Chapter 10: Analgesics Test, Acetaminophen, Pharmacology for Nurses: Practical Applications
The key terms in this Pharmacology course include Analgesics Test, Acetaminophen (Tylenol) Overdose, Patient, Nurse, Pain, Pharmacology, Morphine, Drug, Acetylcysteine (Mucomyst), Opioid Addiction, Methadone (Dolophine), Pharmacologic Management, Dosage, adverse effects, Morphine Sulfate (MS Contin), Acetaminophen, Block, Pharmacology.
While admitting a patient for treatment of an acetaminophen (Tylenol) overdose, the nurse prepares to administer which medication to prevent toxicity?
Phytonadione (vitamin K)
Acetylcysteine is the antidote for acetaminophen overdose. It must be administered as a loading dose followed by subsequent doses every 4 hours for 17 additional doses and started as soon as possible after the acetaminophen ingestion (ideally within 12 hours).
The nurse is caring for a patient with opioid addiction. The nurse anticipates that the patient will be prescribed which medication?
Morphine (MS Contin)
Methadone is a synthetic opioid analgesic with gentler withdrawal symptoms and is the drug of choice for detoxification treatment.
The nurse plans pharmacologic management for a patient with pain. The nurse would administer the pain medication based on what dosage schedule?
Opioid analgesics should not be used for more than 24 hours to prevent drug addiction.
Pain relief is best obtained by administering analgesics around the clock.
Analgesics should be administered as needed (prn) to minimize adverse effects.
Administer the analgesic when the pain level reaches a “6” on a scale of 1 to 10.
When pain is present for more than 12 hours a day, analgesic dosages are best administered around the clock rather than on an as-needed basis, but dosages should always be within the dosage guidelines for each drug used. The around-the-clock (or “scheduled”) dosing maintains steady-state levels of the medication and prevents drug troughs and escalation of pain.
In monitoring a patient for adverse effects related to morphine sulfate (MS Contin), the nurse assesses for stimulation of which area in the central nervous system (CNS)?
The chemoreceptor trigger zone
Autonomic control over circulation
The cough reflex center
Morphine sulfate can irritate the gastrointestinal (GI) tract, causing stimulation of the chemoreceptor trigger zone in the brain, which in turn causes nausea and vomiting.
In developing a plan of care for a patient receiving morphine sulfate (MS Contin), which nursing diagnosis has the highest priority?
Constipation related to decreased GI motility
Risk for injury related to CNS adverse effects
Acute pain related to metastatic tumor cancer
Impaired gas exchange related to respiratory depression
Using Maslow’s hierarchy of needs and the ABCs of prioritization, impaired gas exchange is a priority over pain, constipation, and a risk for injury. If a patient cannot oxygenate sufficiently, all of the other problems will not matter because the patient will not live to worry about them.