Week 4 - Pain and Inflammation

Question 1

• bleeding and kidney dysfunction
• d/c 1 week prior surgery
• take w/ food or milk
• suppress inflammation, reduce fever

Answer 1

NSAID

Question 2

• suppress inflammation, reduce fever, prevents clotting
• prevents prostaglandin synthesis
• complication: bleeding tendencies, salicylism (ringing ears) & aspirin toxicity (sweat, dizzy, fever, worse feeling)
• Nur interv: monitor bleeding (coffee ground emesis, pain, N/V, Hematemesis, bloody stool), salicylism, ER tablet for long term use

Answer 2

NSAID (1st gen): aspirin

Question 3

• suppress inflammation, mild-mod pain, fever reducer
• Nur interv: monitor for MI or stroke
• d/c 1 week prior to surg
  take w/ food or milk

Answer 3

NSAID (1st gen): ibuprofen

Question 4

• Mild - moderate pain; fever reducer
• Complication: acute liver toxicity (vomit, diarrhea, sweats) > start within 48-72hrs of overdose
• Nur interv: no > 4g per day in adults; monitor for overdose (n/v/d, sweating, abd pain, progressively worsen to liver failure)
• Contra: pregnancy risk B & C
• Pt educ: read label carefully due to diff types of meds in it
• antidote for poisoning: acetylcysteine, given PO/IV

Answer 4

Acetaminophen

Question 5

• Moderate- severe pain; preop sedation, anxiety
• Binds to opioid receptors in CNS & PNS
• Schedule: 2 (medical use)
• Complication: resp depression (↓ VS), sedations, constipation, orthostatic hypotension, potential abuse, tolerance & cross tolerance
• Nur interv: monitor VS, hold if RR < 12; make sire mental awareness is present before admin
• Pt ed: PRN & short time; don’t take with opioids; take PO w/ food or milk
• Opioids = VS go down
• have naloxone present w/ resp equipment

Answer 5

Opioid Agonist: morphine

Question 6

• Pain, inflammation, skin disorders
• Leukocyte suppression; immunosuppressant
• Complication: bone loss (osteoporosis - take Ca lvl); infection (lethargic/fatigue, sweaty, ↑ VS except for temp - might be febrile, sore throat, tachycardia)
• Nur interv: tapered dose pack, use lowest dose possible
• Contraindications: PUD (don’t balance gastric acid), osteoporosis (body not absorbing Ca)
• Pt educ: take Ca / Vit D supplement, moon face

Answer 6

Glucocorticoid: prednisone