Questions and Answers
Which substance do antiinflammatories inhibit?
Which drug is considered a cyclooxygenase-2 (COX-2) inhibitor?
Which response by the nurse would be most appropriate if a patient with rheumatoid arthritis expresses concern about infections from infliximab?
Which drug is most appropriate for a patient with back pain caused by inflammation?
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Which instruction given by the nurse ensures effective treatment during the administration of allopurinol?
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Which assessment finding in a patient taking NSAIDs requires intervention?
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Which drug would be added if a patient has hyperuricemia and deposition of sodium urate crystals?
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Which antiinflammatory agent inhibits cyclooxygenase-2 (COX-2) but not cyclooxygenase-1 (COX-1)?
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Which food(s) or dietary supplement(s) would the nurse identify as potentially causing increased sedation with opioid therapy? Select all that apply.
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Which test would the nurse anticipate the HCP ordering for a patient who has been chronically taking high doses of acetaminophen?
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Which action would the nurse take if a patient has a respiratory rate of 8 breaths/min after receiving morphine?
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Which rationale describes why a nurse would record baseline vital signs before administering morphine?
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Which drug may cause tinnitus as a side effect?
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Which medication is used to treat severe adverse effects of an opioid analgesic?
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Which medication would the nurse anticipate incorporating into the care plan for a postoperative patient who developed respiratory depression?
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Which symptom is an adverse effect associated with excessive doses of acetaminophen? Select all that apply.
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Which is considered a cardinal sign of inflammation? (Select all that apply)
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Which serious illness would the nurse suspect in a 6-year-old patient with influenza who has been given 'baby aspirin'?
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What response would the nurse have if a family becomes alarmed at a patient’s large bruises while on aspirin therapy?
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Which supporting evidence would the nurse provide to a patient regarding switching from aspirin to ibuprofen?
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What describes the mechanism of action of allopurinol?
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Which statement indicates understanding of aspirin therapy by a female patient at risk for stroke?
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Which action performed by a patient could cause complications if on ibuprofen therapy for arthritis?
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Which medication would the nurse anticipate if a patient is at an increased risk for ischemic stroke?
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Which assessment finding indicates that an NSAID has been effective?
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Which action will the nurse take first when a patient with Crohn's disease arrives for their first dose of infliximab?
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Which patient(s) would be at high risk for respiratory depression with intravenous morphine therapy? (Select all that apply)
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Which question is a priority for the nurse to ask a patient who has been prescribed sumatriptan for migraine headaches?
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Which type of pain originates from the skin and mucous membranes?
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Which statement about somatic pain is accurate?
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Which assessment finding indicates that a patient has overdosed on morphine sulfate?
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Which condition would the nurse expect to see in a patient who ingested 14 grams of acetaminophen?
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Which finding would the nurse expect when assessing a patient for adverse effects of morphine sulfate?
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Which condition is a contraindication for the administration of acetaminophen?
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Which opioid is used in mild to moderate pain and as an antitussive?
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Study Notes
Anti-inflammatories and Analgesics
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Cardinal Signs of Inflammation: Pain, swelling, and redness are three of the five cardinal signs of inflammation; other signs include heat and loss of function.
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Reye Syndrome: Serious condition that can occur in children treated with aspirin for flu; characterized by vomiting, lethargy, delirium, and possibly coma.
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Aspirin and Bruising: Aspirin can inhibit platelet aggregation, leading to an increased risk of bruising; common with minor injuries in those taking aspirin.
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Aspirin vs. Ibuprofen: Ibuprofen is often preferred over aspirin due to a lower risk of gastrointestinal bleeding; both medications share similar durations of action (4 to 6 hours).
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Mechanism of Allopurinol: Reduces uric acid biosynthesis, effectively treating gout and hyperuricemia.
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Aspirin Administration: Should be taken with food or fluids to minimize gastrointestinal disturbances; contraindicated with warfarin due to increased anticoagulation risk.
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Complications with Ibuprofen: Using ibuprofen may cause bleeding complications when combined with ginger and garlic while it’s safe to avoid aspirin before menstruation.
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Stroke Prevention: Aspirin is commonly prescribed to reduce the risk of ischemic stroke due to its blood-thinning properties.
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Efficacy of NSAIDs: Decreased pain, evaluated effectively by a reduction on the pain scale, indicates NSAID efficacy; look for decreased synthesis of prostaglandins.
Pain Management
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Risk of Morphine: High-risk patients for respiratory depression include those with chronic renal failure and chronic obstructive pulmonary disease (COPD); morphine may exacerbate existing conditions.
