Pain drugs
15 Pages

Pain drugs

Course Number: POFI 1407, Fall 2006

College/University: Tarrant County

Word Count: 7591

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A patient who has had abdominal surgery has been receiving morphine sulfate via a patient-controlled analgesia (PCA) pump. The nurse assesses the patient and notes that the patients pupils are dilated and that the patient is drowsy and lethargic. The patients heart rate is 84 beats per minute, the respiratory rate is 10 breaths per minute, and the blood pressure is 90/50 mm Hg. What will the nurse do? a. Discuss...

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patient A who has had abdominal surgery has been receiving morphine sulfate via a patient-controlled analgesia (PCA) pump. The nurse assesses the patient and notes that the patients pupils are dilated and that the patient is drowsy and lethargic. The patients heart rate is 84 beats per minute, the respiratory rate is 10 breaths per minute, and the blood pressure is 90/50 mm Hg. What will the nurse do? a. Discuss possible opiate dependence with the patients provider. b. Encourage the patient to turn over and cough and take deep breaths. c. Note the effectiveness of the analgesia in the patients chart. d. Prepare to administer naloxone and possibly ventilatory support. 2. Register to View Answer Opioid toxicity is characterized by coma, respiratory depression, and pinpoint pupils. Although pupils are con stricted initially, they may dilate as hypoxia progresses, which also causes blood pressure to drop. This patient has a respiratory rate of fewer than 12 breaths per minute, dilated pupils, and low blood pressure; the patient also is showing signs of central nervous system (CNS) depression. The nurse should prepare to give naloxone and should watch the patient closely for respiratory collapse. Patients with opioid dependence show withdrawal symptoms when the drug is discontinued. When postoperative patients have adequate analgesia without serious side effects, encouraging patients to turn, cough, and breathe deeply is appropriate. This patient is probably rel atively pain free, but providing emergency treatment is the priority. A patient with cancer has been taking an opioid analgesic four times daily for several months and reports needing increased doses for pain. What will the nurse tell the patient? a. PRN dosing of the drug may be more effective. b. The risk of respiratory depression increases over time. c. The patient should discuss increasing the dose with the provider. d. The patient should request the addition of a benzodiazepine to augment pain relief. 4. Register to View Answer This patient is developing tolerance, which occurs over time and is evidenced by the need for a larger dose to produce the effect formerly produced by a smaller dose. This patient should be encouraged to request an in creased dose. PRN dosing is less effective than scheduled, around-the-clock dosing. The risk of respiratory de pression decreases over time as patients develop tolerance to this effect. Benzodiazepines are CNS depressants and should not be given with opioids, as they increase the risk of oversedation. 5. A woman in labor receives meperidine (Demerol) for pain. The nurse caring for the infant will observe the infant closely for: a. congenital anomalies. b. excessive crying and sneezing. c. respiratory depression. d. tremors and hyperreflexia. Register to View Answer Use of morphine or other opioids during delivery can cause respiratory depression in the neonate, because the drug crosses the placenta. Infants should be monitored for respiratory depression and receive naloxone if needed. Opioids given during delivery do not contribute to birth defects in the newborn. Excessive crying and sneezing and tremors and hyperreflexia are all signs of neonatal opioid dependence, which occurs with longterm opioid use by the mother during pregnancy and not with short-term use of these drugs during labor. 6. A postoperative patient has received an epidural infusion of morphine sulfate. The patients respiratory rate decreases to 8 breaths per minute, and he has a decreased level of consciousness and miosis. Which medication would the nurse anticipate administering? a. Naloxone (Narcan) b. Acetylcysteine (Mucomyst) c. Methylprednisolone (Medrol) d. Physostigmine (Antilirium) Register to View Answer7. A patient is brought to the emergency department by friends, who report finding the patient dif ficult to awaken. The friends report removing two fentanyl transdermal patches from the patients arm. On ad mission to the emergency department, the patient has pinpoint pupils and a respiratory rate of 6 breaths per minute. A few minutes after administration of naloxone, the respiratory rate is 8 breaths per minute and the patients pupils are dilated. The nurse recognizes these symptoms as signs of: a. a mild opioid overdose. b. decreased opioid drug levels. c. improved ventilation. d. worsening hypoxia. Register to View Answer The classic triad of symptoms of opioid overdose are coma, respiratory depression, and pinpoint pupils. The pupils may dilate as hypoxia worsens, and this symptom, along with continued respiratory depression (fewer than 12 breaths per minute), indicates worsening hypoxia. Fentanyl is a strong opioid, so this is not likely to be a mild overdose, because the patient was wearing two patches. Fentanyl continues to be absorbed even after the patches are removed because of residual drug in the skin, so the drug levels are not likely to be decreasing. The patient does not have improved ventilation, because the respiratory rate is still fewer than 12 breaths per minute. A patient with chronic pain has been receiving morphine sulfate but now has decreased pain. The pre scriber changes the medication to pentazocine (Talwin). The nurse will monitor the patient for: a. euphoria. b. hypotension. c. respiratory depression. d. yawning and sweating. 8. Register to View Answer Pentazocine is an agonist-antagonist opioid, and when given to a patient who is physically dependent on morphine, it can precipitate withdrawal. Yawning and sweating are early signs of opioid withdrawal. Pentazo cine does not produce euphoria, hypotension, or respiratory depression. 10. A nurse is preparing a patient for surgery and is teaching the patient about the use of the patientcontrolled analgesia pump. The patient voices concern about becoming addicted to morphine. What will the nurse do? a. Ask the patient about any previous drug or alcohol abuse. b. Discuss possible nonopioid options for postoperative pain control. c. Suggest that the patient use the PCA sparingly. d. Tell the patient that the pump can be programmed for PRN dosing only. Register to View Answer The nurse should remember that addiction to opioids usually occurs in patients who already have tendencies for addiction, so an assessment of previous experiences with addictive substances would be indicated. Post operative pain should be treated appropriately with medications that are effective. Nonopioid medications are not sufficient to treat postoperative pain. Patients should be encouraged to use the PCA as needed so that pain can be controlled in a timely fashion. PRN dosing is not as effective as dosing that is continuous, so a basal dose should be given as well as a PRN dose. MULTIPLE RESPONSE A nurse is administering morphine sulfate to a postoperative patient. Which are appropriate routine nursing actions when giving this drug? (Select all that apply.) a. Counting respirations before and after giving the medication b. Encouraging physical activity and offering increased fluids c. Monitoring the patients blood pressure closely for hypertension d. Palpating the patients lower abdomen every 4 to 6 hours e. Requesting an order for methylnaltrexone (Relistor) to prevent constipation 1. Register to View AnswerB, D Respiratory depression, constipation, and urinary retention are common adverse effects of opioid analgesics. It is important to count respirations before giving the drug and periodically thereafter to make sure that respirat ory depression has not occurred. Increased physical