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169 Cards in this Set
- Front
- Back
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What advise would you give to a pt on aspirin (asa) therapy with gastric upset?
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What advise would you give to a pt on aspirin (asa) therapy with gastric upset?
-Take Drug with Food and full glass of water - take drug in the morning instead of evening - sit upright to help avoid GI Upset |
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What is the most common early sign of Colchicine toxicity?
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What is the most common early sign of Colchicine toxicity?
-Diarrhea |
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your pt tells you they usually take ibuprofen/mortin- NSAIDS- 4x’s a day, what are the side effects of NSAIDS?
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your pt tells you they usually take ibuprofen/mortin- NSAIDS- 4x’s a day, what are the side effects of NSAIDS?
-upset stomach, nausea vomiting -GI bleeding, need to ask pt what color are their stools |
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pt has started aspirin therapy, and experiencing a lot of epigastric distress, what should you tell them?
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pt has started aspirin therapy, and experiencing a lot of epigastric distress, what should you tell them?
- take it with food and lot of water - don’t take it at bedtime, better if taken in the morning - don’t take any antacids because it will interfere with the effect of aspirin - take the medication sitting up right |
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why do you need to stop taking aspirin one week before surgery (any kind of surgery)?
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why do you need to stop taking aspirin one week before surgery (any kind of surgery)?
- it’s an anticoagulant, thins out the blood |
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what is colchicine given for?
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what is colchicine given for?
-acute gout |
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pt starts vomiting from taking colchicine, what do you do?
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pt starts vomiting from taking colchicine, what do you do?
-they need to stop taking it even if they have pain |
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pt has been in long-term steroid therapy, how would they appear to you, (physically)?
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pt has been in long-term steroid therapy, how would they appear to you, (physically)?
- round moon face -dowager’s hump -presence of edema |
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things you cannot see with steroid use?
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things you cannot see with steroid use?
- immunosupression, concern with infection -causing increase bleeding tendencies, develop bruising under the skin |
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what kind of drug is Vicodin?
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what kind of drug is Vicodin?
- narcotic drug, analgesic - don’t operate heavy machinery - Causes nausea and vomiting |
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What is the most common side effect with Vicodin?
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What is the most common side effect with Vicodin?
Most common side effect: constipation |
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narcotic analgesics cause what type of effect?
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narcotic analgesics cause what type of effect?
narcotic analgesics cause: - Sedation - Hypotension - Constipation - Respiratory Depression |
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Do narcotic analgesics affect blood sugar levels?
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narcotic analgesics have no affect on the blood sugar level
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what kind of drug is Naloxone (Narcan)?
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what kind of drug is Naloxone (Narcan)?
-Narcotic Antagonist |
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what do we use naloxone for?
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what do we use naloxone for?
Naloxone (narcan) is an opioid antagonist. - overdose - also with addicts, use with extreme caution because they can cause withdrawal (reversal of opiod adverse effects) -postoperative acute resp deppression. (FYI: Antagonists have been developed to reverse the resp. depression associated w opioid.) |
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pt was admitted with Tylenol (acetaminophen) poisoning, what is the antidote?
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pt was admitted with Tylenol (acetaminophen) poisoning, what is the antidote?
- acetylcysteine (Mucomyst) |
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how do you know the Mucomyst has been effective?
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- liver function is stable
- make sure to monitor liver function Liver Test: AST/ALT |
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When giving morphine to a pt what assessment is very important for you to monitor?
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- respiratory rate
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GI upset from any kind of drug, what is your nursing intervention to relieve problem?
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Make pt sit-up and drink full glass of water
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What is the antidote for Tylenol poisoning?
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- Mucomyst (acetylcysteine) to prevent liver damage
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How do you know the Mucomyst has been effective?
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- liver function is stable
- make sure to monitor liver functions tests: AST/ALT |
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When giving morphine to a pt what assessment is very important for you to monitor?
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- respiratory rate
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What class of drug is Actonel (risedronate)?
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- bisphosphonates, use to build bones and prevent further bone loss
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what class of drug is cyclobenzaprine (Flexeril)?
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- muscle relaxants, use to reduce muscle spasms
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What is the most common adverse effect of taking a gold compound?
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- Metallic taste, should not stop taking but do notify physician
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What is the difference between adverse-effect and side-effect?
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-Adverse-effect is harmful
-Side effect can imply that the effects can be beneficial |
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what is the most common side-effect of muscle relaxants?
