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Nursing Pharmacology 1, Exam 2 TEST BANK 9TH EDITION NEWEST VERSION.
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Nursing Pharmacology 1, Exam 2 TEST BANK 9TH EDITION NEWEST VERSION.
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Nursing Pharmacology 1, Exam 2Analgesics - ANS Medications that relieve pain without causing loss of consciousness.
Analgesics - ANS "Painkillers"
Pain - ANS An unpleasant sensory and emotional experience associated with actual or potential
tissue damage.
Nociceptors - ANS Receptors which transmit pain signals from various body regions to the
spinal cord and brain.
Nociceptive Pain - ANS Pain caused by activity in neural pathways in response to potentially
tissue-damaging stimuli.
Neuropathic Pain - ANS Pain initiated or caused by primary lesion or dysfunction in the nervous
system.
Pain Threshold - ANS Level of stimulus needed to produce the perception of pain.
A measure of the physiologic response of the nervous system.
Pain Tolerance - ANS The amount of pain a person can endure without it interfering with normal
function.
Subjective response to pain, not a physiologic function.
Acute Pain - ANS Sudden onset pain.
Usually subsides once treated.
Chronic Pain - ANS Persistent or recurring pain.
Lasts 3 to 6 months.
Often difficult to treat.
Nerve Endings - ANS Tissue injury causes the release of
-Bradykinin
-Histamine
-Potassium
-Prostaglandins
,-Serotonin
These substances stimulate ______, starting the pain process.
Dorsal Horn - ANS Pain's point of spinal cord entry or the "gate."
Enkephalins and Endorphins - ANS Endogenous neurotransmitters which bind to opioid
receptors to fight pain.
Adjuvant - ANS Drugs which assist primary drugs in relieving pain, such as NSAIDs,
antidepressants, anticonvulsants, cotricosteroids.
Opioid Analgesics - ANS Synthetic drugs that bind to the opiate receptors to relieve pain.
Very strong pain relievers.
Opioid Ceiling Effect - ANS Drug reaches a maximum analgesic effect.
Analgesia does not improve, even with higher doses.
Opioid Analgesic - ANS Drug class of *pentazocine*.
Opioid Analgesic - ANS Drug class of *nalbuphine*.
Opioid Analgesic - ANS Drug class of *codeine sulfate*.
Opioid Analgesic - ANS Drug class of *meperidine HCl (Demerol)*.
Opioid Analgesic - ANS Drug class of *methadone HCl (Dolophine)*.
Opioid Analgesic - ANS Drug class of *morphine sulfate*.
Opioid Analgesic - ANS Drug class of *hydromorphone*.
Opioid Analgesic - ANS Drug class of *fentanyl (Duragesic)*.
Opioid Analgesic - ANS Drug class of *oxycodone*.
Partial Agonist - ANS A drug that produces low to moderate receptor activation when
administered alone, but will block the actions of a full agonist if the 2 are given together.
Agonists - ANS Type of opioids which activate mu and kappa receptors in the brain, producing
analgesia, ephoria, sedation, respiratory depression, physical depepndence, constipation, etc.
,Agonists-Antagonists - ANS Type of opioids which bind to a pain receptors, causing a weaker
neurologic response than a full agonist.
Also called "partial agonists" or "mixed agonists."
Agonists-Antagonists - ANS Classification of opioids which includes:
*pentacozine* (prototype)
*nalmuphine*
*butophanol*
*buprenophine*
Antagonists - ANS Reverse the effects of opioids on pain receptors.
Bind to a pain receptor and exert no response.
Also known as competitive antagonists.
Methylnaltrexone - ANS Opioid *ant*agonist used to treat opioid-induced constipation.
Opioid Analgesics - ANS Indicated for moderate to sever pain, as well as:
-Cough center suppression
-Treatment of diarrhea
-Balanced anesthesia
Opioid Analgesics - ANS (Drug class)
Contraindications:
Severe asthma
Use with extreme caution in patients with:
-Respiratory insufficiency
-Elevated intracranial pressure
-Morbid obesity and/or sleep apnea
-Paralytic ileus
-Pregnancy
Somatic Pain - ANS A patient with bone cancer tells the nurse that he is in pain. The nurse
knows that bone pain is classified as which type of pain?
Somatic pain
Referred pain
Visceral pain
, Neuropathic pain
Respirations - ANS 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?
Pulse
Blood pressure
Temperature
Respirations
Opiod Analgesics - ANS (Drug Class)
Adverse Effects:
-CNS depression, Leads to *respiratory depression* (Most serious adverse effect)
-Nausea and vomiting
-Urinary retention
-Diaphoresis and flushing
-Pupil constriction (miosis)
-Constipation
-Itching
Opioid Tolerance - ANS A common physiologic result of chronic opioid treatment.
Result: larger dose is required to maintain the same level of analgesia.
Physical Dependence - ANS Physiologic adaptation of the body to the presence of an opioid.
Psychological Dependence - ANS A pattern of compulsive drug use characterized by a
continued craving for an opioid and the need to use the opioid for effects other than pain relief.
D - ANS A patient who has metastasized bone cancer has been on transdermal *fentanyl*
patches for pain management for 3 months. He has been hospitalized for tests and has told the
nurse that his pain is becoming "unbearable." The nurse is reluctant to give him the ordered
pain medication because the nurse does not want the patient to get addicted to the medication.
The nurse's actions reflect:
A. appropriate concern for the patient's best welfare.
B. appropriate caution for a patient who is already on a long-term opioid.
C. an uncaring attitude toward the patient.
D. a failure to manage the patient's pain properly.
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