activity, increased fluid intake, and increased fiber help al leviate constipation. It is important to assess the patients abdomen and palpate the bladder to make sure that urinary retention has not occurred. Patients taking morphine often experience hypotension, not hypertension. Methylnaltrexone is given as a last resort to treat constipation, because it blocks mu receptors in the intestine. a. b. c. d. e. 2. Which side effects of opioid analgesics can have therapeutic benefits? (Select all that apply.) Biliary colic Cough suppression Suppression of bowel motility Urinary retention Vasodilation Register to View AnswerC, E Individual effects of morphine may be beneficial, detrimental, or both. Cough suppression is usually benefi cial; suppression of bowel motility and vasodilation can be either beneficial or detrimental. Biliary colic and urinary retention are always detrimental side effects. A patient who has cancer reports pain as burning and shooting alternating with feelings of numbness and coldness. The nurse will contact the provider to discuss the use of which medication? a. Acetaminophen b. Ibuprofen c. Imipramine (Tofranil) d. Oxycodone (OxyContin) 1. Register to View Answer This patient is describing neuropathic pain, which results from injury to peripheral nerves. This type of pain re sponds poorly to opioid analgesics but does respond to adjuvant analgesics, which include antidepressants such as imipramine. Acetaminophen and ibuprofen are used for mild nociceptive pain, and oxycodone is used for more severe nociceptive pain. A patient with bone cancer has recently undergone chemotherapy and radiation therapy to reduce the size of the tumor. The patient is taking a large dose of an opioid analgesic, along with acetaminophen and an antidepressant. The nursing student caring for this patient is concerned that the patient is showing drugseeking behaviors, because the individual requested an increased dose of the opioid. The student discusses this concern with the nurse. Which statement by the student indicates a need for further teaching? a. It would probably help this patient more to give a larger antidepressant dose. b. Patients often need more drug to achieve the same effect. c. Radiation and chemotherapy can damage bone tissue and cause increased pain. d. The patients description of pain is the most important part of the assessment of pain. 2. Register to View Answer Pain in cancer patients can arise both from the cancer itself and from the treatments. This patient has bone can cer, which causes somatic pain, and the treatments can increase this pain. Although neuropathic pain can occur as well, this patient is more likely to need analgesia for the nociceptive pain, so increasing the antidepressant dose is not indicated. Patients very often require more drug to achieve the same effect as tolerance develops. Radiation and chemotherapy can damage tissue and increase pain. When assessing pain in patients, the pa tients own description of pain intensity is the most important. A patient with cancer who has been receiving an opioid analgesic reports having pain at a new location even though the previous pain is well controlled. The nurse will contact the provider to discuss: a. breakthrough pain. b. drug-seeking behavior. c. infection or metastasis. d. tolerance to drug therapy. 3. Register to View Answer Caregivers should be alert for new pain; this usually results from a new cause, such as metastasis, infection, or fracture, and should be investigated. Breakthrough pain is pain that occurs even when adequate levels of analgesics are given. Drug-seeking behavior refers to patients who use drugs for euphoric effects instead of for intended effects. Tolerance occurs when more drug is required to receive the same effect. An 8-year-old child with advanced cancer has an order for oxycodone (OxyContin) PO, PRN for moderate to severe pain. The nurse notes that the child is constantly playing computer games and re peatedly denies having pain. What will the nurse do? a. Administer the oxycodone at regular intervals around the clock. b. Contact the provider to discuss using patient-controlled analgesia (PCA). c. Reassure the childs parent that the child will ask for pain medication as needed. d. Tell the child to notify the nurse when pain is present. 4. Register to View Answer For a number of reasons, even children who can verbalize pain correctly often underreport it. The child may fear that reporting pain may lead to painful procedures or may worry caregivers, or the child may be unaware that pain can be alleviated. Children involved in activities such as computer games may actually be using the activity to distract themselves from the pain, so such an activity is not an indication that the child is comfortable. This child has advanced cancer and is likely to have severe pain. A PCA device would give the child control and provide adequate pain relief. The oxycodone order is for PRN dosing, so the nurse cannot administer it around the clock without a prescribers order to do so. Also, because this child is more likely to have severe pain, a PCA would be more effective. Reassuring the parent that the child will report pain and asking the child to report pain do not take into account the fact that children often hide pain for the reasons previously mentioned. An older adult patient who has cancer and Alzheimers disease is crying but shakes her head no when asked about pain. The prescriber has ordered morphine sulfate 2 to 4 mg IV every 2 hours PRN pain. It has been 4 hours since a dose has been given. What will the nurse do? a. Administer 4 mg of morphine and monitor this patients verbal and nonverbal responses. b. Give 2 mg of morphine for pain to avoid increasing this patients level of confusion. c. Request an order for a nonopioid analgesic or an antidepressant adjuvant analgesic. d. Withhold any analgesic at this time and reassess the patient in 30 to 60 minutes. 5. Register to View Answer Older adult patients often are undertreated for pain, because assessing pain is difficult in patients with cognit ive impairment and because practitioners often believe that reduced dosages are necessary to alleviate side effects. This patient does not verbalize pain, but her nonverbal cue (crying) indicates that pain is present. The nurse should give the higher dose, especially because the dosing interval has already been exceeded, and then monitor the patients response to the medication. Giving 2 mg to avoid side effects is not indicated; patients with Alzheimers disease will continue to have confusion unrelated to the opioid. Nonopioid analgesics and an tidepressants are not indicated. Withholding pain medication is not appropriate, because this patient shows nonverbal signs of pain. A nursing student caring for a patient with cancer tells the nurse that the patient seems to be exaggerating when reporting the degree of pain. Which statement by the nurse is an appropriate response to this concern? a. Evaluation of the patients vital signs can help you tell if this patient is exaggerat ing. b. It is important to give pain medication as ordered for the degree of pain the patient reports. c. We may need to evaluate the patient for the development of metastasis or infection. d. You should monitor this patients behavior and facial expressions for a more ac curate assessment. 6. Register to View Answer The patients description of his or her pain is the cornerstone of assessment. Pain is a personal experience, and caregivers must act on what the patient says, even if they suspect the patient is exaggerating or not telling the truth. Evaluation of vital signs can be used to monitor responses to pain medication, as can assessments of be haviors and facial expressions, but they are not determinants of the level of pain in initial assessments. Patients with pain in new locations should be evaluated for metastases or infection or other causes. 