NR 293 Pharm Exam 2 Chamberlain
Questions and Verified Solutions.
Graded A+
QUESTIONS AND ANSWERS
what are analgesics? ANSWER - medications that relieve pain without loss of
consciousness
What is nociception? ANSWER - perception of pain
what is a pain threshold? ANSWER - stimuli needed to produce the sensation of pain
what is a pain tolerance? ANSWER - different for everyone, amount of pain a person can
endure without interfering with normal functioning
somatic pain ANSWER - originates from skeletal muscle, ligaments, and joints
referred pain ANSWER - pain that is felt in a location other than where the pain originates
visceral pain ANSWER - originates from organs and smooth muscle
central pain ANSWER - marked by chronic pain stemming from damage to CNS
bradykinin ANSWER - causes vasodilation
What are adjuvant drugs? ANSWER - assist primary drugs in relieving pain
what are opioid drugs? ANSWER - synthetic drugs that bind to the opiate receptors to
relieve pain
mild agonist opioid drugs ANSWER - codeine and hydrocodone
strong agonists ANSWER - morphine, hydromorphone, oxycodone, meperidine, fentanyl,
and methadone
Can a nurse dilute opioid drugs in an iv? ANSWER - No, not unless the pharmacy
specifically says to and opioids should not be given through a normal saline device
,what is the opioid ceiling effect? ANSWER - drug reaches a maximum analgesic effect
If you take 5 mg of a medication for pain, that 5 mg will go to receptor sites to block pain
signals but let's say you take 10 mg, What will happen? ANSWER - . Even if you increase
the dose, it will have the same effect no matter how much you take, can have more of an
adverse effect (why the pt may take more and more of something and then take more and
then they begin to overdose.
what do opioid agonists do? ANSWER - bind to an opioid pain receptor site to block pain
what do opioid agonists-antagonists do? ANSWER - bind to a pain receptor but causes a
mixed response, weaker than full agonist
what do opioid antagonists do? ANSWER - blocks or takes out the agonist effects
ex: narcan reverses opioid overdose
what is Equianalgesia? ANSWER - ability to provide equivalent pain relief by calculating
dosages that provide comparable analgesia.
opioid analgesics contraindications ANSWER - known drug allergy, severe asthma,
COPD/respiratory insufficiency, pregnancy
opioid analgesics indications ANSWER - moderate to severe pain (7+), cough center
suppression, diarrhea, balanced anesthesia
A patient is recovering from an appendectomy. She also has asthma and allergies to
shellfish and iodine. To manage her postoperative pain, the physician has prescribed
patient-controlled analgesia (PCA) with hydromorphone (Dilaudid). Which vital sign is of
greatest concern?
A.Pulse
B.Blood pressure
C.Temperature
D. Respirations ANSWER - D. respirations
opioid analgesics adverse effects ANSWER - CNS depression, GI upset, urinary retention
(check bladder distention), diaphoresis/flushing, pupil constriction, constipation, itching
what is a common opioid medication given for overdose? ANSWER - Naloxone (Narcan)
what do opioid analgesics interact with? ANSWER - alcohol, antihistamines, barbiturates,
benzos
codeine sulfate ANSWER - less effective, more commonly used as an antitussive
fentanyl ANSWER - narrow therapeutic window; injection, patch, lozenges
,Methadone Hydrochloride (Dolophine) ANSWER - synthetic opioid analgesic, choice for
detoxification for opioid addicts, prolonged QT interval and causes cardiac dysrhythmias
morphine sulfate ANSWER - opioid analgesic, prototype; used for severe pain
Naxolone (Narcan) ANSWER - opioid antagonist; for complete or partial reversal of opioid
induced respiratory depression
Acetaminophen (tylenol) ANSWER - non-opioid analgesic; can alter liver function,
antipyretic and analgesic effects
Acetaminophen MOA ANSWER - blocks pain impulses peripherally by inhibiting
prostaglandin synthesis
Acetaminophen indications ANSWER - mild to moderate pain (3-5), fever, alternative to
aspirin
Acetaminophen max dosage ANSWER - <3000 mg/day
<2000 mg/day for older adults
Acetaminophen Contraindications ANSWER - drug allergy, liver dysfunction, liver failure
A patient with a history of heavy alcohol use needs a medication for pain. The
recommended maximum daily dose of acetaminophen for this patient would be
A.1000 mg.
B.2000 mg.