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- drowsiness
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How much water should the pt drink when taking any kind of acute gout medication?
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- at least 2 liters of water a day until condition has subsided
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What is the drug given for acute gout?
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-colchicine
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pt has been taking 650mg of aspirin 4x’s a day, what are the side-effects?
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- tinnitus, can cause deafness, stop medication
-GI bleeding, instruct pt to look at stool abnormal colors black, dark stool, bright red report (black stool is referred to as "Melena"; Stools - black or tarry |
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What would be a contraindication for giving NSAIDS?
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- peptic ulcers
- GI disorders |
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Aspirin is anti-inflammatory, given to people with arthritis
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Aspirin is anti-inflammatory, given to people with arthritis
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aspirin decrease platelets aggregation (clumping)
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aspirin decrease platelets aggregation (clumping)
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Why don’t we give aspirin to children?
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- Reye’s syndrome
- instead use Tylenol |
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What type of opioid is in the form of a transdermal patch?
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Fentanyl is avail in Transdermal patch
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How is Humira administered?
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- subQ
(FYI: Humira is given by subcutaneous (under the skin) self-injection once every two weeks.) |
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What is Humira given for?
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humira is given subQ for rheumatoid arthritis
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When should Prednisolone be given to prevent GI upset?
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Prednisone is a corticosteroid and it should be given with meals to prevent GI
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What type of drug is Prednisone?
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Prednisone is a corticosteroid used to treat arthritis pain and inflammation
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Allopurinol is given for gout, pt should…
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- take the medication with food
- increase fluid intake - call the doctor if a rash develops -no alcohol |
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What is soma given for?
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carisoprodol (soma) is a muscle relaxant
- used treat muscle spasms |
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what kind of drug is Dilaudid?
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- narcotic opioid analgesic
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what assessment should you use to see if medication is being effective, before and after giving drug?
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- Pain scale
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what is the common Opioid to suppress the cough syndrome
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- codeine
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when do we give colchicine?
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when do we give colchicine
- for acute gout |
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What do u tell the pt to do when pt is experience, nausea, vomiting, diarrhea, and abdominal pain?
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- stop the medication and go see the doctor
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what is sumatriptan (Imitrex)?
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- migraine headaches
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what is the contraindication for Imitrex?
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- coronary artery disease (CAD)
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Which of the following meds could cause impressiveness?
A. Prednisone B. Cyclosporine C. methotrexaste D. darvon |
A- Prednisone yes
B- Cyclosporine yes C- methotrexaste yes |
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S/S of bone marrow suppression?
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- fever
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Which assessment is going to be essential in order to know if pt has developed an infection?
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- fever (temp)
- white blood count would be elevated |
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DMAR’s (disease modifying antirheumatic drugs) are given for what?
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- rheumatoid arthritis
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one of the side effects of DMAR’s is bleeding, what would you advice pt to do prevent bleeding?
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- use soft tooth brush
- look for changes in color in stool |
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DMAR’s causes pancytopenia. What is Pancytopenia?
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DMAR’s causes pancytopenia (a reduction of cellular components of the blood)
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What is the normal RBC’s count?
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normal RBC’s count is 3.5-5 million
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muscle relaxants chief side-effect?
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- drowsiness, do not have pt drive
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what common side-effect should you monitor when giving morphine?
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- respiratory depression
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What are common adverse-effects from methotrexate (Rheumatrex)?
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- mouth sores
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What is methotrexate (Rheumatrex) commonly used for?
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methotrexate (Rheumatrex) commonly used for rheumatoid arthritis
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What kind of drug is probenecid (Benemid)?
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- used for recurrent attacks of gout
- need to monitor uric acid levels to know if medication is being effective |
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Would you question an order for motrin given to a p with a history of stomach ulcers?
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Yes!
- mortin should NEVER be given to a pt with history of stomach ulcers |
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How much water should a pt taking DMAR drink?
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DMAR’s needs to have at least 2-3 liters of water
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gluco-cortico, which of the following are true statements:
- must taper medications not stop it abruptly - take medication regularly don’t skip doses - notify doctor if develop round face or feel thirsty all the time |
They are all true statements
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a pt taking Methotrexate developed a fever, what would you have the pt do?
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- see doctor cause may be infection need to prescribe an anti-biotic
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how should a narcotic be administered or ordered?
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- around the clock
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What drugs do you NOT mix with NSAIDS?
