Analgesic Medication Review
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Questions and Answers

A nurse is teaching a client who has a new prescription for transdermal sumatriptan for migraines. Which instruction is most important?

  • Use contraception while taking this medication. (correct)
  • Activate the patch 30 minutes after application.
  • Apply the patch daily to prevent headaches.
  • You can bathe with the patch in place.

Which client is most at risk when prescribed sumatriptan for migraine headaches?

  • A client with a history of infrequent tension headaches.
  • A client who prefers injectable medications.
  • A client experiencing an acute migraine attack.
  • A client with diagnosed coronary artery disease. (correct)

A client with migraine headaches is prescribed almotriptan. Which statement indicates effective teaching?

  • "I should wait to take the medication until the pain is unbearable."
  • "I will take the medication as soon as I notice migraine symptoms." (correct)
  • "If the first dose does not help, I can take two more doses 15 minutes apart."
  • "I will take a dose every morning to prevent an acute attack."

A client overdoses on acetaminophen. Which finding should the nurse first assess?

<p>Reports of vomiting. (D)</p> Signup and view all the answers

A client regularly takes acetaminophen for knee pain. What adverse effect should the nurse teach the client to monitor for?

<p>Jaundice (D)</p> Signup and view all the answers

An adolescent overdoses on acetaminophen. Which area is most important to assess for pain?

<p>Abdomen (C)</p> Signup and view all the answers

A client takes acetaminophen regularly. The nurse should advise the client to avoid which substance?

<p>Alcohol (C)</p> Signup and view all the answers

A nurse is teaching a client with osteoarthritis. What medication should the nurse anticipate the client will use as a first line treatment?

<p>Acetaminophen (D)</p> Signup and view all the answers

Which client statement indicates that teaching about acetaminophen is effective?

<p>&quot;I have to be careful about which over-the-counter cold preparations I take.&quot; (A)</p> Signup and view all the answers

A nurse administers acetaminophen for pain relief to an infant. What information is most important to include in the medication administration record?

<p>The dose administered based on the client weight (C)</p> Signup and view all the answers

A client with rheumatoid arthritis taking ibuprofen asks if acetaminophen can be substituted. How should the nurse respond?

<p>&quot;Ibuprofen has anti-inflammatory properties, and acetaminophen does not.&quot; (B)</p> Signup and view all the answers

Which medication is safest for a client to take for pain the week before a surgical procedure?

<p>Acetaminophen (C)</p> Signup and view all the answers

Which medication does not increase the risk for upper gastrointestinal (GI) bleeding?

<p>Acetaminophen (D)</p> Signup and view all the answers

A client develops tinnitus. Which medication would the nurse suspect as the cause?

<p>Aspirin 325 mg, two tablets every 4 hours (B)</p> Signup and view all the answers

A client with arthritis takes large doses of aspirin. Which symptom would the nurse include when teaching about aspirin toxicity?

<p>Disturbances in hearing (C)</p> Signup and view all the answers

A client who takes four 325-mg tablets of buffered aspirin four times a day for arthritis complains of dizziness and ringing in the ears. What complication is the client probably experiencing?

<p>Salicylate (chemical of aspirin) toxicity (A)</p> Signup and view all the answers

The nurse is assessing the effectiveness of high-dose aspirin therapy for an 88-year-old with arthritis. The client reports constant ringing in the ears. What action should the nurse implement?

<p>Notify the healthcare provider of the finding immediately. (D)</p> Signup and view all the answers

A nurse is teaching a client newly prescribed aspirin to prevent cardiovascular disease. Which instruction should the nurse include?

<p>Monitor for tinnitus. (C)</p> Signup and view all the answers

A client is receiving aspirin therapy. Which clinical indicator would be related to this therapy?

<p>Prolonged bleeding time (A)</p> Signup and view all the answers

A toddler ingested half a bottle of aspirin tablets. What finding should the nurse expect?

<p>Epistaxis (nose bleed) (B)</p> Signup and view all the answers

A client is taking prednisone and aspirin for rheumatoid arthritis. Which action by the nurse is appropriate?

<p>Test the client's stool for occult blood (blood in stool) (C)</p> Signup and view all the answers

A client is using nonsteroidal anti-inflammatory drugs (NSAIDs) to manage arthritis pain. The nurse should caution the client about what potential side effect?

<p>Occult bleeding (C)</p> Signup and view all the answers

A child with juvenile idiopathic arthritis is prescribed nonsteroidal anti-inflammatory drug (NSAID) therapy at home. Which important toxic effect of NSAIDs should the nurse include in their discharge teaching?

