Medical-Surgical Nursing, 10th Ed., Ignatavicius & Workman, 2020 | Registered Nurse (RN) School Study Aid
Pain Assessment
- Acute Pain
- Chronic Pain
- Onset
- Provoking or Palliative
- Quality
- Radiation
- Severity
- Timing
- Subjective Findings
- Objective Findings
- Reassessment of Pain
Delirium
- Rapid Onset
- Reversible
- Hallucinations
- Decline in Cognition
- Short Attention Span
- Rapid Speech
- Change in Activity Level
- Mood Swings
Acetaminophen
- Fever
- Pain
- Reversibly Inhibits COX
- Acts Primarily in CNS
- Hepatic Necrosis
- N-acetylcysteine Antidote
NSAIDs
- Anti-inflammatory
- Analgesic
- Fever
- Closure of Patent Ductus Arteriosus
- Reversible Inhibition of COX-1 and COX-2
- Block Prostaglandin Synthesis
- Interstitial Nephritis
- Gastric Ulcer
- Renal Ischemia
Ibuprofen (Advil, Motrin)
- NSAID
- COX Inhibitor
- General Pain
- Fever
- Inflammatory Conditions
- GI Ulcers
- Nephrotoxicity
- Rash
- Avoid with Alcohol
- Risk of Thrombotic Event
Celecoxib
- Rheumatoid Arthritis
- Osteoarthritis
- Pain
- NSAID
- Selectively Inhibits COX-2
- Sulfa Allergy
- Increased Risk of Thrombosis
- GI Bleed
- Pregnancy > 30 Weeks
P450 Inhibitors
- Quinidine
- Ciprofloxacin
- Isoniazid
- Grapefruit Juice
- Acute Alcohol Use
- Erythromycin (Macrolide)
- Indinavir
- Cimetidine
- Sulfonamides
- Ketoconazole
- Amiodarone
P450 Inducer
- Griseofulvin
- Phenytoin
- Carbamazepine
- Rifampin
- Barbiturates
- Chronic Alcohol Use
- St. John's Wort
Morphine
- Opioid Receptor Agonist
- Pain
- Myocardial Infarction
- Nausea and Vomiting
- CNS Depression
- Biliary Colic
- Constipation
- Increased Intracranial Pressure (ICP)
- Pupillary Constriction
- Hypotension
Butorphanol
- Migraine
- Severe Pain
- Labor
- Partial Agonist at Mu and Full Agonist at Kappa Receptors
- Less Respiratory Depression
- Withdrawal Symptoms
Naloxone (Narcan)
- Competitive Opioid Receptor Antagonist
- Opioid Induced CNS Depression
- Severe Nausea and Vomiting
- Excitable State
- Opioid Withdrawal Symptoms
- Repeated Dosing Often Required
Opioid Use Disorder and Withdrawal Assessment (Formerly Opioid Abuse and Withdrawal Assessment)
- Euphoria
- Miosis
- CNS Depression
- Yawning
- Gooseflesh
- Sweating
- Rhinorrhea
- Kicking Movements
- Naloxone
Tramadol
- Chronic Pain
- Weak Opioid
- Inhibit Serotonin and NE reuptake
- Increased Risk of Seizure
Meperidine (Demerol)
- Opioid Receptor Agonist
- Moderate to Severe Pain
- Post Anesthesia Shivering
- Tremors
- Constipation
- CNS Depression
- Sedation
- Short Term Administration
- Increased Risk Serotonin Syndrome
- Does NOT cause Miosis
- Renal Failure Increases Toxicity Risk
Codeine
- Opioid Receptor Agonist
- Mild to Moderate Pain
- Cough Suppressant
- Sedation
- Constipation
- Miosis
- Close Monitoring When Breast Feeding
- Often Combined with Non-Opioids
Diazepam (Valium)
- Anxiety
- Seizures and Status Epilepticus
- Muscle Spasms
- Alcohol Withdrawal
- Dizziness/Vision Changes
- Confusion/Amnesia
- Urinary Incontinence
- Behavioral Changes
- Respiratory Depression
- Flumazenil (Romazicon)
- Fall Precaution
- Do Not Stop Abruptly
Benzodiazepine Intoxication Assessment
- Drowsiness
- Confusion
- Respiratory Depression
- Hypotension
- Coma
- Flumazenil (Romazicon)
Promethazine (Phenergan)
- Histamine H1 Receptor Antagonist
- Weak Dopamine Antagonist
- Nausea and Vomiting
- Motion Sickness
- Respiratory Depression
- Sedation
- Anticholinergic Effects
- Extrapyramidal Symptoms
- Use Large Bore IV
- Monitor for Tissue Necrosis
Gabapentin
- Seizure Treatment
- Peripheral Neuropathy
- Postherpetic Neuralgia
- Bipolar Disorder
- Migraine Prophylaxis
- Inhibits Voltage-Gated Ca2+ channels
- GABA Analog
- Ataxia
- Sedation
Pregabalin (Lyrica)
- GABA Analog
- Seizures
- Neuropathic Pain
- Fibromyalgia
- Headache
- Dizziness
- Somnolence (Fatigue)
- Weight Gain
- Angioedema
- Rhabdomyolysis
- Dependence
Tricyclic Antidepressants (TCAs)
- Inhibits Reuptake of Norepinephrine and Serotonin
- Depression
- Bipolar Disorder
- Fibromyalgia
- Sedation
- Orthostatic Hypotension
- Anticholinergic Effects
- Cardiac Toxicity
- Delayed Effect
- Do Not Stop Abruptly
Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
- Depression
- Diabetic Peripheral Neuropathy
- Duloxetine
- Panic and Anxiety
- Venlafaxine
- Inhibits Reuptake of Serotonin and NE
- Hypertension
- Insomnia
- Nausea and Vomiting
- Decreased Libido
Lidocaine
- Blocks Na+ Channels
- Ventricular Arrhythmia
- Anesthetic
- Paresthesias
- Seizures
- Respiratory Depression
- Drowsiness
- Anesthetic Effects Extended with Epinephrine
Transdermal Medication Administration
- Patch or Disc
- Directly on Skin of Arms, Chest, Upper Back
- Avoids First Pass Metabolism
- Sustained Administration of Medication
- Clean Skin After Removal
- Rotate Sites of Patches
- Apply to Dry Skin
- Avoid Shaved Skin
- Avoid Heat
- Nitro Effects Lost After 24 Hours