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Sumatriptan Contraindication: Patients with a history of coronary artery disease must be carefully assessed before using sumatriptan for migraines; it can lead to ischemic complications.
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Pain Classification:
- Superficial pain arises from skin and mucous membranes.
- Somatic pain comes from skeletal muscles, ligaments, and joints.
- Visceral pain is linked to internal organs.
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Signs of Morphine Overdose: Pinpoint pupils are a key sign of opioid overdose; increased peristalsis and urinary output do not occur with overdose.
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Acetaminophen Toxicity: Ingestion of large doses (e.g., 14 grams) can lead to acute hepatotoxicity; contraindicated in patients with liver disease.
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Adverse Effects of Morphine: Expected adverse reactions include drowsiness and constipation; increased peristalsis or urinary output are not typical.
Drug Classifications and Mechanisms
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Anti-inflammatory Mechanism: Anti-inflammatory drugs inhibit the biosynthesis of prostaglandins, which play a key role in inflammation and pain signaling.
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COX-2 Inhibitors: Celecoxib is categorized as a COX-2 inhibitor, distinct from other NSAIDs like naproxen and etodolac which serve different functions.
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Patient Education on Infliximab: Patients should be informed that infliximab suppresses the immune system, increasing infection risk, particularly opportunistic infections such as tuberculosis.### FDA Advertising Requirements
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FDA mandates that prominent adverse reactions be listed in drug advertisements, but full details cannot be conveyed in limited commercial airtime.
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Test-taking tip: Avoid options with absolute terms like always, never, all, or none when answering questions.
Back Pain Medication
- Ibuprofen is the preferred medication for back pain caused by inflammation due to its stronger effect and lower gastric irritation compared to aspirin.
- Aspirin can cause gastric irritation and is less effective for treating inflammation.
Dietary Management for Gout with Allopurinol
- Patients should take allopurinol with plenty of fluids to prevent kidney stones during treatment.
- Meat should be avoided as it raises uric acid levels.
- Oranges, rich in vitamin C, can also elevate uric acid and increase kidney stone risk.
- Coffee should be avoided as it increases uric acid levels.
Adverse Effects of NSAIDs
- Black, tarry stools indicate gastrointestinal bleeding and necessitate medical intervention.
- Headaches and palpitations are not side effects typically associated with NSAIDs.
Gouty Arthritis Treatment
- Gouty arthritis is characterized by hyperuricemia and sodium urate crystal deposition in synovial fluid.
- Allopurinol is indicated for this condition as it lowers uric acid levels and prevents kidney stones, while indomethacin alleviates pain and inflammation.
COX-2 Inhibitors
- Celecoxib selectively inhibits COX-2, distinguishing it from other NSAIDs which generally inhibit both COX-1 and COX-2.
Opioid Sedation and Dietary Interactions
- Kava, valerian, and St. John’s wort can enhance sedation effects when taken with opioids.
- Grapefruit should be avoided with certain medications, while bananas are not contraindicated but should be monitored in renal failure.
Acetaminophen Overdose Risks
- Chronic high doses of acetaminophen can lead to hepatotoxicity, warranting routine liver function tests.
- Acetaminophen does not affect renal function or lung capacity.
Managing Opioid Side Effects
- For a patient with respiratory depression receiving morphine, the nurse should consult the primary health care provider rather than withhold medication.
- Baseline vital signs must be recorded to assess respiratory depression risks, particularly postoperatively.
Side Effects of Aspirin
- Tinnitus and vertigo are common side effects of aspirin.
- Other medications have distinct side effects: tramadol (nausea, dizziness), indomethacin (gastric distress), and acetaminophen (hepatotoxicity).
Opioid Antagonist for Overdosage
- Naloxone is used to reverse adverse effects of opioid analgesics, while acetylcysteine is specific for acetaminophen overdose.
Postoperative Respiratory Depression Intervention
- Naloxone is expected in care plans for patients who experience respiratory depression from fentanyl use.
- Opioids like morphine and meperidine would exacerbate respiratory depression.
Acetaminophen Toxicity Symptoms
- Excess doses of acetaminophen can lead to nausea, vomiting, and hepatotoxicity; blurred vision and polyuria are not associated with overdoses.
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Description
Test your knowledge on anti-inflammatories and analgesics in this quiz covering Topic 11. Answer questions about the cardinal signs of inflammation and other related concepts. Ideal for students and professionals in the field of pharmacology.
