Maryville University NURS 615:NURS 615 Exam 3 Study Guide 2026 update

NURS 615
Exam 3 Review
Study Guide

Week 8 Content
 Pain Management
o Know the treatment of acute pain – what medications are
first-line?
 What would you prescribe first when treating acute
mild musculoskeletal pain?
 Think of the guidelines and the Shadow Health
assignment

 NSAIDS – Ibuprofen, Naproxen, Aspirin, Toradol, Mobic
o Adverse effects –
 GI – nausea, heartburn
 Mild headaches
 Dizziness
o Contraindications –
 History of ulcers, Crohns, GI bleeding
 Liver or Kidney disease
 Heart disease
 Bleeding or platelet disorders
 Unmanaged HTN
 Pregnancy
o Drug interactions –
 Antihypertensives
 Warfarin
 Digoxin
o Symptoms of salicylate toxicity – which one would you see
first;
 N/V
 Diaphoresis
 Tinnitus
 Hyperventilation
 Respiratory alkalosis
o Why do NSAIDS have a black box warning?

 Salicylates
o Uses
o Mechanism of action
o Toxicity

,  Signs and symptoms of toxicity
 Toxicity versus adverse effects at usual doses (these
are different) - what is first seen with toxicity, i.e.
what is the cascade of events?

 Acetaminophen –
o Contraindications –
 Alcohol abuse
 Liver or kidney disease
 Malnutrition
o Acetaminophen toxicity –
 What are the signs and symptoms of liver
damage/failure?

 Opioids –
o Know the difference between agonists, partial agonists
and antagonists
 What are some examples of each –
 Morphine – prototypical opioid agonist
 Full Agonists – Activate opioid receptor fully
o Morphine, codeine, methadone
o Affinity plus efficacy
 Partial Agonists – Activate opioid receptor to a
lesser degree
o Buprenorphine, tramadol
o Affinity but low efficacy
 Antagonists – Bind to opioid receptors without
activating them
o Naloxone (Narcan)
o Affinity but no efficacy
 How do they differ in affinity and efficacy?

 Gout –
o Allopurinol is the first-line agent for lowering urate levels
 What are the adverse effects
 What labs should be monitored periodically when
drug is initiated?
 Know monitoring for the disease and for the drugs
used to treat it, including allopurinol and febuxostat
 What can happen when allopurinol or
febuxostat therapy is initiated?
o Management of gout flares