<p>Blood in the urine (B)</p> Signup and view all the answers

A client who has difficulty swallowing medications is prescribed enteric-coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier. Which response should the nurse provide?

<p>&quot;Crushing the medication might cause you to have a stomachache or indigestion.&quot; (D)</p> Signup and view all the answers

A client with rheumatoid arthritis experiences pain. Which medication would the nurse anticipate the health care provider will prescribe?

<p>Aspirin (A)</p> Signup and view all the answers

A client has been given a prescription for acetylsalicylic acid/aspirin for rheumatoid arthritis. The nurse understands that the medication is being used primarily for which property?

<p>Anti-inflammatory (D)</p> Signup and view all the answers

A client has been given a prescription for acetylsalicylic acid/aspirin. The nurse recognizes that this medication has what property?

<p>Analgesic (C)</p> Signup and view all the answers

A client with a history of myocardial infarction (MI) is prescribed aspirin 325 mg. What action of aspirin will improve their condition?

<p>antiplatelet aggregate (D)</p> Signup and view all the answers

A client is admitted to the emergency department with crushing chest pain. Acute coronary syndrome is suspected. What medication is indicated to prevent progression to a myocardial infarction?

<p>Aspirin (A)</p> Signup and view all the answers

The client with chronic arterial insufficiency of the legs refuses the prescribed dose of aspirin (ASA). The client states, 'My legs are not painful.' What action will the nurse take?

<p>Explain the reason for the medication and encourage the client to take it. (B)</p> Signup and view all the answers

A client is taking aspirin at bedtime long term after a heart attack. The client asks, 'Why am I supposed to take a baby aspirin instead of a regular 325 mg tablet?' Which statement represents the nurse's best response?

<p>&quot;Taking 325 mg of aspirin daily will increase your risk of bleeding.&quot; (A)</p> Signup and view all the answers

How should the nurse instruct a client with arthritis to take aspirin when the client states that the aspirin causes stomach irritation?

<p>With food and a full glass of water (D)</p> Signup and view all the answers

The nurse is teaching a group of clients diagnosed with arthritis about non-steroidal anti-inflammatory agents (NSAIDs). How should the nurse teach the group to minimize side effects of these drugs?

<p>Take the medication with food (C)</p> Signup and view all the answers

What should the nurse advise the client with severe arthritis who is newly prescribed aspirin?

<p>Take the medicine with meals. (C)</p> Signup and view all the answers

A nurse is caring for a client who has rheumatoid arthritis (RA) and is taking aspirin 650 mg every 4 hours. Which diagnostic tests should the nurse monitor to evaluate the effectiveness of this medication?

<p>Erythrocyte sedimentation rate (ESR) (D)</p> Signup and view all the answers

A client with a history of heart disease has been prescribed prophylactic aspirin daily. What action should the nurse implement to help prevent aspirin toxicity?

<p>Monitor serum albumin (D)</p> Signup and view all the answers

The nurse educating a client who is postpartum about the use of ibuprofen for uterine cramping. What statement should the nurse include in the teaching?

<p>This medication could cause gastrointestinal discomfort (C)</p> Signup and view all the answers

What life-threatening complication may occur in clients taking high-dose or long-term ibuprofen?

<p>Gastrointestinal (GI) bleeding (D)</p> Signup and view all the answers

The nurse administers acetaminophen to a child following abdominal surgery over ibuprofen. What response by the nurse answers the request of the child's mother?

<p>&quot;It could prolong bleeding time.' (D)</p> Signup and view all the answers

Which therapeutic outcome would you not expect after administering ibuprofen?

<p>Diuresis (A)</p> Signup and view all the answers

A nurse is reviewing prescriptions for a client with a history of rheumatoid arthritis and peptic ulcer disease, taking ibuprofen and ranitidine. What action will the nurse perform?

<p>Clarify the prescription for ibuprofen (D)</p> Signup and view all the answers

The mother of a toddler with hemophilia A (bleeding disorder) asks the nurse, 'Can I give my child ibuprofen for fever or pain?' How will the nurse respond?

<p>'Give your child acetaminophen. Ibuprofen may cause bleeding.' (C)</p> Signup and view all the answers

A nurse is caring for a client to start therapy with ibuprofen for hip pain. Which of the following information should the nurse provide about ibuprofen?

<p>Take the medication with food. (A)</p> Signup and view all the answers

Which instruction for a client starting treatment with ibuprofen for hip pain should the nurse include?

