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lilley ch 11 12

QuestionAnswer
WHen assessing a patient for adverse effects r/t morphine sulfate the nurse would expect to find? decreased peristalsis, delayed gastric emptying causing constipation, and urinary retention.
Switching analgesic drugs to give effective dose of new drug to control pain. Based on knowledge that potency of analgesic are determined using an equianalgesic table comparing doses with that of? 10mg morphine, the equianalgesic table identifies dosage of narcotics that are equal to 10mg morphine.
Patient admitted to psychiatric for narcotic addiction, nurse anticipates administration of? Methadone, it is a synthetic opioid analgesic that gives gentler with drawal symptoms & drug of choice for detox.
Patient OD of acetaminophen (Tylenol), total ingested 14g in 1 hour, nurse plans to monitor patient for signs and symptoms of? acute hepatic necrosis because Tylenol in large doses over short period is hepatotoxic and long term ingestion of large doses causes nephropathy.
A patient being treated for Tylenol over dose, the nurse will administer what medication to prevent toxicity? acetylcycsteine (mucomyst) because it is antedote.
How do you administer acetylcycsteine (mucomyst) for Tylenol over dose? first admin a loading dose, followed by dose every 4 hours for 17 more doses. (start as soon as possible with in 12 hours of ingestion).
Massage therapy adjunct treatment for muscular skeletal pain, why does rubbing muscles relieve pain? massaging muscles activates large sensory nerve fibers that send signals to spinal cord to close gate blocking painful stimuli from reaching brain.
When assessing for the most serious adverse reaction to a narcotic analgesic, the nurse monitors for what? respiratory rate.
What medication is used to treat patient suffering from severe adverse effects of a narcotic analgesic? Naloxone (Narcan), because it is the narcotic antagonist that reverse adverse & therapeutic effects of opioid narcotics.
Patient with pneumonia is asking why she is receiving codeine, codeine has what effect? Codeine provides both analgesic and antitussive (cough suppressant) therapeutic effects.
Monitoring patient for adverse effects related to morphine sulfate the nurse assesses for stimulation of? Chemoreceptor trigger zone because morphine sulfate can irritate GI causing stimulation of chemoreceptor trigger zone in brain causing nausea and vomiting.
Nurse has order to administer morphine sulfate to patient, but patient has respiratory rate of 10 breaths per minute, what should nurse do? Notify doctor, hold medication, because respiratory depression is side effect, patients respiratory rate is below normal.
Patient taking narcotic analgesic for chronic pain can minimize GI side effects by? increasing fluid and fiber because one of side effects is constipation from reduced peristalsis and delayed motility.
The nurse teaches patient that has a fentanyl (duragesic) transdermal patch to change it every? 72 hours because it is a slow release.
Nurse plans pharmacological therapy for a patient with pain based on? pain relief is best obtained by administering around the clock ATC and not as PRN because scheduled dosing ATC gives steady states of meds & prevents troughs & escalation of pain.
A nursing diagnosis that is a priority with a patient receiving morphine? Impaired gas exchange related to respiratory depression. Use Maslow hierarchy ABC.
While completing preoperative patient teaching the nurse explains that general anesthesia? provides deep muscle relaxation (visceral and skeletal) & loss of consciousness.
Patient fear of nausea and vomiting postoperatively from anesthesia, nurse should explain? the anesthesia before operation to reduce fear & anxiety, and tell patient that nausea and vomiting is not frequent because they use balanced approach to anesthesia.
Intubated & mechanically ventilated Patient in ICU is restless and anxious, nurse should administer which IV anesthesia? Propofol (diprivan) because it is a sedative hypnotic for induction and maintenance of anesthesia controls sedation in patients, has rapid onset & short duration of action allowing easy tritation and maintenance of LOC.
Postoperative nursing action that helps patients recover from effects of anesthesia is? Turning, coughing, & deep breathing every 2 hours to prevent atelectasis a sequelae of general anesthesia & mechanical ventilation.
Immediate post op assessment of patient reveals body temp of 102F, the nurse should? Notify doctor because fever immediately after post op needs to be evaluated for potential malignant hyperthermia, an infection takes several days.
Patient receives epinephrine for repair of laceration, why? Epinephrine causes vasoconstriction, enhances duration action of lidocaine & minimizes bleeding at injury site. Epinephrine causes localized vasoconstriction allowing bloodless suture site & delays absorption of lidocaine enhancing numbing effect.
Mechanically ventilated patient with neuromuscular block is tearing, has increased HR and BP, This is interpreted as? The level of sedation is inadequate, the symptoms are signs of increased anxiety & or pain, patient cannot communicate with neuromuscular block nurse must look at subtle changes for adequate sedation.
For best results when treating severe pain associated with pathologic spinal fractures related to metastatic bone cancer, which type of dosage schedule should be used? around the clock, with additional doses as needed for break through pain.
patient receiving opioid via PCA. Noticed his respirations are 8 breaths/min and he is extremely lethargic. opioid infusion is stopped, what should the nurse do next? Administer an opiate antagonist per standing orders .
What is a benefit of using transdermal fentanyl patches in the management of bone pain from the spread of cancer? It gives more analgesia for longer time periods.
Nurse suspects a patient showing signs of respiratory depression, which drug could be causing: Naloxone (Narcan), Hydromorphone (dilaudid), Actaminophen (tylenol), or Naltrexone (Revia)? Hydromorphone (dilaudid).
PRN for acetaminophen for pain. Which patient is contraindicated for acetaminophen therapy & should receive alternate med? Patient with: fever of 103.4° F, DVT, severe hepatitis, or abdominal surgery a week ago. A patient with severe hepatitis.
Patient undergoing removal of a lymph node from arm under local anesthesia. The doctor requested "Iidocaine with epinephrine." What is the rationale for adding epinephrine? It helps to reduce local bleeding.
2. What type of patient is more prone to complications from general anesthesia? A 79-year-old female who is about to have her gallbladder removed.
What can occur in a patient who has been under general anesthesia for 3 to 4 hours for abdominal-thoracic surgery? Decreased gaseous exchange due to the CNS depressant effect of general anesthesia .
What should be the nurse's main concern about patient recovering from general anesthesia during the immediately postoperative period? Airway
Patient recovering from surgery during which he received an NMBA As he wakes up during recovery, he looks as if he is panicking and yet is unable to speak. Nurses reaction should be? Reassure the patient that he is recovering and that the medication is still wearing off.
The anesthesia provider monitors the patient during surgery by assessing and monitoring level anesthesia by? using a peripheral nerve stimulator or electroencephalogram [EEG] bispectral analysis).
The anesthesia provider monitors the patient during surgery by assessing and monitoring Cardiopulmonary function by? using electrocardiographic [ECG] monitoring, pulse oximetry, end-tidal carbon dioxide monitoring, arterial blood gases [ABGs], & hemodynamic monitoring via arterial lines and/or pulmonary artery catheters.
The anesthesia provider monitors the patient during surgery by assessing and monitoring level of anesthesia, cariopulmonary function, Capnography (monitors ventilation for non-intubated patients), Vital signs, & I/O.
Depending on the patient's needs, anesthesia personnel give? IV fluids, including blood and blood products
Created by: larue10510