Units 1-3
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| What should the nurse teach a patient first about adverse drug reactions? | Seek medical help immediately
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| What happens when a patient has a deficiency of the enzyme needed for drug elimination? | The drug remains in the body much longer.
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| What is the effect of poor circulation due to heart failure on drug metabolism and elimination? | It can lead to slower drug metabolism and elimination resulting in a toxic buildup of drug blood levels.
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| What is the risk for a pregnant woman in taking Category D drugs? | They have been tested and are known to greatly increase the risk of birth defects.
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| What precaution should parents take prior to giving OTC drugs to children? | Have the dosage confirmed by their physician or pharmacist.
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| May a patient refuse a drug? | Yes but the nurse should investigate why. The nurse needs to make sure the patient understands why the drug has been prescribed and the consequences of refusing to take it.
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| What should the nurse do if a patient's vital signs are of concern prior to administering a drug? | Look for limitations of the order; if none notify the physician and ask if the drug may be given.
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| How is Prilosec dosed? | In delayed release capsules.
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| What route is the fastest for pain relief? | The rates of absorption and action are very rapid with the intravenous route.
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| What are the 6 rights of safe drug administration? | Right patient, drug, dose, route, time and documentation.
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| What does the STAT order mean? | Give the drug as soon as available.
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| What is a red flag for a possible drug error? | When a patient does not recognize a drug that is being given.
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| What is the most important question to ask a patient before administering a new drug? | Are you allergic to any drugs?
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| True or false: Any side effect or response a patient has after starting a new drug should be investigated even when it is an expected side effect of the drug. | TRUE
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| What is the first thing the nurse does in her investigation? | Assess the patient. Check the vital signs for changes.
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| Where should a transdermal patch be placed on a child? | Between the shoulders on the back; out of the child's sight.
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| What are the limitations for a patient who cannot swallow? | They should not have any drug, drink or food by the oral route.
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| How can a nurse tell if the feeding tube is in the trachea and not in the stomach? | When carbon dioxide comes from the feeding tube.
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| What are common signs of infiltration? | The IV site is red and swollen; hurts and there is no blood return.
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| What is the nurse's best action when an IV has infiltrated? | Discontinue the IV and notify the prescriber.
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| When is the best time to teach a patient? | When the patient is not distracted or uncomfortable.
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| What is an effective way to motivate a patient? | Focus on the positive aspects of the new knowledge or skill.
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| What should the nurse obtain before teaching a patient about a new drug? | Ask the patient what he wants to know. This determines what the patient already knows and what concerns him most.
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| What should the nurse teach a patient receiving IV drug therapy? | To call if the patient feels any pain or burning at the IV site.
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| What should the nurse do if the IV site develops phlebitis (inflammation of the vein)? The vein will feel hard and cordlike. | Discontinue the infusion and remove the catheter.
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| What should the nurse do if she/he observes pus oozing from the IV site? | Discontinue the IV. You do not need an order. But, you should notify the prescriber of your action.
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| What complication should the nurse be alert for with an IV infusion of potassium chloride? | Potassium chloride is an irritant that can traumatize the vein and stimulate the reponse of phlebitis. Check the vein above the insertion site for vein hardness and a cordlike feel.
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| What is the best action a nurse can take to reduce the risk for chemical trauma when administering a known chemical irritant drug? | Diluting a drug can reduce the chemical trauma but it is necessary to check first with the pharmacist to determine which specific fluid can be used to dilute the drug.
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| What is the nurse's best action if the patient presents with shortness of breath due to fluid overload? | The nurse should slow the IV and notify the prescriber immediately.
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| What must the nurse remember about pain? | Pain may occur more frequently among older adults but is never considered "normal".
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| What is the best way to assess a patient's need for pain medication? | Ask the patient to rate the pain.
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| What is the nurse's best response to a patient afraid of becoming addicted to opioids prescribed for pain relief? | The use of opioid drugs when used for relief of acute pain rarely result in addiction.
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| What must the nurse remember about stress tiggers with chronic pain? | Adaptation to the presence of chronic pain is physiologic. The usual alterations in vital signs do not appear.
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| What is the nurse's best action to assess a patient sleeping 1 hour after receiving an opioid analgesic. | Attempt to rouse the patient by calling his/her name and lightly shaking their arm.
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| What must the nurse ask the patient before administering Celebrex? | Are you allergic to sulfa drugs?
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| Which OTC analgesic does not interfere with blood clotting? | Acetaminophen
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| What precaution should a patient take who is taking acetaminophen? | Acetaminophen can cause severe liver damage and this is more likely when combining the drug with alcohol.
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| What is a adverse effect of nortriptyline? | It can cause fluid retention which can result in weight gain which can make heart failure worse.
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| Why is pain the fifth vital sign? | Because that is how often pain should be assessed, when you take vital signs.
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| Where is pain perceived? | Brain
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| What are the characteristics of acute pain? | Sudden onset, identifiable cause, limited duration, triggers physiological changes, improves with time even when not treated.
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| What are the characteristics of chronic pain? | Present daily for 6 months, persists or increases with time, may not have an identifiable cause, and does not trigger the stress response.
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| What is pain intensity? | How much pain the patient feels.
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| Who is the FLACC pain rating scale used for? | Infants and patients who are not alert
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| Who is FACES pain rating scale used for? | Children and non verbal adults
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| What are nociceptors? | Sensory nerve endings that when activated trigger the message sent to the brain that allows perception of pain.
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| What is localized pain? | Patient feels pain that is confined to the site where the tissue damage is located.
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| What is projected pain? | Patient feels the pain all along the path of the nerve from the point of damaged tissue to the spinal cord.
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| What is radiating pain? | A person feels the pain all around and extending out from
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| What is referred pain? | A person may sense pain in an area that is not close to the tissue causing the pain.
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| What is pain threshold? | The smallest amount of tissue damage that makes a person aware of having pain.
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| What is pain tolerance? | A person's ability to endure or stand the pain intensity.
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| How is the best pain relief obtained? | When drugs are taken on a regular basis rather than PRN.
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| What is the mechanism of action of opioids? | They alter the perception of pain.
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| Why should the patient be checked for pain relief after 30 minutes? | It helps determine if the drug is right for the patient's pain, if the dose needs to be changed, or if the pain control strategy needs to be adjusted.
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| What is a side effect on older adults taking Demerol? | Can make the chest muscles tighter, making breathing and coughing more difficult. Thus the risk for pneumonia and hypoxia is greater.
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| What is a common side effect of opioids? | Constipation
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| What is the mechanism of action of NSAIDs? | They act at the tissue where pain stops and do not change a person's perception of pain, like opioids.
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| What are the S&S of salicylate poisoning? | Fever, rapid heart rate, and respirations, abdominal pain, nausea, vomiting, confusion, tinnitus.
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| Why must you check the blood pressure of a person taking NSAIDs? | NSAIDs can cause retention of sodium and water leading to higher blood pressure.
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| Why should indomethacin and celecoxib be avoided in the last 3 months of pregnancy? | They can cause a blood vessel important to fetal circulation (the ductus arteriosus) to close which would impair the oxygen supply to some fetal tissues.
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| What are the most common antidepressant drugs used for pain control? | Amitriptyline, nortriptyline, paroxetine and sertraline.
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