<p>Take the medication with food. (A)</p> Signup and view all the answers

A nurse is evaluating a client who takes naproxen for osteoarthritis. What documented statement indicates the expected outcome?

<p>Client observed with steady gait upon ambulation (B)</p> Signup and view all the answers

A nurse is caring for a client who is taking naproxen following an exacerbation of rheumatoid arthritis. Which of the following statements requires further discussion by the nurse?

<p>&quot;I've been taking an antacid to help with indigestion.&quot; (C)</p> Signup and view all the answers

Which of the following is a primary consideration when planning pain management with a fentanyl patch?

<p>Assessing for potential allergic reactions to adhesive (A)</p> Signup and view all the answers

The nurse observes a client who is taking ibuprofen has a blood pressure of 134/84 mmHg, heart rate 88 bpm, with new onset dizziness. Which intervention would be MOST important for the nurse to implement?

<p>Contact provider with assessment findings (D)</p> Signup and view all the answers

Which of the following are important to consider when providing care for a client on PCA (Patient-controlled analgesia)?

<p>All of the above (D)</p> Signup and view all the answers

A client receives intrathecal morphine to control severe postoperative pain. What action will the nurse include in the client's initial recovery plan?

<p>Monitoring of respiratory rate hourly (D)</p> Signup and view all the answers

Morphine has been prescribed for a cancer client in a hospice setting. Which information should the nurse provide regarding this pain management regimen?

<p>Dosages of the medication will be given automatically at regular intervals around the clock. (D)</p> Signup and view all the answers

The nurse is readying the administration space for the newly admitted client to be 78 years old with moderate back ache taking Codeine to help with the pain. Where should the nurse administer this medication?

<p>Private Room that's close to the med storage room (B)</p> Signup and view all the answers

Flashcards

Morphine

Highly addictive opioid analgesic that depresses respiration rate.

Aspirin

Medication used to reduce fever, pain, and inflammation; can cause tinnitus and bleeding.

PCA (Patient Controlled Analgesia)

Method of pain management where the patient controls when they give themselves pain medication.

Acetaminophen

Medication for pain relief; watch for liver damage and avoid alcohol.

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Naloxone

Medication that reverses opioid effects by blocking opioid receptors.

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Ibuprofen

NSAID that is used for pain relief.

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Fentanyl

Potent opioid analgesic.

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Codeine

Opioid analgesic used for mild to moderate pain.

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Oxycodone / Hydrocodone

Opioid analgesic used to treat moderate to severe pain.

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Almotriptan/Sumatriptan

Agent for migraine relief that constricts blood vessels.

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Hydromorphone (Dilaudid)

Potent opioid analgesic, 10x more potent than morphine.

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Methadone

Synthetic opioid used for pain management and opioid addiction treatment.

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Naproxen

Medication to treat pain.

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Ketorolac

Potent NSAID but can be hard on the stomach..

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Celecoxib

NSAID less likely to cause GI upset.

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Tinnitus

Damages inner ear hair cells.

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Erythrocyte Sedimentation Rate (ESR)

Test of choice to monitor effectiveness of aspirin use

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Hematuria

Condition where there will be blood in the urine.

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Enteric coated aspirin

Medications to never crush or chew.

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Aspirin

Medication of choice to give a patient suffering from Rheumatoid Arithritis?

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Active Myocardial Infarction - Aspirin

Medication to prevent clots.

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Test Clients stool

To test the clients stool, there are a couple items you need to look out for.

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Major NSAID long term side effect

The use of non steroidal anti-inflammatory drugs (NSAIDs) have a major side affect when it comes to the use of them for long periods of times.

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Nurse teaching mother about childs med

A nurse is preparing to teach a mother about acetaminophen. What should the nurse be careful about before teaching?

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Osteoarthritis drug of choice

A drug thats better safer then an NSAID, better used over the other!

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Myocardial Infarcation and medications

Is safe practice that is in place to monitor the heart at all costs and help determine if its safe to administer medications?

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Respiratory Depression (RD)

This can be a sign of internal issues, make sure to test vitals if a patient has it!

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Constipation treatment drugs

Medications that can be used to treat the side effects of congestion that can happen with other medication use.

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Cardiac enzymes test

Test to help a nurse confirm if the patient is having issues with their heart, or other pain issues!

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Drug Tolerance

When the body needs a larger dose of a medication to produce the same response.

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Use pain scale

Important instructions for client before procedure.

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Blood alteration danger

Interfere platelet production and prolonged bleeding.

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Nursing action!!

