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Questions and Answers
What role can family play in patient education for certain cultures?
What is the primary cause of gout?
What is a common side effect of Diphenoxylate with atropine?
Why should PPIs be used cautiously in ICU patients?
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What is a potential consequence of long-term laxative use?
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What is a serious risk associated with giving aspirin to children?
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What is the maximum recommended dosage of acetaminophen for adults per day?
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Why should NSAIDs be taken with food?
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What potential risk is associated with long-term use of NSAIDs?
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What should be monitored when a patient uses opioids?
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Why should patients using NSAIDs avoid alcohol?
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What important measure should be taught for the safe storage of unused opioid medications?
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What is a common misconception about the use of alternative therapies in medication administration?
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What is the primary consideration when assessing a patient?
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Which pain scale uses a numerical range from 0 to 10 to represent pain levels?
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What does opioid tolerance require from patients over time?
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What is hydromorphone's strength compared to morphine?
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What is the recommended respiratory rate before administering opioids?
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What is a common side effect of opioid use that requires patient education?
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What defines opioid dependence?
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What is naloxone commonly used for?
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Study Notes
Pain Scales
- Verbal Pain Intensity Scale: Describes pain levels from "no pain" to "worst possible pain."
- 0-10 Numeric Pain Intensity Scale: Rates pain on a scale from 0 (no pain) to 10 (worst possible pain).
- Visual Analogue Scale: Uses a line to represent pain intensity, with "no pain" at one end and "worst possible pain" at the other.
- Wong-Baker FACES® Pain Rating Scale: Uses faces to represent pain levels, with "no hurt" corresponding to 0 and "hurts worst" corresponding to 10.
Opioid Terms
- Opioid naive: Individuals with no prior opioid use.
- Opioid Tolerance: The body requires higher doses of opioids to achieve the same pain relief.
- Partial Agonist: An opioid medication that binds to opioid receptors but has a weaker effect than a full agonist. Can also block the effects of other opioids.
- Opioid Dependence: Physical dependence on opioids, marked by withdrawal symptoms when the drug is stopped.
Opioid Analgesics
- Hydromorphone (Dilaudid): 7 times stronger than morphine, requiring smaller doses for pain relief.
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Respiratory Depression: A critical side effect of opioids, which can lead to fatal respiratory failure; monitor respiratory rate before and after administering.
- Older adults: Post-operative older adults are at higher risk for respiratory depression.
- Naloxone (Narcan): Opioid antagonist for reversing opioid-induced respiratory depression; keep available in case of overdoses or surgical anesthesia.
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Discharge Teaching:
- Constipation: Encourage fluids, fiber, and stool softeners.
- Opioid safety: Highlight the risks of tolerance and dependence.
- Side effects: Educate patients on common side effects like drowsiness and dizziness.
Non-Opioid Analgesics and NSAIDs
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Aspirin:
- Children: Avoid aspirin in children due to the risk of Reye's syndrome.
- Adult prophylaxis: Used to prevent coronary artery disease and cardiovascular accidents in high-risk adults.
- Intoxication: Hyperventilation and drowsiness are common signs in children.
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Acetaminophen (Tylenol):
- Max dosage: Do not exceed 4 grams/day to prevent liver damage.
- Common uses: Effective for mild pain and fever reduction.
- Preferred for children: Safest option for pain relief and fever in children.
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Ibuprofen (Advil) and NSAIDs:
- Action: Reduces inflammation, pain, and fever.
- GI considerations: Take with food to minimize stomach upset or ulcers.
- Bleeding risk: Monitor patients for bleeding, particularly those taking anticoagulants or the elderly.
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Patient Teaching:
- Alcohol: Avoid alcohol to minimize liver and GI complications.
- Long-term use: Educate patients on potential kidney damage, increased bleeding risks, and gastric ulcers.
Discharge Instructions
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Opioids:
- Dependence and tolerance: Discuss the risks of these conditions.
- Respiratory depression: Teach signs of slowed breathing and confusion.
- Medication safety: Provide guidance on safe storage and disposal of unused medications.
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NSAIDs:
- GI risks: Emphasize the importance of taking NSAIDs with food, and advise reporting stomach pain or black stools.
- Max doses: Clarify daily maximums and potential risks of exceeding them.
- Contraindications: Explain that NSAIDs are not suitable for patients with renal disease.
Cultural Considerations in Medication Administration
- Tailored education: Consider cultural preferences and provide communication strategies for different cultures, such as using interpreters or providing written instructions in the preferred language.
- Health beliefs: Respect alternative therapies and provide guidance that aligns with individual beliefs.
- Family involvement: Engage families in decision-making and patient education when appropriate, especially in cultures where families play a central role in healthcare.
Anti-Gout
- Gout: Arthritis caused by uric acid crystal buildup in joints, resulting in severe pain, swelling, redness, and tenderness.
- Uric acid: Gout occurs when the body produces too much uric acid or cannot remove enough of it effectively.
- Medications: Allopurinol (Zyloprim) and Colchicine are common treatments.
Gastrointestinal Drugs and Bowel Disorder Drugs
- Diphenoxylate with atropine (Lomotil): OPIOID prescription laxative that slows intestinal motility to reduce diarrhea.
- Bismuth Subsalicylate (Pepto-Bismol): Can cause dark stools, tongue discoloration, and constipation.
- Simethicone (Mylicon): Treats excessive and painful intestinal gas; safe for infants and adults.
- Calcium antacids: Not frequently used due to potential complications.
- Magnesium-containing antacids: Use cautiously in patients with kidney failure due to the risk of complications like kidney stones.
- H. pylori treatment: Often involves omeprazole (PPI) and antibiotics.
Antacid and Medication Administration
- Administration timing: Administer medications at least one hour apart from antacids to prevent interactions.
Cimetidine Side Effects
- Elderly patients: Can cause confusion and disorientation in older individuals.
PPIs and ICU Patients
- Stress ulcers: PPIs are used in this context to prevent stress ulcers in patients with nasogastric tubes and ventilation.
- Osteoporosis: Long-term PPI use increases the risk of osteoporosis.
- Sodium bicarbonate: Overuse can lead to metabolic alkalosis.
Long-Term Laxative Use
- Dependency and bowel tone: Prolonged laxative use can cause laxative dependency and weakened bowel tone.
Histamine (H2)-Receptor Antagonists
- Know your medications: Familiarize yourself with the specific properties and implications of histamine (H2)-receptor antagonists.
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Description
This quiz covers critical concepts related to pain assessment scales and opioid terminology. It includes questions on the Verbal Pain Intensity Scale, Numeric Pain Intensity Scale, and various opioid-related terms such as opioid naive and opioid dependence. Test your understanding of pain management and opioid use in clinical settings.
