VN 16 Test 4 Study Guide-DONE Flashcards
1.Fentanyl toxicity manifestations (ATI pg. 262)
-coma
-respiratory depression
-pinpoint pupils
2.Fentanyl use (pg.33,202 &192)
-severe pain
-anesthetic adjunct,
-management of breakthrough cancer pain.
3.Client education for codeine use (ATI pg.133)
- change positions slowly & lie down if feeling lightheaded
-avoid activities that require alertness (driving,operating heavy machinery)
-take w/food
-increase fluids & dietary fiber
-avoid alcohol & other CNS depressants
4.Client education for enteric coated medications(ATI pg.258)
Do not crush or chew medication
- Celecoxib uses(Ati pg.257)
Uses:
-inflammation
-pain relief
-decreases fever
-protection against colorectal cancer
6.Aspirin contraindications (pg.165)
Contraindications:
-hypersensitivity to salicylates or NSAIDs
-bleeding disorders or tendencies (includes GI bleeding)
-blood dyscrasias (abnormalities)
-receiving anticoagulants
-receiving antineoplastics
-children & adolescents who have viral illness (chicken pox, influenza)
-warfarin
-pregnancy category D & C
7.Acetaminophen toxicity manifestations (slide 7 analgesic & antagonists pp/ ATI pg.259)
-nausea
-vomiting
-sweating
-diarrhea
-abdominal discomfort
-hepatic/renal failure
-coma/death
-confusion
-liver tenderness
-hypotension
-cardiac arrhythmias
-jaundice
8.Non-opioid client education(ATI pg.258, pg170 )
-take w/food or 8oz of water or milk
-avoid alcohol
-notify pcp if tinnitus, sweating, headache, dizziness & respiratory alkalosis occur.
-avoid giving aspirin to a child or adolescent that has chicken pox or flu.
- do not take ibuprofen w/aspirin
-do not take acetaminophen w/aspirin or other NSAIDS
-ketorolac shouldnt be used w/other NSAIDS
-report indications of bleeding when on anticoagulant
-ginger,feverfew,vitamin E,ginkgo, omega 3 oils,garlic supplements can increase risk for bleeding w/NSAIDS
-discard aspirin if it smells like vinegar. Do not use medication that is yellow or cloudy in dispenser
-keep record of when you take pain relievers
-if fever persists for more than 3 days contact provider
-adults do not take acetomenophen for more than 10 days, children more than 5 days
-stop aspirin a week before surgery or expected date of childbirth
-do not self treat chronic pain with otc non opioids
-if drug is fever reducer contact pcp if fever remains elevated for more than 24hr
9.NSAIDS uses(ati pg.257)
-inflammation
-mild to moderate pain relief .
-osteoarthritis &rheumatoid arthritis
-fever reduction
-dysmenorrhea(painful menstrual cramps)
-protect against ischemic stroke & myocardial infarction (aspirin)
10.Opioid contraindications (opioid analgesic slide 6 pp, ATI pg. 262)
-pregnancy category B & C or labor
-acute bronchial asthma, emphysema, or upper airway obstruction
-head injury or increased intracranial pressure
-convulsive disorders
-several renal or hepatic dysfunction
-acute ulcerative colitis
-morphine is contraindicated after biliary tract surgery, and in infants and after delivery.
11.Opioid pre-administration considerations(ford pg.195)
-clients involved in long term opioid therapy for pain relief build tolerance to the physical adverse effects of the drugs
-prepare Naloxone(near an) for reversal opioid overdose
clients at greater risk for respiratory depression:
-long term opioid users, who have a chronic or an acute respiratory issue.
-opioid-naive clients(clients who dont use opioids routinely and are being given an opiod drug for acute pain relief.
Oipiod adverse effects
Sedation (comes before respiratory depression)
Respiratory depression(hold dose for RR below 12)
Euphoria
Physical dependence
Low & slow vitals
Unarousable , falls asleep while talking
Constipation, nausea
Salicylism manifestations
Tinnitus
Dizziness
Headache
Diaphoresis
Tachypenea
Tachycardia
Mental confusion
2.Fentanyl Nursing considerations
- interferes w/respiratory function & pupil reaction
-Should be administered cautiously in clients undergoing biliary surgery.
-wear gloves to prevent accidental exposure to medications
-remove old patches to prevent added dosing of drug, fold sticky sides together and discard in sharp container.
-do not shave area to apply patch it can cause skin irritation.
-low & slow vital signs (easily fall asleep while talking/unarousable)
-patch pain relief can take up to 17hrs but lasts up to 3 days.
-not for post op pain or acute pain
- Celecoxib contraindications (pg.ATI 258)
-clients w/allergy to sulfonamides(antibiotic)
-last choice med for chronic pain due to increased risk of MI & stroke
-late pregnancy
-lactation use caution