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- with other NSAIDS like aspirin or Tylenol
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pt is on a anticoagulant, aspirin needs to be avoided
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pt is on a anticoagulant, aspirin needs to be avoided
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pt is taking aspirins 4x’s a day for arthritis and experiences tinnitus what should pt do?
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- stop taking it
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what is calcitonin used for ?
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- osteoporosis
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How do you give fosamax?
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- first thing in the morning before any other drug, with water, sit up right, wait 30 minutes before doing anything else
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pt had surgery for hip fracture and was medicated 45 min ago, but still is in a lot of pain, what nursing intervention should you do?
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- reposition him
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give medication how long before starting any painful procedure?
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give medication 30 min before starting any painful procedure
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what kind of drug is parafonforte?
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- corticosteroid and muscle relaxant
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what kind of drug is actonel?
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- biphosphonate
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What do skeletal muscle relaxants do?
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- stop muscle spasms
- improve tone - improve movement/ROM - reduce pain |
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allopurinol, you check uric acid levels for effectiveness
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allopurinol, you check uric acid levels for effectiveness
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mom comes in with 8yr old pt that is prescribed pediapred (glucosteroid), and another with the flu. what does she do?
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- keep them apart and have them wear a mask? b/c drug suppresses the immune system
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your pt is diagnosed with acute rheumatoid arthritis, give high doses of cortico steroids, pt says i don't think im going to take that med today, what do you tell her?
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- ask her why she does, persuade them to take it, and don't let them get away with it
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plaquinel for rheumatoid arthritis and has long term therapy, what side effects to monitor?
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- visual problems
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when should pt ask for med for pain?
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onset or when it first starts
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What do you do if a pt has pain (higher than a 5 on pain scale) and it has been over 30 min after med was administered?
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pain med after administered should be less than a 5, if higher, notify MD and reassess
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MD order 400mg, you have 200mg tablets. how many do you give?
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2
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Which patient if you are going to give them an Opioid (morphine) which is likely to develop confusion?
- older patients -answer: 72 yr old female with broke leg |
- older patients
-answer: 72 yr old female with broke leg |
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how does aspirin work?
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anti-inflammatory
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when pt is on predinisone for rheumatoid arthritis or osteoarthritis, what are you going to monitor? WBC or RBC
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- rbc because predinisone causes bleeding
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you have an adult client with rheumatoid arthritis, which statement by the pt is true?
answer: - i should take it everyday to control my joint inflammation |
- i should take it everyday to control my joint inflammation
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pt has started aspirin therapy, and experiencing a lot of epigastric distress, what should you tell them?
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- take drug with food and full glass of water
- take drug in the morning instead of evening - sit upright to help avoid GI upset |
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pt has acute gout, they are taking Allopurinol and colchicine twice a day to prevent recurrence, what would the most common early sign of colchicine toxicity that you may see?
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- diarrhea
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your pt tells you they usually take ibuprofen/mortin 4x’s a day, what are the side effects of NSAIDS?
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-upset stomach, nausea vomiting
-GI bleeding, need to ask pt what color are their stools |
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why do you need to stop taking aspirin one week before surgery (any kind of surgery)?
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- it’s an anticoagulant, thins out the blood
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pt. is taking colchicines for acute gout and start vomiting, what should you do?
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- ask pt. to stop taking it even pt. is still having pain
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S/S of long term steroid therapy?
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- Moon face
- Dowager’s hump - Edema (fluid retention) - Immunosuppressant need to concern about infection - Increase bleeding develop bruising under skin |
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S/S Vicodin?
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- is narcotic analgesic
- do not drive or operate heavy machinery - Nausea, vomiting, constipation (most common) |
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Side effect of narcotic analgesic (being agonist)?
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- Respiratory depression
- Hypotension - Constipation, nausea and vomiting - has no effect on blood sugar |
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What is Naloxone (Narcan)?
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- is opioid antagonist
- is capable of restoring respiratory function within 1-2 minutes - short term use for ppl accidentally over dose |
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Drug that use for narcotic addiction or for detoxification?
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- Naltrexone
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What do u treat a pt. with narcotic addition and also overdose?
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- treat with Narcan (Naloxone) cautiously and giving it very slowly to avoid withdrawal
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What is the antidote for Tylenol poisoning?
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- Mucomyst (acetylcysteine) to prevent liver damage
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What blood test do you use to monitor the liver?
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- AST/ALT
- aspartate aminotransferase (AST) - alanine aminotransferase (ALT) |
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in giving morphine to pt., what do you need to monitor?
