturbances and bone marrow depression and a metallic taste in their mouth. Cataracts if taken for extended period.

85
Q

what are interventions of allopurinol

A

monitor for hypersensitivity syndrome if taking greater than 2-4 weeks
Monitor kidney and liver function and CBC. Give after meals if GI disturbances occur
Visit ophthalmologist regularly

86
Q

how do you administer allopurinol

A

orally or intravenously. Tablets can be crushed and mixed with fluid or food. Drink at least 3 liters of fluid daily.

87
Q

what are contraindications w/ allopurinol

A

bone marrow depression
liver or kidney disease
peptic ulcers
lower GI tract diseases

88
Q

what are precautions of allopurinol

A

minimize exposure of eyes to bright sunlight

89
Q

what are interactions of allopurinol

A

increases the anticoagulant effect of warfarin
increases risk of toxicity if taken with mercaptopurine, theophylline and azathioprine
Increases risk for rash if taken with ampicillin

90
Q

what drug class is prednisone

A

glucocorticoids

91
Q

what is the pharmacologic action of prednisone

A

mimic cortisol by suppressing inflammation
and the immune response resulting in decreasing pain and swelling

92
Q

what are adverse reactions w/ prednisone

A

hyperglycemia
myopathy
peptic ulcer disease and GI distress
Bone loss
cataracts
increased risk for infection

93
Q

what are interventions w/ prednisone

A

monitor hypotension and fatigue
monitor blood glucose levels
observe for sign of infection
I/O
edema
weight gain

94
Q

how do you administer prednisone

A

orally
intramuscularly
intravenously
subcutaneously
topically
intranasally
inhalation
Start with larger doses and progressively decrease doses. Do not stop abruptly.

95
Q

what are contraindications w/ prednisone

A

systemic fungal infection
cataracts
heart failure
peptic ulcer disease
diabetes
hypertension
renal dysfunction
myasthenia gravis
osteoporosis

96
Q

what are precautions of prednisone

A

long term effects even if given for a short period of time

97
Q

what are interactions of prednisone

A

prevent the body from responding appropriately to vaccines
Increased risk of hypokalemia if taking furosemide
Increased risk of dysrhythmias when taking digoxin
Increased risk of GI bleed and ulceration if also taking NSAIDs
effects of insulin and oral hypoglycemics decreased

98
Q

what receptors do opioid agonists primarily bind to

A

mu receptors

99
Q

what receptors do opioid agonist-antagonists primarily bind to

A

mu and kappa receptors

100
Q

what is the pasero opioid-induced sedation scale

A

s=sleep, easy to arouse; no action necessary
i=awake & alert; no action necessary
3=frequently drowsy, drifts to sleep during
conversation; decrease the opioid
4=somnolent with minimal or no response to stimuli; discontinue the opioid and consider use of naloxone

101
Q

what is a uricosuric

A

Treat gout: an inflammatory disorder that occurs due to high levels of uric
acid in the blood. The uric acid crystalizes and deposits in joints. Primarily
small joints such as the big toe. Can also deposit in the skin and organs if
untreated.

102
Q

what are corticosteroids

A

Treat inflammation and autoimmune diseases: wide variety of disorders of
the skin, respiratory system, allergic reactions, rheumatoid arthritis and to
prevent organ rejection and respiratory

103
Q

what is drug diversion

A

any act that causes a drug to not reach the right person

Ellie-NUR 120 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions