Neuro Medications

Neuro Medications NSAIDs Correct Answer: Use: Pain (mild to moderate), Fever, Headache, myalgia, arthralgia, neuralgia, post-op pain, osteoarthritis, rheumatoid arthritis, and acute gout. NSAIDs Correct Answer: MOA: Blocks synthesis of prostaglandins, Cox-1 and Cox-2 inhibition NSAIDs Correct Answer: Serious Side Effects: GI distress GI bleeding NSAIDs Correct Answer: Nursing considerations: Observe pt for hx of cardiac decompensation for evidence of fluid retention/edema Labs; LFT's/Renal/Hgb Plts Renal and Liver function Skin, assess for tinnitus; hearing NSAIDs Correct Answer: Patient Teaching: Notify provider of dark tarry stools or "coffee ground" emesis Avoid Alcohol Do not take in conjunction with Aspirin Avoid Ginko Liloba Cox-2 Inhibitors Correct Answer: Use: Analgesia Anti-inflammatory Anti-rheumatic Used for rheumatoid and osteoarthritis Cox-2 Inhibitors Correct Answer: MOA: Suppress only the COX-2 enzyme, relieving symptoms & leaving the gastro protective COX-1 enzyme in place. Stomach protection is why COX-2s have been so widely used. Cox-2 Inhibitors Correct Answer: Serious Side Effects: Increased risk for MI GI distress GI bleeding GI Bleed Liver damage Renal failure Fluid Retention Stevens-Johnson syndrome Cox-2 Inhibitors Correct Answer: Nursing Considerations: Observe pt with hx of CHF or HTN for evidence of fluid retention/edema "Flu-like" S/S Labs; LFT's/Renal/Hgb Plts; Electrolytes Renal and Liver function Skin, assess for tinnitus; hearing Monitor Lithium levels if also taking Monitor PT/INR if taking Coumadin Cox-2 Inhibitors Correct Answer: Patient Teaching: Notify provider of dark tarry stools or "coffee ground" emesis Avoid Alcohol Do not take in conjunction with Aspirin Avoid Ginko Liloba Report unexplained weight gain, skin rash True Correct Answer: True or False: A patient who has a history of chronic pain is in danger of experiencing respiratory depression when taking opioids as long-term therapy. Opioids Correct Answer: Use: Analgesia/ Severe and chronic pain Preanesthisia adjunct Relief of Acute Left Ventricular Failure & PE and pain of MI Opioids Correct Answer: MOA: Opioids work by binding natural opioid receptors in the body. Synthetic Opioid structure closely replicate those in the natural form which lead to the analgesic effect. Opioids Correct Answer: Serious Side Effects: CNS depressant (Respiratory) Opioids Correct Answer: Nursing Considerations: Obtain baseline resp Observe for pain relief Check vital signs Monitor I & O; check for bladder distention Have nalaxone available! (Antidote) Do not allow patient to ambulate without assistance Opioids Correct Answer: Patient Teaching: Avoid Alcohol and other CNS depressants Use caution with other OTC druge/notify physician Do not drive or operate heavy machinery Patient Controlled Analgesia-PCA Correct Answer: The purpose of this is: Patient able to self-medicated Able to give Bolus Reduces amount of Opioid used Requires continuous monitoring B. Laxative or stool softener Correct Answer: The patient is receiving his first dose of an opioid analgesic for pain. The nurse expects that another medication that will probably be ordered concurrently for this patient will be a(n): A. Antacid agent B. Laxative or stool softener C. Anti-anxiety agent D. Breakthrough pain reliever C. 42-year-old man who is mentally alert and is recovering from a fractured femur Correct Answer: Which patient would benefit most from the use of a patient-controlled analgesia pump? A. 75-year-old woman in the last stages of the dying process who is experiencing occasional episodes of confusion