7. A patient with cancer has been receiving codeine and a nonsteroidal anti-inflammatory medication for pain. The patient reports worsening of pain in both intensity and frequency. The nurse will tell the pa tient to contact the provider to discuss: a. using a fentanyl transdermal patch. b. adding an adjuvant analgesic drug. c. increasing the dose of the codeine. d. using hydrocodone or oxycodone. Register to View Answer As patients have increased pain, it is important to increase the level of analgesia. Hydrocodone or oxycodone is useful as pain increases, after nonopioid analgesics have been tried. Fentanyl transdermal patches are used for chronic, severe pain in patients who are already tolerant to opioids. Adjuvant analgesics can be used at any stage of pain progression but are used for neuropathic pain. Codeine is not recommended for cancer pain, be cause it has dose-limiting side effects; increasing the dose of codeine is never recommended. 8. A patient who is taking a fixed-dose combination drug with an opioid and acetaminophen for cancer pain reports increased muscular pain. The patient asks the nurse if the pain medication dose can be increased. What will the nurse tell this patient? a. An adjuvant analgesic medication will probably be used to help with this pain. b. An additional dose of acetaminophen can be used to enhance pain relief. c. Increasing the dose is possible, because there is no ceiling to opioid pain relief. d. The provider will prescribe separate dosing of the opioid and acetaminophen. Register to View Answer Fixed-dose combination products are not useful as pain increases, because the side effects of the nonopioid drug become intolerable as the dosage increases. As pain becomes more severe, the components of the combined regimen should be given separately. Adjuvant analgesics are used for neuropathic pain and not nociceptive pain (which this patient has described). Acetaminophen doses should not be increased. Increasing the dose of a fixed-dose combination drug is not recommended. 9. A patient with cancer is admitted to the hospital. The nurse obtains an admission history and learns that the patient has been taking oxycodone and a nonsteroidal anti-inflammatory drug (NSAID) for a year. The patient reports a recent increase in the intensity of pain, along with a new pain described as burning and shooting. The nurse anticipates that the prescriber will order: a. a combination opioid/NSAID and an adjunctive analgesic. b. a fentanyl transdermal patch, acetaminophen, and an adjunctive analgesic. c. an increase in the oxycodone and NSAID doses. d. intramuscular morphine sulfate and acetaminophen. Register to View Answer As pain increases in severity, more powerful opioids should be used. This patient has been taking oxycodone, which is a moderate-strength opioid; fentanyl is stronger. Because the pain is chronic and is now severe and because the patient has opioid tolerance, a transdermal patch may be used. Long-term use of NSAIDs is not re commended because of the risk of thrombotic events. The patient also is describing neuropathic pain, which can be treated with an adjuvant analgesic. Fixed-dose combination drugs are not recommended for increasing pain. NSAIDs are not recommended long term. Intramuscular medications are not recommended because of the pain associated with administration. 10. A patient is taking hydrocodone and ibuprofen for cancer pain and is admitted to the hospital for chemotherapy. The nurse anticipates that the prescriber will _____ ibuprofen. a. reduce the dose of b. discontinue the c. increase the dose of d. order aspirin (ASA) instead of Register to View Answer NSAIDs are contraindicated in patients undergoing chemotherapy because of decreased platelet production caused by bone marrow suppression. Any NSAID further increases the risk of bruising and bleeding. ASA is especially dangerous, because it causes irreversible inhibition of platelet aggregation. Ibuprofen should be dis continued, not reduced or increased. 12. A patient newly diagnosed with cancer is admitted to the hospital, and the provider orders oxy codone (OxyContin) every 4 to 6 hours PRN pain. The patient requests pain medication whenever he reports pain as a 7 or 8 on a scale of 1 to 10 (10 being the worst pain), but he tells the nurse the medication is not working well. The nurse will contact the provider to discuss: a. a fixed dosing schedule for the oxycodone. b. intramuscular meperidine (Demerol). c. intravenous morphine sulfate. d. transdermal fentanyl. Register to View Answer Dosing should be done on a fixed schedule to prevent opioid levels from becoming subtherapeutic once pa tients begin to have more severe pain. IM and IV dosing are more invasive and should not be used unless other methods have failed. Transdermal fentanyl is used for chronic, severe pain in patients tolerant to opioids. A patient who has had cancer for 1 year uses a fentanyl transdermal patch for pain relief. The patient reports having three or four episodes of pain (which she rates as 8 or 9 on a scale of 1 to 10) each day, and each episode lasts 15 to 30 minutes. The nurse will contact the provider to: a. discuss the use of an adjuvant analgesic. b. request an order for an NSAID. c. request a strong, short-acting opioid PRN. d. suggest increasing the dose of fentanyl. 13. Register to View Answer Breakthrough pain can occur in patients who otherwise have well-controlled pain, and it should be managed with extra doses of short-acting, strong opioids. This pain is moderate to severe and is not neuropathic, so ad juvant analgesics or NSAIDs are not useful. Increasing the dose of the long-acting opioid would not alleviate breakthrough pain. 1. Over time, patients taking opioid analgesics develop tolerance to which side effects? (Select all that apply.) a. Constipation b. Euphoria c. Physical dependence d. Respiratory depression e. Sedation Register to View AnswerD, E 2. A patient who takes daily doses of aspirin is scheduled for surgery next week. The nurse should advise the pa - tient to: a. continue to use aspirin as scheduled. b. reduce the aspirin dosage by half until after surgery. c. stop using aspirin immediately. d. stop using aspirin 3 days before surgery. Register to View Answer3. A patient who is taking acetaminophen for pain wants to know why it does not cause gastrointestinal upset, as do other over-the-counter pain medications. The nurse will explain that this is most likely because of which property of acetaminophen? a. It does not inhibit cyclooxygenase. b. It has minimal effects at peripheral sites. c. It is more similar to opioids than to nonsteroidal anti-inflammatory drugs (NSAIDs). d. It is selective for cyclooxygenase-2. Register to View Answer The differences between the effects of acetaminophen and aspirin are thought to result from selective inhibition of cyclooxygenase; acetaminophen has only minimal effects on cyclooxygenase at peripheral sites, which may explain why acetaminophen does not have adverse GI, renal, and antiplatelet effects. Acetaminophen is a se lective COX inhibitor. It is not more similar to opioids than NSAIDs. It is not selective for COX-2. 4. A patient tells the nurse that she takes aspirin for menstrual cramps, but she does not feel that it works well. What will the nurse suggest? a. The patient should avoid any type of COX inhibitor because of the risk of Reyes syndrome. b. The patient should increase the dose to a level that suppresses inflammation. c. The patient should use a first-generation nonsteroidal anti-inflammatory medica- tion instead. d. The patient should use acetaminophen because of its selective effects on uterine smooth muscle. Register to View Answer Aspirin (ASA) has analgesic effects for joint pain, muscle pain, and headache, but it is relatively ineffective against visceral pain, including uterine smooth muscle pain, for which NSAIDs are indicated. The risk of Reyes syndrome is associated with the use of ASA in children to treat fever. Increasing the ASA dose to anti -inflammatory levels is useful for rheumatic fever, tendonitis, and bursitis. Acetaminophen is not effective for dysmenorrhea. 