Quiz 4

Question 1

NSAIDs Patient Education

Answer 1

Discontinue ASA 1 week prior to surgery; take NSAID with food; DO NOT crush enteric tablets; watch for excessive bleeding

Question 2

NSAID Interactions

Answer 2

Alcohol, anticoagulants, corticosteroids, concurrent use of other NSAIDs

Question 3

ASA Toxicity (NSAID) Signs and Symptoms

Answer 3

Tinnitus, hearing loss, hyperventilation, dizziness, drowsiness
*No antidote

Question 4

NSAIDs Adverse Effects

Answer 4

Gastric ulcers, GI bleeding, renal failure, MI, CVA

Question 5

NSAIDs Contraindications

Answer 5

Allergy, Peptic Ulcer Disease, bleeding disorders, renal or hepatic disease, children with chicken pox or influenza (ASA), Cardiovascular Disease

Question 6

NSAIDs Indications

Answer 6

Mild to moderate pain; fever; inflammation; dysmenorrhea (menstual cramps); inhibits platelet aggregation

Question 7

NSAIDs MOA & Drug Effects

Answer 7

MOA: blocks the chemical activity of the enzyme COX

Drug effects: analgesic, antiinflammatory, antipyretic (fever), antiplatlet

Question 8

Acetaminophen Patient Education

Answer 8

Acetaminophen is found in many combination medications (Vicodin, Norco)

Question 9

Acetaminophen Toxicity & Antidote

Answer 9

Causes hepatic necrosis (>150mg/kg)

Antidote=Mucomyst

Question 10

Acetaminophen Contraindications

Answer 10

Allergy, severe liver disease, G6PD Disease, alcohol (use with caution)

Question 11

Acetaminophen Indications

Answer 11

Fever, mild to moderate pain, alternative for those who cannot use ASA

Question 12

Acetaminophen MOA & Drug Effect

Answer 12

MOA: selective inhibition of Cyclooxygenase (COX) in the CNS

Drug effects: analgesic (pain reliever); antipyretic (fever reducer)

Question 13

Opioid Nursing Implications

Answer 13

Assess: pain (0-10); respiratory depression, constipation, and watch for orthostatic hypotension

Question 14

Opioid Interactions

Answer 14

Coadministration with: alcohol, barbiturates, benzodiazepines, CNS depressants

Question 15

Opioid Toxicity Antidote

Answer 15

Narcan

Question 16

Opioid Contraindications

Answer 16

Allergy, Biliary Tract surgery, severe asthma, head injuries, morbid obesity (sleep apnea), paralytic ileus

Question 17

Opioid Adverse Effects

Answer 17

Sedation, pupils constric, respiratory depression, orthostatic hypotension, constipation, urinary retention

Question 18

Opioid Indications

Answer 18

Pain, cough suppressant, diarrhea

Question 19

Opioids are regulated by:

Answer 19

Controlled Substance Act (1970)

Question 20

Opioid MOA &Drug Effect

Answer 20

MOA: Mu receptor agonists, similar to the body’s own endorphines
Drug effect: Opioid binds to mu receptor, relieving pain

Question 21

Two classes of Opioid Analgesics

Answer 21

1. ) Mild (Tylenol #3, Vicodin, Norco)

2. ) Strong (Morphine, Dilaudid, Fentanyl)

Question 22

Reye’s Syndrome Definition & Causes

Answer 22

Causes swelling in the brain &liver

Suspected cause: use of ASA to treat a viral infection in children and teens (influenza or chicken pox)

Question 23

Pain Tolerance (Psychological)

Answer 23

The amount of pain a person can endure without it interfering with normal function

Question 24

Pain Threshold (Physiological)

Answer 24

The level of stimulus needed to produce the perception of pain

Question 25

Opioid Tolerance

Answer 25

A common physiologic result of chronic opioid treatment. | Reduced effects of drug as a result

Question 26

Psychological Dependency

Answer 26

Need to use opioids for effects other than pain | Characterized by: impaired control over drug use, compulsive use, continued use despite harm, craving

Question 27

Physical Dependency

Answer 27

Physiological adaptation which results in withdrawal symptoms if discontinued S&S: mental agitation, tachycardia, hypertension, seizures

Question 28

Pain Definition

Answer 28

Unpleasant sensory or emotional experience associated with actual or potential tissue damage

Question 29

Nociceptive Pain

Answer 29

Term used to describe noxious stimuli are perceived as pain

Question 30

Four phases of Nociception

Answer 30

1. ) Transduction: injured tissue releases chemicals 2. ) Transmission: impulse moves from spinal cord to brain 3. ) Perception 4. ) Modulation: neurons from brain stem release neurotransmitters that block the pain impulse

Question 31

Neuropathic Pain

Answer 31

- Exact mechanism unclear - Often perceived long after site of injury heals - Difficult to assess and treat

Question 32

Three different types of pain

Answer 32

- Acute: sudden - Chronic: 3-6 months - Breakthrough: in between pain medication doses

Question 33

JCAHO Pain Management Standards

Answer 33

- Every patient has a right to have his/her pain assessed & treated - RN must evaluate pain after med administration (every 30 min-1 hr)