Study Guide for NR 293 Exam 2
Major categories of medication: Nursing implication related to the administration of medication.
Focusing on
Adverse Effects/Contraindications/side Effects/interactions (both drug and food interactions)
Expected actions/Outcomes Medication administration (patient education, assessment,
monitoring and evaluation)
Chapter 10
• Opioid: Morphine Sulfate/ naloxone hydrochloride
• Indications : alleviate moderate to severe pain, also used for cough suppression,
treatment of diarrhea, balanced anesthesia
• Contraindications : drug allergy, severe asthma, resp insufficiency, elevated
intracranial pressure, obesity, sleep apnea, paralytic ileus, pregnancy
• Adverse effects : CNS depression, nausea, vomiting, urinary retention,
diaphoresis, pupil constriction, constipation, itching
• Nursing implications : oral forms to be taken with food, withhold dose if
respirations are less than 10-12 breaths/min, constipation is common- eat fiber
drink fluids, monitor pulse ox
• Opioid antagonist : reverse effects of these drugs on pain receptors.
o Narcan: used for opioid toxicity or OD. Regardless of withdrawal symptoms,
when a pt. experiences severe resp. depression an opioid antagonist
should be given.
• Tylenol : OTC, analgesic and antipyretic effects.
●Mechanism of action: blocks pain impulses peripherally by inhibiting prostaglandin
synthesis
● Indication: mild to moderate pain, fever, and alternative to aspirin
● Dose: MAX adults: 3000 mg/daily, MAX elderly w liver disease: 2000mg/daily, ●
Contradictions: drug allergy, liver dysfunction, possible liver failure, G6PD
deficiency- dangerous w alcohol and drugs that cause hepatotoxicity
● Toxicity and Overdose: hepatic necrosis, hepatotoxicity
, ○ Antidote: acetylcysteine regimen
Chapter 12
Benzodiazepines: “azepam” “azolam” o
Mechanism of action:
o Indications:
Long acting (valium): seizures
Intermediate acting (Xanax,
valium):
Short acting ( o
Contraindications: o Adverse
effects:
o Nursing implications:
**Nursing implications relate to nursing administration of CNS depressants
Chapter 44
• Ibuprofen
• Ketorolac (Toradol)
• Allopurinol
**Nursing implications relate to NSAID administration
Chapter 13 CNS stimulant
(Use diazepam for status epilepticus)
• CNS stimulant for ADHD o Amphetamines/methylphenidate, o
Non –CNS stimulant for ADHD: atomoxetine (Strattera)
• CNS Stimulant for migraine: o Serotonin agonists “triptan”
• CNS Stimulant for Obesity:
o CNS stimulant: phentermine o Non-CNS
stimulant anorexiant: Orlistat
**Nursing implication relate to CNS stimulant administration
Chapter 14 Antiepileptic Drugs (AEDs)
Phenytoin (Dilantin)- highly protein bound, therapeutic drug levels are 10-20 mcg/mL
Major categories of medication: Nursing implication related to the administration of medication.
Focusing on
Adverse Effects/Contraindications/side Effects/interactions (both drug and food interactions)
Expected actions/Outcomes Medication administration (patient education, assessment,
monitoring and evaluation)
Chapter 10
• Opioid: Morphine Sulfate/ naloxone hydrochloride
• Indications : alleviate moderate to severe pain, also used for cough suppression,
treatment of diarrhea, balanced anesthesia
• Contraindications : drug allergy, severe asthma, resp insufficiency, elevated
intracranial pressure, obesity, sleep apnea, paralytic ileus, pregnancy
• Adverse effects : CNS depression, nausea, vomiting, urinary retention,
diaphoresis, pupil constriction, constipation, itching
• Nursing implications : oral forms to be taken with food, withhold dose if
respirations are less than 10-12 breaths/min, constipation is common- eat fiber
drink fluids, monitor pulse ox
• Opioid antagonist : reverse effects of these drugs on pain receptors.
o Narcan: used for opioid toxicity or OD. Regardless of withdrawal symptoms,
when a pt. experiences severe resp. depression an opioid antagonist
should be given.
• Tylenol : OTC, analgesic and antipyretic effects.
●Mechanism of action: blocks pain impulses peripherally by inhibiting prostaglandin
synthesis
● Indication: mild to moderate pain, fever, and alternative to aspirin
● Dose: MAX adults: 3000 mg/daily, MAX elderly w liver disease: 2000mg/daily, ●
Contradictions: drug allergy, liver dysfunction, possible liver failure, G6PD
deficiency- dangerous w alcohol and drugs that cause hepatotoxicity
● Toxicity and Overdose: hepatic necrosis, hepatotoxicity
, ○ Antidote: acetylcysteine regimen
Chapter 12
Benzodiazepines: “azepam” “azolam” o
Mechanism of action:
o Indications:
Long acting (valium): seizures
Intermediate acting (Xanax,
valium):
Short acting ( o
Contraindications: o Adverse
effects:
o Nursing implications:
**Nursing implications relate to nursing administration of CNS depressants
Chapter 44
• Ibuprofen
• Ketorolac (Toradol)
• Allopurinol
**Nursing implications relate to NSAID administration
Chapter 13 CNS stimulant
(Use diazepam for status epilepticus)
• CNS stimulant for ADHD o Amphetamines/methylphenidate, o
Non –CNS stimulant for ADHD: atomoxetine (Strattera)
• CNS Stimulant for migraine: o Serotonin agonists “triptan”
• CNS Stimulant for Obesity:
o CNS stimulant: phentermine o Non-CNS
stimulant anorexiant: Orlistat
**Nursing implication relate to CNS stimulant administration
Chapter 14 Antiepileptic Drugs (AEDs)
Phenytoin (Dilantin)- highly protein bound, therapeutic drug levels are 10-20 mcg/mL