5. A patient who takes aspirin for rheumatoid arthritis is admitted to the hospital complaining of headache and ringing in the ears. The plasma salicylate level is 300 mcg/mL, and the urine pH is 6.0. What will the nurse do? a. Increase the aspirin dose to treat the patients headache. b. Notify the provider of possible renal toxicity. c. Prepare to provide respiratory support, because the patient shows signs of overdose. d. Withhold the aspirin until the patients symptoms have subsided. ANS: patient D This shows signs of salicylism, which occurs when ASA levels climb just slightly above therapeutic level. Salicylism is characterized by tinnitus, sweating, headache, and dizziness. Tinnitus is an indication that the maximum acceptable dose has been achieved. Toxicity occurs at a salicylate level of 400 mcg/mL or high er. ASA should be withheld until the symptoms subside and then should be resumed at a lower dose. Increas ing the dose would only increase the risk of toxicity. Signs of renal impairment include oliguria and weight gain, which are not present in this patient. This patient has salicylism, not salicylate toxicity, so respiratory support measures are not indicated. 6. An adolescent is brought to the emergency department by a parent who reports that the patient took a whole bottle of extended-release acetaminophen tablets somewhere between 8 and 10 hours ago. The nurse will anti cipate administering which of the following? a. Acetylcysteine (Mucomyst) b. Activated charcoal c. Hemodialysis d. Respiratory support Register to View Answer7. An older male patient with an increased risk of MI is taking furosemide (Lasix) and low-dose aspirin. The pa - tient is admitted to the hospital, and the nurse notes an initial blood pressure of 140/80 mm Hg. The patient has had a 10-pound weight gain since a previous admission 3 months earlier. The patient has voided only a small amount of concentrated urine. The serum creatinine and blood urea nitrogen (BUN) levels are elevated. The nurse will contact the provider to discuss: a. adding an antihypertensive medication. b. obtaining serum electrolytes. c. ordering a potassium-sparing diuretic. d. withdrawing the aspirin. Register to View Answer This patient shows signs of renal impairment, as evidenced by weight gain despite the use of diuretics, de creased urine output, hypertension, and elevated serum creatinine and BUN. ASA can cause acute, reversible renal impairment and should be withdrawn. Hypertensive medications do not treat the underlying cause. Serum electrolytes are not indicated. Addition of a potassium-sparing diuretic is not indicated. 8. A pregnant patient in her third trimester asks the nurse whether she can take aspirin for headaches. Which re - sponse by the nurse is correct? a. Aspirin is safe during the second and third trimesters of pregnancy. b. Aspirin may cause premature closure of the ductus arteriosus in your baby. c. Aspirin may induce premature labor and should be avoided in the third trimester. d. You should use a first-generation nonsteroidal anti-inflammatory medication. Register to View Answer Aspirin poses risks to the pregnant patient and her fetus, including premature closure of the ductus arteriosus. ASA is not safe, especially in the third trimester, because it can cause anemia and can contribute to postpartum hemorrhage. ASA does not induce labor but can prolong labor by inhibiting prostaglandin synthesis. NSAIDs have similar effects and also should be avoided. 9. A nurse is caring for a patient who has been taking low-dose aspirin for several days. The nurse notes that the patient has copious amounts of watery nasal secretions and an urticarial rash. The nurse will contact the pro vider to discuss: a. administering epinephrine. b. changing to a first-generation NSAID. c. reducing the dose of aspirin. d. giving an antihistamine. Register to View Answer Aspirin can cause a hypersensitivity reaction in some patients. This may start with profuse, water rhinorrhea and progress to generalized urticaria, bronchospasm, laryngeal edema, and shock. It is not a true anaphylactic reaction, because it is not mediated by the immune system. Epinephrine is the treatment of choice. Patients with sensitivity to ASA often also have sensitivity to NSAIDs; the first indication with this patient is to treat the potential life-threatening effect, not to change the medication. Reduction of the dose of ASA is not indic ated, because this reaction is not dose dependant. Antihistamines are not effective, because this is not an aller gic reaction. 10. A nurse is teaching a nursing student who wants to know how aspirin and nonaspirin first-generation NSAIDs differ. Which statement by the student indicates a need for further teaching? a. Unlike aspirin, first-generation NSAIDs cause reversible inhibition of cyclooxy genase. b. NSAIDs do not increase the risk of MI and stroke; however, unlike ASA, they do not provide protective benefits against those conditions. c. Unlike aspirin, first-generation NSAIDs do not carry a risk of hypersensitivity re actions. d. Unlike aspirin, first-generation NSAIDs cause little or no suppression of platelet aggregation. Register to View Answer Nonaspirin first-generation NSAIDs carry a risk of hypersensitivity reactions similar to the risk posed by ASA. These agents cause reversible COX inhibition, whereas ASA causes irreversible COX inhibition. NSAIDs do not provide protective benefits for MI or stroke, as does ASA. Nonaspirin first-generation NSAIDs do cause suppression of platelet aggregation, but the suppression is reversible. 11. A nurse is providing teaching for an adult patient with arthritis who has been instructed to take ibuprofen (Mo - trin) for discomfort. Which statement by the patient indicates a need for further teaching? a. I may experience tinnitus with higher doses of this medication. b. I may take up to 800 mg 4 times daily for pain. c. I should limit alcohol intake to fewer than three drinks a day. d. I will take this medication with meals to help prevent stomach upset. Register to View Answer NSAIDs do not cause salicylism and therefore do not cause tinnitus with higher doses. The maximum dose for adults is 3200 mg/day, or 800 mg 4 times/day. Patients taking NSAIDs should be cautioned to limit alcohol intake. Taking NSAIDs with meals helps prevent GI upset. 12. A patient with arthritis asks a nurse which nonsteroidal anti-inflammatory medication is best to take. The nurse learns that this patient has a family history of cardiovascular disease. The nurse will recommend which NSAID? a. Celecoxib (Celebrex) b. Diclofenac (Voltaren) c. Ketorolac intranasal (Sprix) d. Naproxen (Aleve) Register to View Answer Naproxen is COX-1 selective, and the risk of MI and stroke appear lower with this drug than with other NSAIDs. Celecoxib is a COX-2 inhibitor and has increased risks of cardiovascular effects. Cardiovascular risks appear to be increased with diclofenac. Ketorolac carries the same risk as other NSAIDs, even with in tranasal dosing. 15. A patient who reports regular consumption of two or three alcoholic beverages per day asks about taking acet- aminophen when needed for occasional, recurrent pain. What will the nurse tell the patient? a. Do not take more than 2 gm of acetaminophen a day. b. Do not take more than 3 gm of acetaminophen a day. c. Do not take more than 4 gm of acetaminophen a day. d. Do not take a fixed-dose preparation with opioid analgesics. Register to View Answer4. A nurse is taking care of a diabetic patient who is 2 days postoperative after a total knee replacement. The patient has been requesting morphine sulfate frequently for pain, which she rates as 7 or 8 on a scale of 0 to 10. Her vital signs are T98.9 F, P88/minute, R 12/minute, and BP136/88. Which of the following classes of medications should the nurse be most concerned about giving concur rently with morphine sulfate? a. Antihypertensives b. Benzodiazepines c. Antihistamines d. Antidiabetics Register to View Answer 5. A nurse is reviewing discharge instructions with a patient. The patient asks the nurse why the oral dose of the opioid is so much high er than the intravenous dose he has been receiving. The nurses best response would be a. Only a maintenance dose of the medication is required. Your body already has built up the medic ation from its intravenous administration. b. The oral form of