C.3000 mg.
4000 mg. ANSWER - B. 2000 mg
Implications for Analgesics ANSWER - -obtain thorough health history, medications,
including herbals
-monitor I and O
-monitor liver enzymes
-monitor pain
-oral taken with food
-monitor vitals, hold meds if abnormal
WATCH RR
what are sedatives? ANSWER - CNS depressant drugs that have an inhibitory effect on
the CNS; reduce:
nervousness
excitability
irritability
, what do hypnotic sedatives do? ANSWER - cause sleep; these are dose dependent
what are benzodiazepines? ANSWER - CNS depressant drugs commonly prescribed for
sedation or sleep
benzodiazepines sedative hypnotic types (3) ANSWER - long acting, intermediate acting,
short acting
what are the long acting benzodiazepines? ANSWER - Clonazepam (Klonopin) and
Diazepam (Valium)
what are the short acting benzodiazepines? ANSWER - Midazolam (Versed), Eszopiclone
(Lunesta)
what are the intermediate acting benzodiazepines? ANSWER - Alprazolam (Xanax),
lorazepam (Ativa)
when is clonazepam used? ANSWER - for alcohol withdrawal or extreme anxiety
when is xanax used? ANSWER - reduce anxiety
when is ativan used? ANSWER - clinical setting, sleep
when is Versed used? ANSWER - clinical setting, outpatient procedures, puts patient to
sleep for 20-30 minutes
Benzodiazepines MOA ANSWER - depresses CNS activity
Benzodiazepines: Drug Effects ANSWER - calming on CNS, not a direct muscle relaxant
Benzodiazepines: Indications ANSWER - sedation, skeletal muscle relaxation, anxiety
relief, acute seizure disorders, agitation
Benzodiazepines adverse effects ANSWER - headache, drowsiness, dizziness, "hangover
effect or daytime sleepiness
When providing education to the patient on the use of a benzodiazepine medication, the
nurse will include which information?
A.These medications have little effect on the normal sleep cycle.
B.Using this medication may cause drowsiness the next day.
C.It is safe to drive while taking this medication.
D.These drugs are safe to use with alcohol. ANSWER - B
which is more common with Benzodiazepines- overdose or respiratory depression?
ANSWER - overdose
Questions and Verified Solutions.
Graded A+
QUESTIONS AND ANSWERS
what are analgesics? ANSWER - medications that relieve pain without loss of
consciousness
What is nociception? ANSWER - perception of pain
what is a pain threshold? ANSWER - stimuli needed to produce the sensation of pain
what is a pain tolerance? ANSWER - different for everyone, amount of pain a person can
endure without interfering with normal functioning
somatic pain ANSWER - originates from skeletal muscle, ligaments, and joints
referred pain ANSWER - pain that is felt in a location other than where the pain originates
visceral pain ANSWER - originates from organs and smooth muscle
central pain ANSWER - marked by chronic pain stemming from damage to CNS
bradykinin ANSWER - causes vasodilation
What are adjuvant drugs? ANSWER - assist primary drugs in relieving pain
what are opioid drugs? ANSWER - synthetic drugs that bind to the opiate receptors to
relieve pain
mild agonist opioid drugs ANSWER - codeine and hydrocodone
strong agonists ANSWER - morphine, hydromorphone, oxycodone, meperidine, fentanyl,
and methadone
Can a nurse dilute opioid drugs in an iv? ANSWER - No, not unless the pharmacy
specifically says to and opioids should not be given through a normal saline device
,what is the opioid ceiling effect? ANSWER - drug reaches a maximum analgesic effect
If you take 5 mg of a medication for pain, that 5 mg will go to receptor sites to block pain
signals but let's say you take 10 mg, What will happen? ANSWER - . Even if you increase
the dose, it will have the same effect no matter how much you take, can have more of an
adverse effect (why the pt may take more and more of something and then take more and
then they begin to overdose.
what do opioid agonists do? ANSWER - bind to an opioid pain receptor site to block pain
what do opioid agonists-antagonists do? ANSWER - bind to a pain receptor but causes a
mixed response, weaker than full agonist
what do opioid antagonists do? ANSWER - blocks or takes out the agonist effects
ex: narcan reverses opioid overdose
what is Equianalgesia? ANSWER - ability to provide equivalent pain relief by calculating
dosages that provide comparable analgesia.
opioid analgesics contraindications ANSWER - known drug allergy, severe asthma,
COPD/respiratory insufficiency, pregnancy
opioid analgesics indications ANSWER - moderate to severe pain (7+), cough center
suppression, diarrhea, balanced anesthesia
A patient is recovering from an appendectomy. She also has asthma and allergies to
shellfish and iodine. To manage her postoperative pain, the physician has prescribed
patient-controlled analgesia (PCA) with hydromorphone (Dilaudid). Which vital sign is of
greatest concern?
