ATI Pharmacology Made Easy 4.0 "Pain and Inflammation"

Which of the following instructions should the health care provider give the client regarding the use of aspirin prior to the surgery?

Stop taking one week before surgery.

A nurse is reviewing the medical record of a client who has a new prescription for celecoxib. The nurse should identify that which of the following conditions is a contraindication to celecoxib?

Sulfonamide allergy Clients allergic to sulfonamides can have severe allergic reactions to celecoxib (COX2 inhibitor). Also those allergic to salicylates.

Client is about to start taking oral morphine to treat acute pain from an injury. Which of the following instructions should you include when talking with the client about taking morphine? (Select all that apply)

Take it with food Rise slowly from sitting or reclining Increase fluid and fiber intake Do not take it before driving

A nurse is caring for a client who takes low-dose aspirin to prevent cardiovascular events. The client asks the nurse about taking ibuprofen to treat rheumatoid arthritis. Which of the following responses should the nurse make?

"Ibuprofen will reduce the cardioprotective effects of low-dose aspirin" Clients taking low-dose aspiring for its ability to decrease platelet aggregation should not take ibuprofen.

A nurse is caring for a group of postoperative clients. The nurse should identify that morphine is contraindicated for which of the following clients?

A client who had a cholecystectomy Morphine can cause biliary colic.

A client arrives at the emergency room immediately following an acetaminophen overdose. Which drug should you prepare to administer?

Acetylcysteine

W nurse is reviewing the medical record of a client who reports taking acetaminophen at home. The nurse should identify that which of the following client conditions is a contraindication for acetaminophen?

Alcohol use disorder Acetaminophen can cause liver toxicity.

A client is about to start taking tramadol to treat moderate pain. Which of the following instructions should you include when talking with the client about taking this drug?

Allow 1 hr for it to take effect

A nurse is caring for a child who has a viral infection. The nurse should identify that which if the following drugs can increase the risk of Reye Syndrome in children who have viral infections?

Aspirin Known to increase the risk of Reye syndrome in children with viral infection (chickenpox/ influenza). Manifestations include lethargy, and persistent vomiting.

A nurse is teaching a client who has a new prescription of allopurionol. Which of the following instructions should the nurse include?

Avoid driving or activities that require mental alertness Allopurinol can cause drowsiness. Limit activities requiring mental alertness until they know the effect the drug will have on them

A client is about to begin celecoxib therapy for osteoarthritis. You should instruct the client to watch for and report which of the following possible indications of a serious reaction to this drug?

Black, tarry stools

A nurse is caring for a client who has a new prescription for prednisone for long-term treatment of rheumatoid arthritis. The nurse should monitor the client for which of the following adverse drug reaction?

Bone loss Prednisone (glucocorticoid) can cause osteoporosis, especially w long term use. Pts should increase weight-bearing activity, report back pain. Monitor clients bone density.

A nurse is caring for a client who is taking acetaminophen at regular intervals for mild discomfort. The nurse should tell the client to report which of the following early indications of acetaminophen toxicity? (Select all that apply)

Diaphoresis Nausea Diarrhea Acetaminophen toxicity can cause nausea, vomiting, lethargy, diarrhea, diaphoresis, and anorexia, and can lead to liver damage. Unlikely to cause tachycardia or palpitation

A nurse is teaching a client who has a new prescription for tramadol. Which of the following instructions should the nurse include? (Select all that apply.)

Increase fiber and fluid intake Take the drug with food Avoid driving after taking the drug Change position gradually Tramadol can cause: - constipation and dry mouth. Increase fiber/ fluid intake, sip water, suck on hard candy, chew gum - nausea, vomiting. take w food/ milk and lie down if nauseous. - sedation and drowsiness.

A provider prescribes prednisone for a client who has type 1 diabetes mellitus. Recognizing the risk for an adverse drug reaction to prednisone, which of the following precautions should the primary care provider take for this client?

Increase serum glucose monitoring

As a health care provider prepares to give the client morphine IV for pain, she makes sure she has which of the following drug available?

Naloxone

A client is about to start taking aspirin to prevent cardiovascular events. You should instruct the client to watch for and report which adverse drug reaction of aspirin?

Petechiae

In addition to celecoxib (Celebrex) the client takes low-dose aspirin daily for which of the following purposes?

Reduces the risks of a cardiovascular event

A nurse is caring for a client who asks about taking acetaminophen. The nurse should identify that acetaminophen is indicated for which of the following conditions? (Select all that apply.)

To reduce fever To relieve mild pain

A nurse is caring for a client who is receiving morphine to relieve severe pain. The nurse should monitor the client for which of the following adverse drug reactions? (Select al that apply.)

Urinary retention Respiratory depression Sedation Orthostatic hypotension Morphine causes constipation, urinary retention, severe respiratory depression, sedation, dizziness, lightheadedness, and hypotension/ postural hypotension. Pts should: - increase/ monitor fluid intake/ output, assess for bladder distention - withhold the drug for a respiratory rate below 12/min - avoid activities that require alertness - change positions gradually

A nurse is caring for a client who is a opioid dependent and has a new prescription for butorphanol. The nurse should monitor the client for which of the following manifestations of abstinence syndrome. (Select all that apply.)

Vomiting Abdominal cramps Hypertension Butorphanol (opioid agonist-antagonist) can cause nausea, dizziness, drowsiness, headaches, and increased intracranial pressure. Patients should lie down when nauseous, avoid activities that require alertness when taking the drug, and report severe headaches.

A nurse is reviewing the drug list form a client who has a new prescription for allopurinol. The nurse should identify that which of the following drugs interact with allopurinol?

Warfarin Allopurinol can increase effectiveness of warfarin. Lower dose warfarin may be required.

Because the client is taking celecoxib (Celebrex) for osteoarthritis, he knows to watch for and report which of the following possible indications of an adverse reaction to celecoxib?

Weight Gain

A nurse is caring for a patient who has a prescription for aspirin to treat an ankle sprain. The nurse should instruct the client to report which of the following adverse drug reactions?

Weight gain ASA can cause renal impairment, which can result in the retention of salt and water. Clients should report reduced urine output, wt gain, edema, bloating. Monitor BUN and creatinine levels and stop ASA therapy for clients who develop signs of renal dysfunction.

Morphine (opioid analgesic) Prednisone (glucocorticoid) Ibuprofen (non-steroidal anti-inflammatory drug) Naloxone (opioid antagonist)

match the drugs + class

Morphine (sedation) Acetaminophen (fever reduction) Butorphanol (anesthesia adjunct) Prednisone (prevention of organ rejection)

medication + use

The health care provider prepares to give the client morphine IV for pain. Knowing the adverse drug reactions of morphine, she should monitor the client for which of the following?

respiratory depression

A nurse is caring for a client who has a new prescription for celecoxib. The nurse should tell the client to report which of the following adverse drug reactions?

Chest pain Celecoxib (COX2 inhibitor) can cause cardiovascular/ cerebrovascular events. Report chest pain, SOB, HA, numbness, weakness, and confusion. Prescribe the lowest effective dosage for the shortest time possible.

A nurse is teaching a client who has a new prescription for prednisone. Which of the following instructions should the nurse include. (Select all that apply)

Discontinue the drug gradually Report illness or infection Increase intake of calcium and vitamin D Monitor for signs of gastric bleeding Prednisonse (glucocorticoid): - suppresses adrenal function; taper down before discontinuing to allow resumption of adrenal activity. - Clients might need higher doses during times of stress/ illness/ infection; report stressful events/ signs of infection. - can cause bone loss/ reduced calcium absorption. - can cause peptic ulcer disease. report gastric bleeding (hematemesis/ black tarry stools)

A nurse is teaching a client who is talking allopurinol about minimizing adverse effects. Which of the flowing instructions should the nurse include?

Eat a small meal before taking this drug Eating or drinking a glass of milk can prevent stomach upset

A nurse is caring for a client who is taking allopurinol to treat gout. The nurse should monitor the client for which of the following manifestations of hypersensitivity syndrome

Fever Allopurinol (antigout drug) can cause hypersensitivity syndrome. Monitor for rash, itching, and fever as manifestations of hypersensitivity syndrome, which can lead to renal/ liver dysfunction. Stop taking the drug.

A nurse is caring for for client who is about to begin taking aspirin. The nurse should instruct the client to report which of the following manifestations of salicylism? (Select all that apply)

Fever Tinnitus Diaphoresis Dizziness Late manifestations of acute aspirin poisoning, or salicylism, include fever, tinnitus (ringing/ buzzing), sweating, headache, and dizziness. Stop taking until effects resolve and report to providers.

A nurse is caring for a client who is taking naloxone to treat acute morphine toxicity. The nurse should monitor the client for which of the following adverse drug reactions? (Select all that apply)

Increased respiratory rate Increased pain Ventricular arrhythmias Hypertension Naloxone: - treats respiratory depression but can cause hyperventilation. Monitor respiration and oxygenation - reverses the analgesic effects of opioids and can cause increased pain and discomfort. Assess pain frequently. -can increase partial thromboplastin time, and cause bleeding. - cause ventricular arrhythmias. Monitor HR and ECG. - cause hypertension. Monitor BP.

A nurse is planning for a client who has started taking prednisone. Which of the following interventions should the nurse include?

Monitor the clients blood glucose Prednisone can cause hyperglycemia. Monitor blood glucose regularly.

A nurse is caring for a client who has a new prescription for butorphanol. The nurse should monitor the client for which of the following adverse drug reactions?

Nausea Dizziness Headache

A nurse is reviewing the medical record of a client who has a new prescription for tramadol. The nurse should identify that which of the following conditions is a contraindication for tramadol?

Seizure disorder tramadol, nonopioid analgesic, can cause seizure activity. Clients w seizure disorders, head injuries, or increase ICP should not take.

A nurse is teaching a client who has a new prescription for allopurinol. The nurse should instruct the client to report which of the following adverse effects? (Select all that apply)

Sore throat Vertigo Bruising Vision changes Allopurinol (antigout drug) can cause liver/ kidney dysfunction, agranulocytosis, drowsiness, vertigo, thrombocytopenia, and cataracts with extended use. Pts should: - increase fluid intake, report abd pain, jaundice and reduced urine output. -Monitor WBC count, report fever/ sore throat, avoid crowds/ exposure to communicable diseases -avoid activities that require mental alertness -monitor platelet count, report bleeding/ bruising -report vision changes, eye exams at recommended intervals

Butorphanol is an unsafe analgesic choice for clients who

Use a fentanyl patch for chronic pain

A client who is receiving chemotherapy takes allopurinol prior to the chemotherapy to reduce the risk for which condition?

Hyperuricemia

A nurse is caring for a client who currently takes furosemide and has new prescription for prednisone. The nurse should monitor the client for which of the following manifestations during concurrent use of the two drugs

Hypokalemia Prednisone (glucocorticoid) can cause hypokalemia. The risk for electrolyte imbalance increases when the client is taking potassium-depleting diuretics, such as furosemide. The nurse should clarify the prescription with the provider and monitor the client's levels.