the drug passes through the liver and is then metabolized prior to obtaining the desired effect. c. Opiates are subject to being acid labile and destroyed in the gut, so the dose required is higher. d. The doses should be the same. The prescriber must think that your pain is not well controlled. Register to View Answer 6. A postoperative patient has received an epidural infusion of morphine sulfate. The patient's respiratory rate decreases to 8, and he has a decreased level of consciousness and miosis. Which medication would the nurse anticipate administering? a. Naloxone (Narcan) b. Acetylcysteine (Mucomyst) c. Methylprednisolone (Medrol) d. Physostigmine (Antilirium) Register to View Answer 7. A patient who has been taking an opiate for 2 years is preparing to discontinue use of the medication. Which statement made by the patient, indicates no need for further teaching? a. I will discontinue the drug when I am ready. b. I will continue taking a very low dose for 3 to 6 months. c. I will taper the drug slowly over 7 to 10 days. d. I can switch to another opiate and then discontinue the medication. Register to View Answer 8. A nurse is conducting patient education about the physical dependence induced by narcotic analgesics. Which comment made by the patient indicates that the person understands the meaning of physical dependence on a drug? Physical dependence is a state in which a. larger doses are required to produce the same response formerly produced by a lesser dose. b. an individual will seek and use the drug despite physical, psychological, or social harm. c. pain is undertreated and the patient appears to be drug seeking. d. an abstinence syndrome will occur if the drug is abruptly discontinued. Register to View AnswerPhysical dependence is a state in which an abstinence syndrome occurs if the drug is discontinued abruptly. Tolerance is a state in which larger doses are required to produce the same response formerly produced by a lesser dose. Drug abuse is a state in which an individual will seek and use the drug despite physical, psychological, or social harm. If the pain is undertreated, the patient may actually need more effective pain medication. 9. A nurse is working on an intensive care unit and caring for a patient with increased intracranial pressure. The patient is to receive an opiate. The nurse questions the order because a. patients with increased intracranial pressure are more prone to dysphoria, which can be produced when opiates are first initiated. b. the sedation that opiates produce can last longer in patients with elevated increased intracranial pressure. c. opiates can be given to patients with elevated intracranial pressure, although higher doses are required. d. opiates suppress respirations and therefore increase the CO2 content of the blood, which further increases intracranial pressure. Register to View AnswerThe ability of opiates to suppress respirations increases the CO2 content in the blood which will result in elevated increased intracranial pressure, which should be prevented in someone who already has an increase in intracranial pressure. Patients with increased intracranial pressure are not more prone to dysphoria when opiates are first initiated. Opiates are contraindicated in patients with increased intracranial pressure due to their effect on respirations as well as their increased sedation effects which can mask relevant changes in intracranial pressure. 10. A patient with pneumonia is at risk for developing respiratory depression. A nurse has just administered a dose of morphine sulfate intravenously. How long after the administration of morphine sulfate should the nurse monitor the patient for signs of respiratory de pression? a. 2 hours b. A half-hour c. 1 hour d. 4 hours Register to View AnswerThe nurse should continue to monitor the patient for respiratory depression for at least 4 hours. Respiratory depression should be monitored for at least 4 hours after administration of the morphine sulfate; any time less than 4 hours is too brief, and respiratory depression could be overlooked. 11. A patient taking Duragesic (fentanyl) appears lethargic, is not easily aroused, has pinpoint pupils, and has the following vital signs: respirations 10/minute, pulse 98/minute, BP 100/42. Which of the following actions by the nurse would be the most appropriate phar macological intervention? a. Administer flumazenil (Romazicon). b. Administer naloxone (Narcan). c. Administer atropine (AtroPen). d. Administer epinephrine (Adrenaline). Register to View Answer 12. A nurse admits a patient who has chronic pain and has been taking morphine sulfate for 4 months. The nurse should anticipate which of the following long-term effects in the patient? a. Tolerance b. Psychosomatic symptoms c. Withdrawal d. Respiratory depression Register to View AnswerWith prolonged use, morphine sulfate produces tolerance in a patient. Psychosomatic disorders are not expected in a patient taking morphine sulfate long term. Until the patient stops taking the morphine sulfate, which is not indicated here, withdrawal would not be a concern. Respiratory depression would most likely have occurred during the initial stages of drug therapy and would be less of a concern at 4 months into the regimen. 13. A nurse is providing a community education class on morphine sulfate. Which symptom, chosen by a member of the audience, indic ates a need for further teaching with regard to an understanding of adverse effects of morphine sulfate? a. Orthostatic hypotension b. Diarrhea c. Urinary retention d. Bradypnea Register to View Answer 1. The nurse is teaching a pharmacology class and is differentiating between aspirin and other cyclooxygenase inhibitors. The nurse would correctly identify which of the following as a unique characteristic of aspirin, not found in other cyclooxygenase inhibitors? a. Aspirin promotes gastric bleeding. b. Aspirin irreversibly inhibits cyclooxygenase. c. Aspirin promotes platelet synthesis. d. Aspirin enhances prostaglandin synthesis. Register to View Answer 2. A nurse counsels parents about antipyretic choices for an 8-year-old with influenza. Which statement, made by one of the parents, best demonstrates understanding of an appropriate antipyretic choice? a. Acetaminophen is toxic to the liver. b. Ibuprofen may increase fever in children younger than age 10. c. Sponge baths are the best option. d. Aspirin may increase the risk of Reyes syndrome. Register to View Answer 3. A patient who takes daily doses of aspirin is scheduled for surgery in the next few days. The nurse should advise the patient to a. continue to use aspirin as scheduled. b. stop using aspirin immediately. c. stop using aspirin 3 days prior to surgery. d. reduce the aspirin dosage by half until after surgery. Register to View Answer 4. The nurse is providing education to a patient who is to be discharged on a COX-2 inhibitor. The nurse would recognize that the pa tient understands the teaching if the patient states, COX-2 inhibitors increase the risk of a. peptic ulcer disease. b. liver toxicity. c. acid-base imbalance. d. myocardial infarction and stroke. Register to View Answer6. A mother brings her 17-year-old daughter to the emergency department. She states that the daughter took 40 extended-release acet aminophen tablets 8 hours ago. The nurse would anticipate an order for a. activated charcoal. b. high doses of antacids. c. acetylcysteine (Mucomyst). d. hemodialysis. Register to View Answer 7. The nurse is preparing to administer an initial dose of a COX-1 inhibitor and obtains a brief health history. Based on an understand ing of the therapeutic effects of this drug, the nurse would anticipate the patient to have which medical diagnosis? a. Ulcerative colitis b. Asthma c. Arthritis d. Polycythemia Register to View AnswerThe nurse should anticipate that the initial dose of a COX-1 inhibitor will reduce inflammation; therefore, the nurse would expect the patient to be experiencing an inflammatory disorder, such as arthritis. Aspirin would be inappropriate for patients with ulcerative colitis, because they already are at risk for bleeding, and the use of aspirin could potentiate further bleeding. Aspirin can exacerbate asthma and would not be used. Aspirin would be inappropriate for patients with polycythemia; these patients need additional fluids or phlebotomy. 