A.Pulse
B.Blood pressure
C.Temperature
D. Respirations ANSWER - D. respirations
opioid analgesics adverse effects ANSWER - CNS depression, GI upset, urinary retention
(check bladder distention), diaphoresis/flushing, pupil constriction, constipation, itching
what is a common opioid medication given for overdose? ANSWER - Naloxone (Narcan)
what do opioid analgesics interact with? ANSWER - alcohol, antihistamines, barbiturates,
benzos
codeine sulfate ANSWER - less effective, more commonly used as an antitussive
fentanyl ANSWER - narrow therapeutic window; injection, patch, lozenges
,Methadone Hydrochloride (Dolophine) ANSWER - synthetic opioid analgesic, choice for
detoxification for opioid addicts, prolonged QT interval and causes cardiac dysrhythmias
morphine sulfate ANSWER - opioid analgesic, prototype; used for severe pain
Naxolone (Narcan) ANSWER - opioid antagonist; for complete or partial reversal of opioid
induced respiratory depression
Acetaminophen (tylenol) ANSWER - non-opioid analgesic; can alter liver function,
antipyretic and analgesic effects
Acetaminophen MOA ANSWER - blocks pain impulses peripherally by inhibiting
prostaglandin synthesis
Acetaminophen indications ANSWER - mild to moderate pain (3-5), fever, alternative to
aspirin
Acetaminophen max dosage ANSWER - <3000 mg/day
<2000 mg/day for older adults
Acetaminophen Contraindications ANSWER - drug allergy, liver dysfunction, liver failure
A patient with a history of heavy alcohol use needs a medication for pain. The
recommended maximum daily dose of acetaminophen for this patient would be
A.1000 mg.
B.2000 mg.
C.3000 mg.
4000 mg. ANSWER - B. 2000 mg
Implications for Analgesics ANSWER - -obtain thorough health history, medications,
including herbals
-monitor I and O
-monitor liver enzymes
-monitor pain
-oral taken with food
-monitor vitals, hold meds if abnormal
WATCH RR
what are sedatives? ANSWER - CNS depressant drugs that have an inhibitory effect on
the CNS; reduce:
nervousness
excitability
irritability
, what do hypnotic sedatives do? ANSWER - cause sleep; these are dose dependent
what are benzodiazepines? ANSWER - CNS depressant drugs commonly prescribed for
sedation or sleep
benzodiazepines sedative hypnotic types (3) ANSWER - long acting, intermediate acting,
short acting
what are the long acting benzodiazepines? ANSWER - Clonazepam (Klonopin) and
Diazepam (Valium)
what are the short acting benzodiazepines? ANSWER - Midazolam (Versed), Eszopiclone
(Lunesta)
what are the intermediate acting benzodiazepines? ANSWER - Alprazolam (Xanax),
lorazepam (Ativa)
when is clonazepam used? ANSWER - for alcohol withdrawal or extreme anxiety
when is xanax used? ANSWER - reduce anxiety
when is ativan used? ANSWER - clinical setting, sleep
when is Versed used? ANSWER - clinical setting, outpatient procedures, puts patient to
sleep for 20-30 minutes
Benzodiazepines MOA ANSWER - depresses CNS activity
Benzodiazepines: Drug Effects ANSWER - calming on CNS, not a direct muscle relaxant
Benzodiazepines: Indications ANSWER - sedation, skeletal muscle relaxation, anxiety
relief, acute seizure disorders, agitation
Benzodiazepines adverse effects ANSWER - headache, drowsiness, dizziness, "hangover
effect or daytime sleepiness
When providing education to the patient on the use of a benzodiazepine medication, the
nurse will include which information?
A.These medications have little effect on the normal sleep cycle.
B.Using this medication may cause drowsiness the next day.
C.It is safe to drive while taking this medication.
D.These drugs are safe to use with alcohol. ANSWER - B
which is more common with Benzodiazepines- overdose or respiratory depression?
ANSWER - overdose
