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P&I
Pain and Inflammation Meds
| Question | Answer |
|---|---|
| What findings may be a side effect in a patient taking celecoxib? | sinusitis, dizziness, headache, constipation |
| What side effects would the nurse teach the patient to immediately report to the primary health care provider if the nurse is providing medication education to a patient with RA who is on infliximab therapy? | dyspnea, seizures, depression |
| What substance do anti inflammatories inhibit? | prostaglandin |
| What drug is consider a cyclooxygenase-2 (COX-2) inhibitor? | celecoxib |
| What is an indication for disease-modifying antirheumatic drugs (DMARDs)? | psoriasis, Crohn's Disease, RA (all are autoimmune disorders) |
| What interventions performed by the nurse would ensure effective treatment if the nurse is caring for a patient with arthritis who is on aspirin therapy? | monitor serum salicylate level (toxicity- 30-50), tarry stools, bleeding gums, and petechiae |
| What NSAID can be administered via IV. | ketorolac tromethamine |
| What statement made by the female patient who is at risk for stroke and on aspirin therapy, indicates an understanding of the nurse's instructions regarding the correct use of aspirin? | "I should take aspirin at meal time" (avoidance of GI disturbances) |
| Which action would the nurse expect to take while caring for a patient who has been prescribed 40 mg of ketorolac and antibiotics after orthopedic surgery? | stop administering ketorolac after 5 days |
| What condition in a patient who has been prescribed celecoxib for arthritis would prompt the nurse to contact the primary health care provider? | anemia |
| What adverse effects are associated with NSAIDs? | tinnitus, anorexia, dyspepsia |
| What inflammatory agent inhibits cyclooxygenase-2 (COX-2) but not cyclooxygenase-1 (COX-1)? | celecoxib (2nd generation NSAID) |
| 22 year old patient delivered a baby 6 hours ago. The baby weighed 9 lb 6 oz. The patient sustained a 2nd degree tear and rates her pain as a 6/10. The patients genital area is swollen and tender. What action will the nurse take? | administer 600 mg ibuprofen PO |
| What interventions would be most beneficial for a postoperative patient on naloxone therapy? | assess heart rate, respiratory rate, and monitor for bleeding |
| What laboratory level would the nurse monitor in a patient who is receiving acetominophen? | bilirubin, ALP, ALT, AST |
| What patients would be at high risk for respiratory depression with the use of IV morphine therapy? | 77 year old patient with chronic renal failure and 45 year old patient with COPD |
| What action would the nurse take if a patient receiving 1-2 mg of morphine sulfate IV every 2 hours PRN has a respiratory rate of 8 breaths/min and pain scale of 8/10 aft the last 2 mg dose? | consult the primary health care provider and obtain another drug prescription |
| What medication would support a patient's recovery efforts if the patient is in treatment for narcotic addiction? | methadone (synthetic opioid analgesic) |
| What patch change frequency would the nurse note when teaching a patient about the administration of a transdermal fentanyl patch? | every 72 hours (slow release analgesic) |
| What drug may cause tinnitus as a side effect? | aspirin |
| What finding would the nurse expect when assess a patient for adverse effects of morphine sulfate? | drowsiness |
| What medication would the nurse administer for severe post-op pain? | meperidine 75 mg IM |
| What signs and symptoms are indicative of salicylate toxicity? | vertigo, tinnitus, and hyperventilation |
| What side effects are associated with excessive doses of acetaminophen are likely to be found in a patient? | nausea, vomiting, and hepatotoxicity |
| Patient with RA and temp of 100.3 presents to the ED after taking several extra pain tablets for fever reduction & faster relief of arthritis pain. If toxicity is expected, what result would be analyzed? | serum acetaminophen level |
| Younger patient who underwent abdominal surgery is prescribed morphine for pain. What condition would the nurse rule out prior to administration? | bronchial asthma (contraindicated due to respiratory depression and increased airway resistance) |
| What are considered cardinal signs of inflammation? | pain, swelling, redness |
| What adverse effect is the patient at for if they neglect to the primary health care provider about daily aspirin use and are prescribed a high dose diflunisal? | decreased clotting ability (diflunisal is also a salicylate) |
| What serious illness would the nurse expect in a 6-year old patient with influenza if the nurse learns that the patient's parents gave the child a baby aspirin for fever? | Reye Syndrome (children should not receive especially when febrile) |
| Characteristics of Reye syndrome | vomiting, lethargy, delirium, and coma |
| What response would the nurse have if a family visits a patient in a LTC and becomes alarmed after noticing several large bruises on the patient, who is on a moderate dose of aspirin daily? | this is common with people taking aspirin |
| What response by the nurse would be most appropriate if a patient RA who is considering treatment with infliximab expresses concern because a TV ad mentions several infections as side effects? | the medication suppresses your immune system |