8. Which of the following assessment findings would lead the nurse to believe that a patient taking high doses of aspirin is experiencing renal impairment? (Select all that apply.) a. Reduced urine output b. Weight loss c. Potassium level of 6.2 d. Tinnitus e. Elevated BUN f. Hematuria Register to View AnswerE 9. The nurse understands that the priority benefit of enteric-coated aspirin preparations is to prevent a. Reyes syndrome. b. salicylism. c. gastritis. d. acid-base imbalance. Register to View Answer 10. The principal indication for use of nonaspirin NSAIDs is a. fever. b. dysmenorrhea. c. arthritis. d. MI prevention. Register to View Answer 11. When administering aspirin to a patient with a history of peptic ulcer disease, the nurse may anticipate administering which drug(s) for prophylaxis against aspirin-induced ulcers? (Select all that apply.) a. Misoprostol (Cytotec) b. Ranitidine (Zantac) c. Omeprazole (Prilosec) d. Lansoprazole (Prevacid) e. Antacids Register to View AnswerC, D Misoprostol stimulates prostaglandin synthesis and is used for prophylaxis in patients taking aspirin. Omeprazole and lansoprazole are proton pump inhibitors that can be used to prevent and treat aspirin-induced ulcers, because proton pump inhibitors suppress gastric acid. Ranitidine and antacids are not indicated for the prevention and treatment of aspirin-induced ulcers. 1. A nurse is acting as a preceptor for a new nurse on the oncology unit. To evaluate the new nurses understanding of pain, the nurse asks, Which statement is correct regarding the differences between nociceptive and neuropathic pain? a. The two types of pain result from injury to nerves. b. The two types of pain respond differently to analgesic drugs. c. d. Somatic pain is a common subtype of neuropathic pain. Neuropathic pain is more common than nociceptive pain in cancer patients. Register to View Answer 2. A nurse is caring for a patient undergoing chemotherapy. A patient asks for ibuprofen (Motrin) and states, I didnt bring mine with me. I usually take them about four times a day. The nurse should notify the prescriber and anticipate an order for a(n) a. serum creatinine level. b. platelet count. c. salicylate level. d. absolute neutrophil count. Register to View AnswerFor patients undergoing chemotherapy, inhibition of platelet aggregation by nonsteroidal anti-inflammatory drugs is a serious concern, because many anticancer drugs suppress bone marrow function and reduce platelet production. Thrombocytopenia may result, putting the patient at risk for bleeding. A serum creatinine level is not indicated, because ibuprofen is not a nephrotoxic drug. A salicylate level would be indicated if the patient were taking aspirin, not ibuprofen. An absolute neutrophil count is not indicated in a patient taking ibuprofen. 3. A patient with cancer has been undergoing chemotherapy and also has risk factors associated with thrombocytopenia. The patient rates her pain as a 5 on a scale of 0 to 10, with 10 being the greatest pain. Which medication would the nurse anticipate being ordered for this patient? a. Ibuprofen (Motrin) b. Celecoxib (Celebrex) c. Acetylsalicylic acid (aspirin) d. Choline salicylate (Arthropan) Register to View AnswerCholine salicylate is indicated for moderate pain; it does not inhibit platelet aggregation and therefore is safe for patients with throm bocytopenia. Motrin inhibits platelet aggregation and should not be used in patients with thrombocytopenia. Acetylsalicylic acid should not be used in patients with thrombocytopenia. Celebrex is not indicated, because it poses a risk of thrombotic events. 4. A nurse is discussing the side effects of opioid medications with a group of cancer patients. Which signs and symptoms are side ef fects of chronic opiate use that should be discussed? (Select all that apply). a. Sedation b. Orthostatic hypotension c. Hypertension d. Nausea e. Diarrhea Register to View AnswerB, D 5. A nurse is caring for a patient with cancer, who manages her mild pain with acetaminophen (Tylenol) and nonsteroidal anti-inflam matory drugs. Her husband asks to speak with the nurse privately and explains that since his wife was diagnosed with cancer 2 years ago, she has been drinking about half a bottle of wine per day, along with a mixed drink before bed. The nurse should obtain from the prescriber an order for which of the following laboratory tests? a. Liver function tests b. Platelet count c. Ammonia level d. Hemoglobin and hematocrit level Register to View AnswerA patient with chronic alcohol abuse and frequent use of acetaminophen should have liver function tests to assess for any damage to the liver. 6. When asked the significance of tolerance as it related to drug therapy, the nurses best response would be that a. It means more drug is needed to produce the same effect after opioids have been used for over 1 to 2 weeks. b. Addiction to opioids is developing, and the drugs should be discontinued. c. The patient needs a smaller amount of drug to produce the same effect. d. Organ toxicity has occurred, and the drug should be discontinued. Register to View Answer7. A patient is brought to the emergency department by his spouse. The patient has a history of bone cancer and has been experiencing severe pain, which has not been relieved by doubling of his dose of opiates. The wife tells the nurse that her husband became con fused and that his eyes looked funny. Upon assessment, the nurse notes miosis and a respiratory rate of 6/minute. The nurse should immediately prepare for administration of which medication? a. Naloxone (Narcan) b. Flumazenil (Romazicon) c. Methamphetamine hydrochloride (Desoxyn) d. Acetylcysteine (Mucomyst) Register to View Answer 8. A nurse is caring for an anxious patient who has cancer. The patient has been experiencing nausea, and his pain is controlled most of the time by opiate analgesics. What prn medication can the nurse administer to help alleviate the nausea and also facilitate pain con trol? a. Dextroamphetamine (Dexedrine) b. Carbamazepine (Tegretol) c. Hydroxyzine (Vistaril) d. Dexamethasone (Decadron) Register to View AnswerHydroxyzine can reduce pain, anxiety, and nausea and also has sedative actions. Dextroamphetamine can enhance opioid-induced analgesia but does not help nausea. Carbamazepine is indicated for relief of neuropathic pain but does not relieve nausea. Dexamethasone, a corticosteroid, reduces edema, which indirectly may reduce pain but does not provide relief of nausea. 9. The prescriber asks a nurse to prepare the patient for an intraspinal injection of an opioid medication. The nurse understands that this route of administration is most beneficial for a. a patient with intractable pain that cannot be controlled by less invasive routes. b. patients at risk for thrombocytopenia who cannot tolerate intramuscular injections. c. a patient experiencing pain caused by advancing gastric cancer. d. a patient suffering from excruciating bone pain. Register to View Answer 11. A nurse cares for an alert patient with cancer who has been on large doses of opioids for several months. When the patient is hospit alized and placed on patient-controlled analgesia with morphine, the nurse is concerned about the risk of respiratory depression. The primary nursing action should be which of the following interventions? a. Administer naloxone (Narcan) prophylactically. b. Obtain an arterial blood gas measurement at least once per shift. c. Measure respiratory pattern and oxygen saturation initially and periodically throughout treatment. d. Assess level of consciousness and compare to previous day. Register to View Answer 12. A nurse is providing patient education to a group of elderly cancer patients. The nurse states that which of the following major prob lems may occur in the management of an elderly patient with cancer pain? a. Undertreatment of pain b. Potential for overdose c. Assessment of decreased sensitivity to pain d. Assessment of a high tolerance of pain Register to View Answer

