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UWorld NCLEX-RN Pharmacology STUDY GUIDE 173QUESTION AND ANSWERS 2024 AGRADE
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UWorld NCLEX-RN Pharmacology STUDY GUIDE 173QUESTION AND ANSWERS 2024 AGRADE
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UWorld NCLEX-RN Pharmacology STUDY GUIDE173QUESTION AND ANSWERS 2024 AGRADE
Naloxone - <<ANSWER>>(narcan) opioid antagonist
-counteracts the effects of opioids/ post-op anesthesia/ over-sedation
-short halflife (wears off in 1-2h)
-important to assess respiratory status at 1 h post administration and perform
appropriate action(s)
Opioid analgesics: side effects - <<ANSWER>>sedation
hypotension/ orthostatic hypotension
N/V (short-term effect)
constipation (long-term effect)
respiratory depression
codeine is an - <<ANSWER>>opioid
______position will decrease nausea - <<ANSWER>>still, supine
(anti-emetic may be necessary initially)
Opioid analgesics: nursing indications - <<ANSWER>>-monitor sedation level
-instruct pt not to get out of bed unassisted
-administer PRN stool softeners
It is most important for the nurse to monitor _______ when a pt is taking opioid
analgesics; notify the HCP if the pt: A. _____________ or B. _____________ -
<<ANSWER>>sedation level
A. falls asleep during conversation
B. has minimal or no response to verbal or physical stimuli
If the pt falls asleep during conversation: - <<ANSWER>>monitor respiratory status and
notify HCP to decrease sedation by 25-50%
(slightly drowsy is acceptable/normal)
,If pt has minimal or no response to verbal/physical stimuli: - <<ANSWER>>stop
sedation, consider using naloxone, notify HCP, monitor respiratory status
Pts at high risk for respiratory depression associated w/ opioid analgesics: -
<<ANSWER>>-advanced age
-surgery w/in 24 h
-COPD/ underlying pulmonary disease
-smoking
-snoring
-obesity
-opiate naive
IV hydromorphone should be given _______, over ______-______ minutes -
<<ANSWER>>slowly, 2-3 minutes
Hold morphine if RR is less than - <<ANSWER>>12
Pt prescribed IV PCA, but still has a lot of pain- - <<ANSWER>>preform thorough pain
assessment
Extended release Oxycodone or Oxycontin, a long-acting opioid analgesic, is given
when immediate release opioids are inadequate for pain management; they should be
administered __________, even if the pt denies ________ - <<ANSWER>>around-the-
clock
pain
(effective for 12 h; administered 2x daily)
*tolerance and dependence is developed and higher doses are eventually required to
achieve therapeutic effect
NSAIDs - <<ANSWER>>-naproxen (Aleve)
-ibuprofen (Advil)
-idomethacin (Tivorbex)
-ketorlac (Toradol) *potent*
Complications associated with NSAIDs - <<ANSWER>>-GI toxicity: dyspepsia, peptic
ulcers, pain, bleeding (report black tarry stool and take med w/ food)
-Nephrotoxicity: (associated w/ long term use; can lead to AKI and CKD)
-HTN and HF: NSAIDs can cause fluid retention which can exacerbate HF, HTN, and
ascites, or lead to MI, or stroke
-Bleeding: mainly GI (tell HCP if taking w/ other NSAIDs, aspirin, or anti platelets)
*Do not give NSAIDs to pts who have the above conditions*
, *NSAIDs should be used at the lowest dose for the shortest period possible*
NSAIDs decrease the effectiveness of _______ and ______ medications -
<<ANSWER>>diuretic, blood pressure
Misoprostol - <<ANSWER>>tx: prevents gastric ulcers in long-term NSAID therapy;
induces labor
Indications:
*can be taken w/ food but NOT ANTACIDs
*effective birth control should be in place
*causes labor induction (can give to induce labor but NOT w/ oxytocin, pt w c-section
hx, and pt w/ abnormal cxs)
Salicylate meds - <<ANSWER>>acetylsalicylic acid (Aspirin)
acetaminophen (Tylenol)
bismuth subsalicylate (Pepto Bismol)
acetylsalicylic acid (Aspirin) overdose - <<ANSWER>>Give activated charcoal
Aspirin and other salicylate meds should not be given to children with viral infections
such as ______ or _______, otherwise _______syndrome can occur -
<<ANSWER>>influenza, varicella, Reye
NO
aspirin, acetaminophen (Tylenol), bismuth subsalicylate (Pepto Bismol)
Furosemide - <<ANSWER>>(Lasix) diuretic
Tx: HTN, fluid overload
Complications:
1. Ototoxicity (trouble hearing, balancing; r/t high doses in pts w/ compromised renal fx)
*high IV doses should be administered slowly*
2. Hypokalemia
(look for muscle cramps, weakness, paresthesia)
3. Hypotension
Potassium sparing diuretics - <<ANSWER>>spironolactone, triamterene, amiloride,
eplerenone
weak diuretics and antihypertensives
*useful when combined w/ thiazide diuretics to reduce potassium loss
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