Acetylcysteine – Pharmacology for Nurses: Practical Apps

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Chapter 10: Analgesics Test, Acetylcysteine , Pharmacology for Nurses: Practical Applications

The key terms in this Pharmacology course include Analgesics Test, Acetylcysteine (Mucomyst), Acetaminophen (Tylenol) Overdose, Herbal Therapies, Menstrual Cramps, Herb FeverFew, Opioid Overdose, Respiration Rate, Nalbuphine (Nubain), End-Stage Breast Cancer, Transdermal Opioid Analgesic, Nurse, Pain, Patient, Block, Pharmacology for Nurses: Practical Applications.


A patient is to receive acetylcysteine (Mucomyst) as part of the treatment for an acetaminophen (Tylenol) overdose. Which action by the nurse is appropriate when giving this medication?

Avoiding the use of a straw when giving this medication

Disguising the flavor with soda or flavored water

Preparing to give this medication via a nebulizer

Giving the medication undiluted for full effect

Acetylcysteine has the flavor of rotten eggs and so is better tolerated if it is diluted and disguised by mixing with a drink such as cola or flavored water to help increase its palatability. The use of a straw helps to minimize contact with the mucous membranes of the mouth and is recommended. The nebulizer form of this medication is used for certain types of pneumonia, not for acetaminophen overdose.


The nurse is reviewing herbal therapies. Which is a common use of the herb fever-few?

Joint pain

Incision pain after surgery

Muscle aches

Menstrual cramps

Feverfew is commonly used for migraine headaches, menstrual problems, arthritis, and fever. Possible adverse effects include muscle stiffness and muscle and joint pain.


The nurse is assessing a patient who has been admitted to the emergency department for a possible opioid overdose. Which assessment finding is characteristic of an opioid drug overdose?

Respiration rate of 6 breaths/min

Heart rate of 55 beats/min

Restlessness

Dilated pupils

The most serious adverse effect of opioid use is CNS depression, which may lead to respiratory depression. Pinpoint pupils, not dilated pupils, are seen. Restlessness and a heart rate of 55 beats/min are not indications of an opioid overdose.


The drug nalbuphine (Nubain) is an agonist-antagonist (partial agonist). The nurse understands that which is a characteristic of partial agonists?

They are given to reverse the effects of opiates.

They have anti-inflammatory effects.

They have a lower dependency potential than agonists.

They have a higher potency than agonists.

Partial agonists such as nalbuphine are similar to the opioid agonists in terms of their therapeutic indications; however, they have a lower risk of misuse and addiction. They do not have anti-inflammatory effects, nor are they given to reverse the effects of opiates. They do not have a higher potency than agonists.


A 57-year-old woman being treated for end-stage breast cancer has been using a transdermal opioid analgesic as part of the management of pain. Lately, she has been experiencing breakthrough pain. The nurse expects this type of pain to be managed by which of these interventions?

Administering an immediate-release opioid

Changing the opioid route to the rectal route

Making no changes to the current therapy

Administering NSAIDs

If a patient is taking long-acting opioid analgesics, breakthrough pain must be treated with an immediate-release dosage form that is given between scheduled doses of the long-acting opioid. The other options are not appropriate actions.


A 16-year-old field hockey player fell and twisted her ankle during a game. The nurse will expect to administer which type of analgesic?

Opioid antagonist, such as naloxone HCL (Narcan)

Synthetic opioid, such as meperidine (Demerol)

Opium alkaloid, such as morphine sulfate

Nonopioid analgesics, such as indomethacin (Indocin)

Somatic pain, which originates from skeletal muscles, ligaments, and joints, usually responds to nonopioid analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs). The other options are not the best choices for somatic pain.


A patient arrives at the urgent care center complaining of leg pain after a fall when rock climbing. The radiographs show no broken bones, but he has a large bruise on his thigh. The patient says he drives a truck and does not want to take anything strong because he needs to stay awake. Which statement by the nurse is most appropriate?

“We will discuss with your doctor about taking an opioid because that would work best for your pain.”

“You can take acetaminophen, also known as Tylenol, for pain, but no more than 1000 mg per day.”

“You can take acetaminophen, also known as Tylenol, for pain, but no more than 3000 mg/day.”

“It would be best for you not to take anything if you are planning to drive your truck.”

Acetaminophen is indicated for mild-to-moderate pain and does not cause drowsiness, as an opioid would. Currently, the maximum daily amount of acetaminophen is 3000 mg/day. The 1000-mg amount per day is too low. Telling the patient not to take any pain medications is incorrect.