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Johns Hopkins - CIVENG - 560.202
ty of vB at angle from the horizontal. Assume the wheels are free to roll, and neglect the size of the wheels and the deformation of the material. Units Used: Mg = 10 kg kN = 10 N Given: M = 2.70 Mg a = 1.3 m3 3 = 20 degb = 1.6 mkG = 1
Berkeley - ECE - 1234
ted-mode interrupt or exception handler. 5. A return from the 8086 monitor to redirect an interrupt or exception back to an interrupt or exception handler in the 8086 program running in virtual8086 mode. 6. Internal redirection of a software interrup
University of Phoenix - BUS - 201
greement? If there’s a disagreementin a group the first thing to do is to establish principles. You should talk about the disagreementbefore it gets out of hand. We all know that we will not agree on everything however everyoneshould compromise.
DeVry Chicago - BUSN427 - 427
tsourcing, and Logistics88. (p. 475) Historically, most outsourcing decisions have involved:A. the manufacture of physical products.B. the procurement of agricultural products.C. the mining of precious resources.D. the production of high-tech c
Tarrant County - POFI - 1407
Chapter 34 Sedative-Hypnotic Drugs Sedative-Hypnotic Drugs Drugs that depress CNS function Primarily used to treat anxiety and insomnia Antianxiety agents or anxiolytics Distinction between antianxiety effects and hypnotic effects is often a matter o
Tarrant County - POFI - 1407
Chapter 33 Drugs for Bipolar Disorder Bipolar Disorder Formerly known as manic-depressive illness Afflicts an estimated 3.7% of the adult population Mainstays of therapy Lithium, valproic acid Many also receive an antipsychotic Chronic condition th
Tarrant County - POFI - 1407
Chapter 32 AntidepressantsPrimarily used to relieve symptoms of depressionCan also help patients with anxiety disordersNot indicated for uncomplicated bereavementAntidepressant Groups Tricyclic antidepressants Selective serotonin reuptake inhibitors
Tarrant County - POFI - 1407
Antipsychotic Agents- chapter 31 Chemically diverse group of compounds Used for diverse spectrum of psychotic disorders Schizophrenia, delusional disorders, bipolar disorders, depressive psychoses, drug-inducedpsychoses Also used to suppress emesis
Tarrant County - POFI - 1407
SteroidsSteroidsNURS 20163 PharmacotherapeuticsSteroidsMade by adrenalcortexGlucocorticoids(Cortisol)Mineralocorticoids(Aldosterone)Gonadocorticoids(Androgens)ANDROGENSxResponsible for certain male & female sexhormonesMINERALOCORTICOIDS (ALDO
Tarrant County - POFI - 1407
Respiratory Drugs:Lehne (7th ed.) Chap 69, 75, 76PharmacotherapeuticsGas Exchange (Between Alveoli of theLung and CapillariesReview A& P of Upper AirwayRespiratory DrugsOxygenAntitussivesAntihistaminesExpectorantsDecongestantsAsthma Management
Tarrant County - POFI - 1407
Nurses Role inPain ManagementNon-Opioid Analgesics, NSAIDs, & OpioidAnalgesicsPharmacology TeamFacts about PAINHow much it hurts does not always equalhow minor or serious the injury / illness !Pain Tolerance: point pain becomesintolerableHighly
Tarrant County - POFI - 1407
Assessment & Planning1. *Check each MAR listing of order for type and amount of IV solution and infusion rate comparing it with physicians written order:right client, drug, dosage, route and time for administration . Review medication action, purpose, s
Tarrant County - POFI - 1407
1. What is the major purpose of intravenous therapy? To give medications, nutrition, andfluids and electrolytes F&E to maintain adequate fluid balance or to replace lost fluid2. Identify types of IV fluids and their common usage:Isotonic: same osmolali
Tarrant County - POFI - 1407
PharmacotherapeuticsNurs 20163 Principals of Drug Therapy related toAntimicrobials What are Antimicrobials? Drugs used to prevent or treat infection. Bacteria Fungus Viruses Parasites Review Microbiology Of all of the different drugs the Anti
Tarrant County - POFI - 1407
TCU- HCN MEDICATION SHEETStudent Name_Christi Hill_Patient Diagnosis (Admitting/Current) _ Date of Care_Allergies:_Weight in Kg: _Reference - APA Format: Deglin, J. H., Vallerand, A. H., & Sanoski, C. A. (2010). Davis's drug guide for nurses. (12th
Tarrant County - POFI - 1407
Drugs andInformation:HeparinLovenoxCoumadinPradaxaMechanismof Action- Potentiates theinhibitory effect ofantithrombin on factor Xaand thrombin.- In low doses, preventsthe conversion ofprothrombin to thrombinby its effects on factor Xa.- Hi
Tarrant County - POFI - 1407
POST-TEST High-alert drugs: Strategies for safe I.V. infusionsEarn contact hour credit online at www.AmericaNurseToday.com!InstructionsTo take the post-test for this article and earn contact hour credit, please go towww.AmericanNurseToday.com. Once yo
Tarrant County - POFI - 1407
Name _Pass/FailCheck-off for Intravenous Therapy: Preparing and Hanging IV (Primary)* The student mustcomplete this check-offwithin 15 minutes.PointsPossiblePoints EarnedCommentsAssessment & Planning1. *Check each MAR for typeand amount of IV
Tarrant County - POFI - 1407
Describe important elements in the physiology of hemostatis and thrombosis.Hemostatis: to keep the blood fluid and clot-free in normal vessels and to form alocalized plug rapidly in injured vessels. An injured blood vessel must induce theformation of a
Tarrant County - POFI - 1407
AntiDiabeticDrugsSystemWithInsulinWithoutInsulin(Anabolism=thebuild(Catabolism=opposite)CHOup) Glucose uptake to muscle& adipose tissueCHO Glucose oxidationCHO Glucose storage Glycogen synthesis GlycogenolysisCHOGluconeogenesisAA&Protei
Tarrant County - POFI - 1407
Name: _FailPass orCheck-off for Mastery of Injections Intramuscular* Thestudent must complete this check-off within 15 minutes.Assessment & Planning1. *Check each MAR listing of prescribed medications and times for accuracy bycomparing it with phy
Tarrant County - POFI - 1407
Student Name: Christi HillTCU- HCN MEDICATION SHEETPatient Diagnosis (Admitting/Current) _Allergies:_Weight in Kg: _Date of Care_Reference - Deglin, J. H., Vallerand, A. H., & Sanoski, C. A. (2010). Davis's drug guide for nurses. (12th ed.). Philad
Tarrant County - POFI - 1407
HypertensionNormalPrehypertensiveStage 1Stage 2Systolic Diastolic<120<80120-139 80-89140-159 90-99>160>100Systolic BP above 140; diastolic above 90. When systolicand diastolic fall in different categories, BP classification isbased on higher
Tarrant County - POFI - 1407
HYDROCHLOROTHIAZIDETrade Names: Microzid, OreticPregnancy Category : Category BTher. Class: antihypertensives, diureticsPharm. Class: thiazide diureticsIndications Management of mild to moderate hypertension. Treatment of edema associated with: HF
Tarrant County - POFI - 1407
IntroductiontoAutonomicSystemPharmacologySympathomimeticsakaAdrenergic(&)agonists Stimulationcaneitherbedirectorindirect. Usesophthalmicprepsforpupils systemicprepsforptsinshock.Whateffectsdoyouexpect?HRIntraocularPressureBloodVesselsGlycogen
Tarrant County - POFI - 1407
Tarrant County - POFI - 1407
Guide for Insulin AdministrationBefore you give insulin these are the things I will ask you to assess yourpreparedness. Please, think through all of these steps prior to paging the instructorto assist you with this skill..1. Name of insulin & type of
Tarrant County - POFI - 1407
Texas Christian UniversityHarris School of NursingNURS 20163/30163 Introduction to Pharmacology in NursingInjection Sites GuideIM SiteVentroglutealMuscleGluteusmediusUpper landmark(s)Place index finger tip of your opposite hand to thepatients l
Tarrant County - POFI - 1407
Name _PASS/FAILCheck-off for Injections: Subcutaneous* Thestudent mustcomplete this check-offwithin 15 minutes.Total PointsPoints EarnedAssessment & Planning1. Check each MAR listing of2.prescribed medications and timesfor accuracy by compari
Tarrant County - POFI - 1407
Texas Christian University-Harris College of Nursing & Health SciencesNURS 20163 PharmacotherapeuticsStudy Guide for Drug AdministrationUNIT II1. Define the following terms:Intravenous:Intramuscular:Subcutaneous:Intradermal:Parenteral:2. What fa
Tarrant County - POFI - 1407
