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Questions and Answers
What role can family play in patient education for certain cultures?
What role can family play in patient education for certain cultures?
What is the primary cause of gout?
What is the primary cause of gout?
What is a common side effect of Diphenoxylate with atropine?
What is a common side effect of Diphenoxylate with atropine?
Why should PPIs be used cautiously in ICU patients?
Why should PPIs be used cautiously in ICU patients?
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What is a potential consequence of long-term laxative use?
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?
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?
What is the maximum recommended dosage of acetaminophen for adults per day?
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Why should NSAIDs be taken with food?
Why should NSAIDs be taken with food?
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What potential risk is associated with long-term use of NSAIDs?
What potential risk is associated with long-term use of NSAIDs?
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What should be monitored when a patient uses opioids?
What should be monitored when a patient uses opioids?
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Why should patients using NSAIDs avoid alcohol?
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?
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?
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?
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?
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?
What does opioid tolerance require from patients over time?
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What is hydromorphone's strength compared to morphine?
What is hydromorphone's strength compared to morphine?
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What is the recommended respiratory rate before administering opioids?
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?
What is a common side effect of opioid use that requires patient education?
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What defines opioid dependence?
What defines opioid dependence?
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What is naloxone commonly used for?
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.