| What supporting evidence would the nurse provide to the patient regarding a proposed change in pain medication if the nurse encourages the patient to switch from OTC aspirin to OTC ubuprofen? | aspirin is associated with more gastric bleeding than ibuprofen |
| In what manner does aspirin differ from ibuprofen? | aspirin intake may lead to Reye syndrome in children |
| What drug is most appropriate for a patient with back pain caused by inflammation? | ibuprofen |
| What condition does the nurse review that patient's medical history before administering febuxostat to a patient with gouty arthritis? | cardiovascular disease (antigout med with potential cardiovascular side effects) |
| What response would be appropriate if the nurse is caring for a patient who takes aspirin and reports stomach irritation? | you can try enteric-coated aspirin |
| What medication would the nurse expect to find included in the care plan if the nurse discovers, after review of the laboratory reports, that a 3 year old child with a fever has influenza B? | acetaminophen |
| What instruction given by the nurse would ensure effective treatment if the nurse is teaching a patient with gout about dietary management during the admin. of allopurinol? | take the medication with lots of fluids (avoid development of kidney stones; antigout med.) |
| What assessment finding in a patient taking NSAIDs requires intervention? | black, tarry stools |
| Which type of agent are prostaglandin inhibitors primarily used as? | anti inflammatory |
| What assessment finding indicates that NSAID has been effective? | pain has decreased from 6 to a 1 on a scaled of 10 |
| What property of aspirin differentiates it from other NSAIDs? | antiplatelet |
| What information regarding the use of methotrexate is accurate? | may be used to suppress the inflammatory process of RA when other treatment fails |
| What response would the nurse provide to a patient who asks, "what is causing my gout?" | gout is a metabolic disorder of uric acid and purines (accumulation of uric acid in body) |
| What signs or symptoms are associated with gout? | tophi in the great toes (accumulation of uric acid deposits in subq tissue bumps) |
| When planning medication administration for multiple patients, the nurse should recognize that aspirin will be contraindicated in what patients? | 10 year old with flu symptoms, 24 year old who is 36 weeks gestation, and 63 year old hospitalized with GI bleeding |
| What adverse response to aspirin therapy would the nurse be concerned about in a patient who is receiving high-dose aspirin and reports dizziness and ringing in the ears in addition to have RR of 30 per min.? | salicylate toxicity |
| What test would the nurse anticipate the health care provider ordering for a patient who has been chronically taking high doses of acetaminophen? | liver function |
| What rationale describes why a nurse would record baseline vital signs before administering 5 mg of morphine sulfate IV to a patient who underwent surgery 30 mins prior? | morphine sulfate depresses the respiratory center |
| What assessment finding indicates that a patient has overdosed on morphine sulfate? | pinpoint pupils |
| What condition would the nurse expect to see in a patient who ingested 14 grams of acetominophen? | acute hepatotoxicity (max is 3 g) |
| What effect of codeine would the nurse note when responding to an admitted patient with pneumonia who has asked the nurse why codeine is being administered in the absence of pain? | antitussive |
| What medication is used to treat severe adverse effects of an opioid analgesic? | naloxone |
| What assessment is a priority when monitoring a patient for adverse effects related to morphine sulfate? | respiratory rate |
| What time frame would the nurse include when teaching a patient about the emergence of withdrawal symptoms associated with opioid dependency? | 24-48 hours |
| What medication would the nurse anticipate incorporating into the plan of care for a post-op patient who received fentanyl and subsequently developed respiratory depression? | naloxone |
| What action would the nurse take if a patient receiving morphine has a respiratory rate of 7 breaths/min and pupils are 1 mm and unreactive? | administer naloxone |
| What medication would the nurse anticipate administering to prevent toxicity in a patient who has been admitted for treatment of acetaminophen overdose? | acetylcysteine |
| What condition is a contraindication for the administration of a acetaminophen? | liver disease |
| What finding in a patient receiving morphine sulfate requires immediate action by the nurse? | pinpoint pupils |
| What assessment is most important for the nurse to monitor in a patient receiving an opioid analgesic? | respiratory rate |
| What patient problem is a priority for a patient receiving morphine sulfate? | impaired gas exchange related to respiratory depression |
| Which opioid is used in mild to moderate pain and as an antitussive? | codeine sulfate |
| What drug is used for opioid dependence and withdrawl? | buprenorphine hydrochloride |
| What route is best suited for the administration of opioid drugs if prescribed for chronic pain? | transdermal |
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