The action a nurse must do before administering a drug to ensure all is good?

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Why have time controlled machine?

Reason to use PCA machines that prevent any extra doses?

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Reduce stomach irritation with aspirin

Take medicine with meals.

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Naproxen side adverse effect

GI discomfort/Bleed.

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Acetaminophen, N-aceTYL-para-aminophENOL risk for damage of

Liver.

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DON'T Take What with Blood Thinners?

Do NOT take with blood thinners.

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Patient is in TOTAL control, what does this mean?

The patient can give when they want and need.

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Whats important about medication stage and stage of development of the infant?

These should be documented to prevent errors or any type of record messes.

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Study Notes

Analgesic Homework Key Overview

  • The summary includes 135 questions across different analgesic medication categories.
  • The medications are ordered from most to least asked in the homework questions.

Top Medication Classes

  • Morphine featuring in 34 questions leads the list.
  • Aspirin is second, appearing in 23 questions.
  • PCA (Patient-Controlled Analgesia) is third, used in 11 questions.
  • Acetaminophen appears in 10 questions.
  • Naloxone (Narcan) is next with 9 questions, used to reverse opioid effects.
  • Ibuprofen is sixth in the list, featuring in 8 questions.
  • Fentanyl features in 7 questions, noted as 100x more potent than morphine.
  • Miscellaneous Pain Management & Narcotic Pain Management accounts 6 questions.
  • Codeine is the ninth highest, with 5 questions.
  • Oxycodone and hydrocodone are involved in 4 questions.
  • Almotriptan and sumatriptan have 4 questions, migraine medications.
  • Hydromorphone and methadone are each addressed in 3 questions.
  • Meperidine, naproxen, ketorolac, and celecoxib have the fewest questions, with only 2 each.

Migraine Medications - Almotriptan & Sumatriptan

  • Contraindicated in pregnancy, need to take contraception
  • Contraindicated with coronary artery disease as they cause vasoconstriction.
  • Optimal effectiveness comes with administering sumatriptan at the onset of a migraine headache.
  • Maximum adult dose of sumatriptan is two 6-mg doses in 24-hours with doses separated by at least one hour.
  • It is acceptable to take a second dose if the headache goes away and comes back after taking one dose and no more than 2 doses in 24 hours.
  • Almotriptan and other triptans are serotonin receptor agonists.
  • They work by causing vasoconstriction of intracranial arteries.
  • They are most effective as soon as migraine symptoms start but before the onset of acute pain
  • They will not prevent headaches or reduce the number of attacks.

Acetaminophen

  • Overdose is indicated by vomiting.
  • Can lead to liver damage, watch for jaundice.
  • Limit alcohol consumption due to being hepatotoxic.
  • Acetaminophen is 1st drug of choice for osteoarthritis.
  • Be cautious as many OTC drugs contain acetaminophen.
  • Do not exceed 3 to 4 g a day.
  • Use with caution in infants and dose based on weight.
  • It inhibits prostaglandins, which serve as mediators for pain and will not affect platelet function.
  • For acetaminophen toxicity, assess pain in the right upper quadrant of the abdomen and other signs indicating liver damage, such as nausea and vomiting.
  • Report jaundice, abdominal pain, clay colored stools, and fever
  • Diarrhea is an early manifestation of acetaminophen poisoning.
  • It is critical to be aware that various over-the-counter cold preparations contain acetaminophen.
  • Documented dose administered is most important based on client weight.
  • It is not a nonsteroidal anti-inflammatory drug (NSAID) and does not have anti-inflammatory action.
  • It is a safer alternative to NSAIDs to reduce the risk of GI bleeding.
  • Alcohol increases the risk of liver injury.
  • No anti-inflammatory qualities, works in the brain and does not know how

Aspirin

  • Side effects include tinnitus and bleeding.
  • Take with food and a full glass of water.
  • Tinnitus is an early sign of aspirin toxicity. The healthcare provider should be notified immediately.
  • For cardiovascular disease, monitor for tinnitus. Other manifestations include sweating, headache, dizziness, and discarding tablets that smell like vinegar.
  • Low serum albumin increase risk for toxicity patients with heart disease.
  • Used as a low dose helps prevent heart attacks.
  • A dose of 325 mg daily may increase the risk of bleeding.
  • It interferes with platelet aggregation, thereby lengthening bleeding time.
  • A large dose inhibits prothrombin formation and lowers platelet levels.
  • Check for occult blood (blood in stool).
  • Monitor serum albumin.
  • Increased toxicity can occur with low serum albumin levels
  • Adverse gastrointestinal (GI) reactions includes ulceration, perforation, nausea and vomiting.
  • Decreased absorption occurs if enteric-coated aspirin is chewed or crushed.
  • Report black, tarry stools.
  • Side/adverse effects include damaging inner ear, tinnitus, and bleeding.
  • Contraindications include salicylate allergy.
  • Used for effective anti-inflammatory, analgesia, good for mild and helps prevent heart attacks.
  • It is given to a acute MI to prevent further clot formation