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- Respiratory
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gr = ? mg
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gr = 60mg (65)
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What are the side effects of colchicines?
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- Severe nausea
- vomiting - Bone marrow damage (FYI: Colchicines is used to ward off gout because of its anti-inflammatory value) |
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What advice do give to pt. with GI upset when administering colchicines?
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- sit pt. upright and give med. with a full glass of water
- take med. with food |
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What do you need to know before administer Opioid Analgesic to a child?
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- Age
- High - Weight - Respiratory status |
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What kink of drug is Actonel?
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- is Bisphosphonate
- use to strengthen bone - treat or prevent bond loss (osteoporosis) (FYI: Bisphosphonates, including Actonel, may cause upper gastrointestinal disorders such as dysphagia, esophagitis and esophageal or gastric ulcers.) |
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Bicarbonate ion
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HCO3-
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Common adverse effect of taking ‘gold salts’?
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- is DMARDs (Disease Modifying Anti-Rheumatic Drugs)
- use to reduce inflammation in rheumatoid arthritis - Common adverse effect is metallic taste in mouth; notify doctor - Common side effects: decrease appetite, nausea, hair thinning, diarrhea |
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Most common side effect of muscle relaxing drugs?
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- Vision changes (double or blurred vision)
- Dizziness - Light headedness - Drowsiness - Dry mouth |
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What pt. need to do when taking med. for gout to get rid of uric acid?
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- taking med. with copious amount of water (2-3 litter per day)
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Drugs for acute gout?
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- Colchicines: for treating acute gout
- Allopurinol: prevent acute gout (decrease production of uric acid) |
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High dose of aspirin is taking (625mg), what is the side effect?
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- GI bleeding (bright red blood in stool)
- Gastric upset - Tinnitus |
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FYI: Tinnitus may lead to deafness… stop taking medication
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FYI: Tinnitus may lead to deafness… stop taking medication
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What should you check for with GI bleeding?
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- check the color of stool (bright red blood) or dark tarry color for upper GI Bleeding
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what type of drug is Toradol (ketorolac)?
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- is an NSAIDs for moderate pain
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What is a Contraindication of NSAIDs?
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Contraindication of NSAIDs is peptic ulcer (duodenal ulcer)
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Major rationale for using aspirin for RA?
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- is anti-inflammatory drug
- reduce inflammation of the joint |
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Normal dose of aspirin should not interfere with?
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- should not interfere with the liver unless over dose
- interfere with platelet aggregation - promote bleeding |
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Which Opioid is available as Transdermal patch?
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- Fentanyl is a Transdermal patch
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How is Humira administered?
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- subQ
(FYI: Humira is given by subcutaneous (under the skin) self-injection once every two weeks.) |
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How does Probenecid work?
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- treat acute gout
- increase uric acid secretion |
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pt. on med. and develop rash, what can you tell the pt.?
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- it is a sign of allergic reaction, call doctor
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what kind of drug is soma?
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- Muscle relaxer
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What do you assess if given Dilaudid (pain reliever) to pt.?
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- Pain level
(FYI: Dilaudid, a narcotic analgesic) |
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What Opioid analgesic frequently added to Antitussive for coughing?
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- Codeine
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pt. on colchicines and having SE of nausea, vomiting, diarrhea and abdominal pain what would you have pt. do?
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- stop med. and come in to see doctor
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Contraindication of imitrex?
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- Coronary artery disease (CAD)
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Primary action of prednisone?
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- Anti-inflammatory
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Which of the following med. could cause immunosuppressiveness?
- Prednisone - Cyclosporine - methotrexaste - darvon |
Which of the following med. could cause immunosuppressive
- Prednisone yes - Cyclosporine yes - methotrexaste yes - darvon no |
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S/S of bone marrow suppression?
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- fever
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what instruction should you give to pt. that is on methotrexate (DMARDs)?
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- use soft tooth brush
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What is the norm blood count range for:
- RBC = ? - WBC = ? |
- RBC = 3.5 – 5 mil. cells per mL
- WBC = 8000 - 10000 |
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most common and alarming S/E of morphine (opioid)?
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- respiratory depression
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adverse effects of methotrexate?
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- mouth sores
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pt. with back pain and history of ulcer, doctor prescribed NSAIDs, would you question the order?
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- yes (contraindication of NSAIDs is ulcer)
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how would you educate pt. on morphine?