Texas Christian UniversityHarris College of Nursing & Health SciencesNURS 20163 Pharmacotherapeutics LabPARENTERAL MEDICATION WORKSHEET A - UNIT 21) Ordered: Meperidine (Demerol) 75 mg IM.Available: Meperidine (Demerol) 100 mg in 2 ml._ ml2) Ordere
Tarrant County - POFI - 1407
TCU/HCNHS MEDICATION SHEETSCHEDULED MEDSPRN MEDS (Circle One)NAME_Christi Hill_ MEDICAL DIAGNOSIS _ DATE _9/18/12_Reference - Deglin, J. H., Vallerand, A. H., & Sanoski, C. A. (2010). Davis's drug guide for nurses. (12th ed.). Philadelphia: F A Davis
Tarrant County - POFI - 1407
TCU- HCN MEDICATION SHEETStudent Name_Christi Hill_Patient Diagnosis (Admitting/Current) _ Date of Care_Allergies:_Weight in Kg: _Reference - Deglin, J. H., Vallerand, A. H., & Sanoski, C. A. (2010). Davis's drug guide for nurses. (12th ed.). Philad
Tarrant County - POFI - 1407
TCU- HCN MEDICATION SHEETStudent Name_Patient Diagnosis (Admitting/Current) _ Date of Care_Allergies:_Weight in Kg: _Reference - Deglin, J. H., Vallerand, A. H., & Sanoski, C. A. (2010). Davis's drug guide for nurses. (12th ed.). Philadelphia: F A D
Tarrant County - POFI - 1407
GenericNameT 1/2Therapeutic EffectsMechanism ofActionRNImplicationsInteractionsIndications/dosagePrecautions/contraindicationsAdverseNitroglycerinnitro1-4 minAnti anginaVasodilatorAntihypertensionProphylaxisdrug- Take baselineBP
Tarrant County - POFI - 1407
Chapter 02B: Dimensional Analysis Calculations27. How many kilograms are in 25 pounds?Conversion formula: 1 kg = 2.2 lbDA equation:Evaluation:ANS:28. How many grams are in 350 milligrams?Conversion formula: 1000 mg = 1 gram g. Move the decimal poin
Tarrant County - POFI - 1407
Chapter 04: Patient Records, Medication Orders and Labels1. Define the following medical abbreviations:a. NPO:b. IV:c. IM:d. ID (route):e. NG:f. PO:g. SL:h. subcut:i. stat:j. bid:ANS:a. Nothing by mouthb. Intravenousc. Intramusculard. Intr
Tarrant County - POFI - 1407
TCU/HCNHS MEDICATION SHEETSCHEDULED MEDSPRN MEDS (Circle One)NAME_Haley Tomlinson_ MEDICAL DIAGNOSIS _ DATE _9/18/12 _Generic and tradenameClass/ActionGeneric: MetoprololClass: Betaadrenergic;Antihypertensive;Antianginal;CardioselectiveTrade:
Tarrant County - POFI - 1407
Texas Christian University-Harris College of Nursing & Health SciencesFt. Worth, TexasN 20163 PharmacotherapeuticsABSOLUTELY ESSENTIAL CONVERSIONS1000 mg = 1 Gm.Note: gram = Gm = gDo not confuse g (gram) with gr (grain)1 mg = 1000 mcg1 Kg. = 2.2 p
Tarrant County - POFI - 1407
Texas Christian University-Harris College of Nursing & Health SciencesMathematical Rounding Rule Policy for Drug CalculationsThe following guidelines are to be followed when calculating dosage problems.1)No rounding will be done until the last answer
Tarrant County - POFI - 1407
Student Name_Allergies:_Reference - APA Format:Generic/TradeNameClass/ActionInformation/AssessmentRN Needs ImmediatelyPrior to AdministrationTCU- HCN MEDICATION SHEETPatient Diagnosis (Admitting/Current) _Weight in Kg: _Dose, Times,Route,Sa
Tarrant County - POFI - 1407
Received: from MAILGW-SR1.TCU.EDU (138.237.38.56) by exhub1.tcu.edu(138.237.49.115) with Microsoft SMTP Server (TLS) id 8.3.279.1; Tue, 11 Sep2012 00:07:47 -0500Received: from c2.ecollege.com ([159.182.160.37]) by MAILGW-SR1-MTA.TCU.EDUwith ESMTP; 11
Tarrant County - POFI - 1407
Normal Laboratory ValuesPART I. HEMATOLOGYConventional UnitsAcid hemolysis test (Ham)Alkaline phosphatase, leukocyteCell countsErythrocytesMalesFemalesChildren (varies with age)LeukocytesTotalDifferentialMyelocytesBand neutrophilsSegmented
Tarrant County - POFI - 1407
Name _PASS/FAILCheck-off for Administering Oral Medications* The student must complete thischeck-off within 15 minutes.Total PointsPoints EarnedAssessment & Planning1. Check each MAR listing of prescribedmedications and times for accuracy bycomp
Tarrant County - POFI - 1407
Christi Hill107171850Ever since I was little I have always enjoyed taking care of others and in returnfeeling a great sense of gratitude. From this class I hope to build on what I have alreadylearned so far from taking other nursing classes. And I hav
Tarrant County - POFI - 1407
TCU/HCNHS MEDICATION SHEETSCHEDULED MEDSPRN MEDS (Circle One)NAME _ MEDICAL DIAGNOSIS _ DATE _Generic and tradenameGeneric:Class/ActionClass:Action:Trade:Generic:Class:Action:Trade:Generic:Class:Action:Trade:Generic:Class:Trade:Actio
Tarrant County - POFI - 1407
DIMENSIONALANALYSISMADEFUNDIMENSIONALANALYSISMADEFUNJoNellWells,PhD,RN,OCNSpring2004Dimensional Analysis is Delightfully Awesome1. BEGIN where you want to END2. FOLLOW the LEADER3. LEAP FROG the Label4. END where you BEGINSTEP 1: BEGIN where you
Tarrant County - POFI - 1407
Tarrant County - POFI - 1407
Elsevier Inc. items and derived items 2010 by Saunders, an imprint of Elsevier Inc.Sedative-Hypnotic DrugsElsevier Inc. items and derived items 2010 by Saunders, an imprint of Elsevier Inc.2 Drugs that depress the CNS function Primarily used to treat
Tarrant County - POFI - 1407
GASTROINTESTINALTRACTDRUGSGASTROINTESTINALTRACTDRUGSAntisecretoryAgents(H2Antagonists) ProtonPumpInhibitors(PPIs) Anticholinergics Antacids Antidiarrheals Laxatives Antiemetics/Emetics MucosalProtectants AntibioticsFIGURE761THERELATIONSHIPOFM
Tarrant County - POFI - 1407
Fluids and ElectrolytesNurs 20163Body Fluid Spaces60% of total body weight is fluidIntracellular space (ICF) 40% of body is ICFExtracellular space (ECF) 20% of body is ECF75% of ECF is Interstitial (fluid surrounding the cells)25% of ECF is Intrava
Tarrant County - POFI - 1407
DrugsthataffectHemostasisHemostasis Basic steps1. Blood vessel constriction2. Platelet plug formation (loose/temporary)3. Blood coagulationchemical events in sequence of clottingStagesofHemostasis Stage 1: Platelet Plug Tissue injury adhesion of
Tarrant County - POFI - 1407
Principals of DrugTherapyPharmacotherapeuticsrelated toNurs 20163AntimicrobialsWhat areAntimicrobials?Drugsused to prevent ortreat infection.BacteriaFungusVirusesParasitesOfReview Microbiologyall of the different drugsthe Antimicrobials
Tarrant County - POFI - 1407
IntroductiontoAutonomicSystemPharmacologyBasic Principles ofNeuropharmacologyNeuropharmacologyisthestudyofdrugsthatalterprocessescontrolledbythenervoussystem.PhysiologyoftheNervousSystemThedivisionsofnervoussystem Centralnervoussystem Brainand
Tarrant County - POFI - 1407
CardiovascularDrugsthingsthatControlBP HeartRate StrokeVolume(totalamtofbloodpumpfromventriclewitheachbeat) TotalPeripheralresistance(resistanceofmusculararteriesasbloodispumpedthroughthevessels.Arteriolesmostsignificanthavethesmallestlumen,there
Tarrant County - POFI - 1407
Variations in Drug ResponseEthnic and GeneticVariationsCardiovascular MedsAA less responsive to propranolol (Inderal)Chinese more sensitive to Inderal thanCaucasianAnalgesicsChinese require > dose of analgesiaCNS AgentsChinese require lower dosa
Tarrant County - POFI - 1407
Nurses Role inAlternative/ComplementaryTherapiesRodney Kelly StoryTexas BNE Position Statementon Alternative/ComplementaryBe Knowledgeable !TherapiesUse the Nursing ProcessRN is obligated to:ASSESS for use of therapiesAsk: What activities are y
Tarrant County - POFI - 1407
Principals of Drug ActioncontdPharmacodynamics,Drug Interactions,and Drug EffectsSerum Drug LevelsSerum drug level the amount of a drug in the blood at aparticular time.It reflects : DOSAGE, ABSORPTION, BIOAVAILABILITY, HALF-LIFE, RATES&OF
Tarrant County - POFI - 1407
PHARMACOKINETICSPharmakon = drug/poisonKinetics = movementThe study and analysis ofthe time course of the drugin the body.Pharmaceutic Phase: Drug formulation,disintegration, dissolution plus ADMINISTRATIONFactors thatinfluence intensityof drug
Tarrant County - POFI - 1407
Orientation to PharmacologyEthical, Legal Issues& Nursing ProcessRequirements in MedicationAdministrationPharmacology Science that studies drug effectswithina living system. (A drug is a substance that affects a livingsystem). Medication: drugs
Tarrant County - POFI - 1407
Texas Christian University-Harris College of Nursing & Health SciencesNURS 20163 PharmacotherapeuticsStudy Guide for Drug AdministrationUNIT IA True StoryA public health nurse was opening a case of 144 multidose vials of flu vaccine from a statedepa