Ibuprofen

  • Side effects include GI discomfort and prolonged bleeding time.
  • Life-threatening complication is GI bleeding.
  • Avoid during the postoperative period due to prolongs bleeding time.
  • Good for pain relief, temp reduction, reduce inflammation but not diuresis.
  • Contraindications include bleeding conditions, peptic ulcers, and Hemophilia.
  • Lowers the antiplatelet of aspirin.
  • Should be taken with food.
  • Do not use it with Bleeding and Peptic Ulcers.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) taken for long periods of time may cause serious side effects, including bleeding in the gastrointestinal tract.
  • Monitor for ringing in the ears, weight loss, high blood pressure and edema.
  • Should not be crushed.
  • Increase ROM/ambulation

Naproxen

  • Adverse effect is GI discomfort/bleed.

Ketorolac

  • Causes bleeding.
  • NSAIDs cause bleeding.

Celecoxib

  • Side effects include bleeding.
  • Increased risk for bleeding and adverse gastrointestinal (GI) reactions.
  • Do not use it with sulfa Allergy.
  • Is a blood thinner need to watch for black potty.
  • Can cause gastrointestinal bleeding, peripheral edema.

Patient-Controlled Analgesia (PCA)

  • Only the patient pushes/uses the PCA button.
  • The patient has total safe control of their analgesic.
  • The patient can give when they want and need.
  • There must be two RN's for checks and waste.
  • Narcotics will depress respirations, so respirations must be monitored.
  • Educate on when to push, pain scales and that there is machine is a overdose preventer.
  • Fentanyl requires verifying infusion recorded with licensed healthcare provider to help reduce of rediscounting usage.
  • Nurse doesn't sign medication waste of unused narcotics if not witnessed.
  • Priority is to check lung rates before starting pump and is for pain relief.
  • A 4-year-old is not appropriate for PCA, requires high education.

Morphine

  • All narcotics/opioids can respiratory depression
  • Monitor their respiratory rate (HOLD meds for less than 12 breaths per minute)
  • Constipation
  • Dizziness and Hypotenstion
  • Intrathecal depresses respiratory.
  • Assess respiratory rate and hold if lower than 12 and can cause a decrease in blood pressure.
  • Treats chronic pain, hospice, anxiety and is gold standard for severe pain
  • Managing severe pain quickly by IV.
  • Give regularily to hospice patients to treat pain as terminal
  • Watch if having a hard time breathing or issues and is okay when getting extra doses and will need nalaxone IV.
  • Opioids are used to treat postoperative pain.
  • Respiratory Depression – all narcotics/opioids decrease respiratory rate
  • Monitor respiratory rate and hold meds for less than 12 breaths per minute and get staff.
  • If low blood pressure put in trenlenburg

Naloxone

  • For opioid overdose as it will reverse opiods but wears off
  • Can give to help open airways again for low respirations
  • Beats opiodies to the receptors.
  • Need to watch to make sure no cardiac depreession or heart failure

Fentanyl

  • Patch is for administration.
  • Liver is better for them than any pain killer and is for long term
  • Can take like a licorice to treat pain.
  • Liver disease better than tylenol but be careful liver and watch for
  • Pain can be treated over time with a patch.
  • Give other pain meds while starting up a patient on fentanyl.
  • Don't use any hot pads or hot tubs etc to help decrease pain.
  • Used for shorter procedures and Managing Severe Pain Quickly

Oxycodone/hydrocodone

  • Increase dose when not getting enough pain control.
  • Can administer when the discomfort begins .
  • Patient might say my tummy and need respiratory
  • Extended Release Tablet – Give about every 12 hours and is an opiate

Methadone

  • Used to keeps opiod addicts away and calms and is an opiate

Narbuphine

  • Rhymes with Morphine and follow opioid issues.

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Description

Summary of 135 questions across different analgesic medication categories. Includes medications like Morphine, Aspirin, PCA, Naloxone, and Ibuprofen. It covers opioid effects, pain management, and migraine treatments.

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