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- take med. around the clock
- take at very onset of pain - take stool softener - take med. when pain scale is 5 or above teach pt. how to use the pain scale - get assistance when get out of bed |
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pt. on sulfasalazine (Sulfazine) (DMARDs - containing sulfa), what blood test do we monitor?
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- creatinine blood test
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How much fluid should u encourage a pt on sulfa drug drink?
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for sulfa drug, we need to encourage fluid from 2 – 3 litter a day
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pt. with RA is on Imuran (immunosuppressive), complain about fever, sore throat and chill, what should you do about the Imuran?
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- it is a sign of infection hold the imuran and notify doctor
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pt. on glucose corticoid like prednisone, how do you wean pt. off the drug?
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- taper it down
- do not skip doses - notify doctor when have moon face and thirsty |
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pt. on methotrexate for RA and have temperature of 100.8 F, what should you tell him to do?
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- go see doctor for antibiotic due to infection
- hold the next dose |
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what order should you question for RA?
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- vicodin PRN because we don’t order vicodin PRN unless it has the frequency (bid, tid, qid…)
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cumadin should or should not be taken with aspirin? Tylenol?
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cumadin should not take with aspirin (acetaminophen – Tylenol is OK)
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FYI: motrin (NSAIDs)
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FYI: motrin (NSAIDs)
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what kind of drug calcitonin or calcimar?
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- for osteoporosis
- add calcium to bones |
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pt. with hip Fx complain about pain after 30 of medicated, what kind of action should you take?
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- reposition pt.
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what should you do before changing dressing or any painful procedure on a pt.?
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- medicate pt. 30 min. before the procedure
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alternative for numeric pain scale?
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- facial scale
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nursing instruction for PCA (patient controlled analgesia) pumps?
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- give pt. power of control their pain
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pt. with abnormal size of swelling or echymosis, what should you ask the pt.?
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- if pt. is taking aspirin
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what kind of drug is parafon forte?
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- is corticosteroid and muscle relaxer
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pt. has flu system since started the med., what can you tell the pt.
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- go see doctor
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what kind of drug is actonel?
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- biphosphonate
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rationale for high doses of glucose corticoid (cortisone) for pt. with RA
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- it is anti-inflammatory
- reduce inflammation of the joint - prevent further muscle damage |
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pt. is on med. for RA and has epigastric pain, what should you ask pt.?
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- what color of her stool
- if she take med. with food - what time of a day pt. is taking the med. (morning or night) |
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What is the action of skeletal muscle relaxants?
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- decrease muscle spasm
- increase muscle tone - relieve pain |
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Why should a pt on prednisone be isolated?
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ppl on prednisone should be isolated from others because they are immunosuppressed
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how often should cortico steroid be given?
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- on regular schedule with meal to prevent GI upset
- drink lots of fluid |
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what kind of drug is plaquenil?
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- is use for RA
- S/E = visual problem - To comply, pt. should have eye exam every 6 months |
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what kind of assessment before pt. taking DMARDs (immunosuppressive) drug?
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- temperature
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when should pt. take med. for pain?
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- Onset of the pain
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how do you know if pain medication is effective?
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- ask pt. what level of the pain base on the pain scale, pain level should go down
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what kind of drug is vicodin?
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- narcotic
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S/E of narcotic
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- constipation
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question to ask before given imitrex
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- if pt. is pregnant
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S/E of prednisone?
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- Hyperglycemia (high blood sugar)
- Immonusuppressive (result of infection) - cause weight gain bc of the fluid - edema fluid retension |
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pt. most likely develop confusion after taking opioid (morphine)
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- older pt. (answer: 72 yr old female with broken leg)
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pt. is on prednisone (corticosteroid), what lab test do you want to monitor
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- RBC
- WBC - Platelets |
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what statement is true about ibuprofen effective?
- pt. take motrin everyday to control joint inflammation - pt. take motrin if temperature is 100 or higher - take motrin for muscle spasm |
- pt. take Motrin everyday to control joint inflammation? - Yes. Ibuprofen (Advil, Motrin, Nuprin) are non-steroidal anti-inflammatory drugs.
- pt. take Motrin if temperature is 100 or higher? - yes, but pt should contact primary care physician if fever persists for over 3 days. If therapy began with fever, pt should contact dr if fever persists over 24 hours. - take Motrin for muscle spasm? No |
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Pt is perfect. No imperfections, what is her name?
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ATUSA ....Ha! I bet u got this one right
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