Pharmacology III - Chapter 26 - Nonopioid and Opioid Analgescis - EXAM 4.rtf - Chapter 26 Nonopioid and Opioid Analgesics Pharmacology III \u2013 Study

Pharmacology III - Chapter 26 - Nonopioid and Opioid Analgescis - EXAM 4.rtf

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Chapter 26: Nonopioid and Opioid AnalgesicsPharmacology III – Study Guide – EXAM 4MULTIPLE CHOICE1.The nurse is evaluating a patient 2 hours after giving a dose of 30 mg of codeine with acetaminophen for postoperative pain after abdominal surgery. The patient reports a pain levelof 7 on a scale of 1 to 10. The nurse notes a heart rate of 110 beats per minute, a respiratory rate of 28 breaths per minute, and a blood pressure of 180/90 mm Hg. Which action will the nurse take?a.Administer the next dose of codeine one hour early.b.Ask the provider if the codeine dose can be increased.c.Contact the provider to ask if a dose of ibuprofen may be given now.d.Request an order for oxycodone with acetaminophen (Percocet).ANS: DThe patient is showing signs of moderate to severe pain unrelieved by codeine, so the nurse should request a more potent opioid analgesic such as oxycodone. Codeine is effective for mild to moderate pain so will not be effective for this patient even if the dose is increased. Themedication should not be given more frequently than every 4 hours. Ibuprofen is used for musculoskeletal pain and not postoperative pain. Page 3612.The nurse is teaching a female patient who will begin taking 2 tablets of 325 mg acetaminophen every 4 to 6 hours as needed for pain. Which statement by the patient indicatesunderstanding of the teaching?The maximum daily dose of acetaminophen is 4000 mg. If this patient takes 650 mg/dose 6 times daily, this amount is safe. Taking acetaminophen with caffeine increases the effect of theacetaminophen. Taking acetaminophen with OCPs decreases the effect of the acetaminophen but does not diminish the effect of the OCP. Many over-the-counter medications contain acetaminophen, so patients should be advised to read labels carefully to avoid overdose. Page3553.The parent of a 5-year-old child asks the nurse to recommend an over-the-counter pain medication for the child. Which analgesic will the nurse recommend?
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Acetaminophen is safe to give children and does not cause gastrointestinal upset or interfere with platelet aggregation. Aspirin carries an increased risk of Reye’s syndrome in children. Diflunisal (Dolobid) is not available over the counter. Page 355
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