p.15
Fibromyalgia Characteristics and Treatment
Which body parts are affected by fibromyalgia?
Joints, muscles, tendons, and surrounding tissues.
p.7
Inflammatory Response Mechanisms
What is a common symptom of inflammatory disorders?
Pain and swelling in the affected area.
p.17
Fibromyalgia Characteristics and Treatment
What factors can influence the clinical manifestations of fibromyalgia?
Weather, stress, fatigue, physical activity, and time of day.
p.20
Adverse Effects of Pain Medications
What are some contraindications for using salicylates?
Allergy to the drug or NSAIDs, bleeding abnormalities, impaired renal function, chickenpox or flu, pregnancy/lactation, and GI ulcers.
p.20
Nursing Interventions for Pain Management
Why should salicylates be taken with food?
To minimize gastrointestinal irritation.
p.3
Inflammatory Response Mechanisms
What role do white blood cells play in inflammation?
They help to fight infection and initiate the healing process.
What is a common clinical manifestation of osteoarthritis?
Joint pain and tenderness.
p.24
Adverse Effects of Pain Medications
What serious condition can acetaminophen cause?
Liver failure/dysfunction.
p.24
Nursing Interventions for Pain Management
What should be monitored when administering acetaminophen?
Pain, temperature, and liver function tests (ALT, AST).
p.44
Opioid and Non-Opioid Analgesics
How do opioid antagonists work on opioid receptors?
They act as antagonists on mu receptors and agonists on kappa receptors.
What are Bouchard’s nodes?
Bony growths that occur on the proximal joints of the fingers in osteoarthritis.
p.35
Pain Classification and Types
What are the five types of receptors in the human body?
Mechanoreceptors, Chemoreceptors, Thermoreceptors, Photoreceptors, Nociceptors.
p.7
Inflammatory Response Mechanisms
What are inflammatory disorders?
Conditions characterized by inflammation in the body, often resulting in pain, swelling, and redness.
p.47
Pain Classification and Types
What is the primary function of local anesthetics?
To relieve pain in a localized area.
p.44
Opioid and Non-Opioid Analgesics
What is the primary function of opioid antagonists?
To interfere with opioid effects by competing for opioid receptors.
What are Heberden’s nodes?
Bony growths that develop on the distal joints of the fingers in osteoarthritis.
p.6
Inflammatory Response Mechanisms
What is edema in relation to inflammation?
Swelling caused by excess fluid in tissues.
How does osteoarthritis affect walking?
It can lead to an altered gait.
p.17
Fibromyalgia Characteristics and Treatment
What are common symptoms associated with fibromyalgia?
Fatigue, sleep disturbances, depression, irritable bowel syndrome, headaches, and memory problems.
p.15
Fibromyalgia Characteristics and Treatment
Is there any apparent inflammation or degeneration in fibromyalgia?
No apparent inflammation or degeneration is noted.
p.37
Opioid and Non-Opioid Analgesics
What are the two main categories of pain medications?
Opioid and Non-Opioid analgesics.
What characterizes the course of rheumatoid arthritis?
Exacerbations and remissions.
p.3
Inflammatory Response Mechanisms
How does chronic inflammation differ from acute inflammation?
Chronic inflammation lasts for a longer period and can lead to tissue damage, while acute inflammation is a short-term response.
p.4
Inflammatory Response Mechanisms
What are some mediators involved in the inflammatory response?
Histamines and prostaglandins.
p.35
Pain Classification and Types
Where are pain receptors located?
In the skin, bones, and internal organs.
p.24
Adverse Effects of Pain Medications
What are some contraindications for acetaminophen?
Allergy to the drug, hepatic dysfunction, chronic alcoholism.
p.25
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
When is gold compound therapy used?
Only in clients unresponsive to conventional therapy due to risk of toxicity.
p.19
Anti-Inflammatory Medications
How do salicylates work?
They inhibit the synthesis of prostaglandins and platelet aggregation.
What happens to the joints in osteoarthritis?
The joints become inflamed.
What is synovitis in the context of rheumatoid arthritis?
Inflammation of the synovial membrane.
p.36
Pain Classification and Types
What is pain tolerance?
How much pain a person can tolerate.
p.28
Adverse Effects of Pain Medications
What is a significant black box warning associated with Tumor Necrosis Factor Blockers?
Fatal infections and lymphoma/leukemia development.
What is ankylosis in rheumatoid arthritis?
Joint fixation and deformity.
How does obesity relate to osteoarthritis?
Obesity is a risk factor for developing osteoarthritis.
p.6
Inflammatory Response Mechanisms
What are the clinical manifestations of an inflammatory response?
Pain, redness (erythema), swelling (edema), and heat.
p.15
Fibromyalgia Characteristics and Treatment
What are the primary symptoms of fibromyalgia?
Widespread muscular pains and fatigue.
p.4
Inflammatory Response Mechanisms
What types of myelocytes are involved in the inflammatory response?
Neutrophils, basophils, eosinophils, and monocytes/macrophages.
p.12
Gout and Its Management
What is the primary cause of gout?
Recurrent joint inflammation caused by hyperuricemia.
p.15
Fibromyalgia Characteristics and Treatment
What is believed to be the cause of fibromyalgia?
An altered pattern of central neurotransmission resulting in sensitivity to substance P.
p.7
Inflammatory Response Mechanisms
What are some common inflammatory disorders?
Examples include rheumatoid arthritis, lupus, and inflammatory bowel disease.
p.23
Opioid and Non-Opioid Analgesics
What is known about the analgesic effects of acetaminophen?
The action related to its analgesic effects is not well understood.
p.16
Fibromyalgia Characteristics and Treatment
What is the effect of fibromyalgia on pain threshold?
It leads to a lowered pain threshold.
p.46
Pain Classification and Types
What is the role of antihistamines like hydroxyzine in pain management?
They decrease anxiety, prevent insomnia, and relieve nausea/vomiting.
How does trauma affect the risk of osteoarthritis?
Trauma to joints increases the risk of developing osteoarthritis.
p.26
Adverse Effects of Pain Medications
What allergic reaction can occur with gold compounds?
An allergic reaction can occur.
Is osteoarthritis more common in men or women?
It occurs equally in men and women.
p.29
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
How do DMARDs work in treating rheumatoid arthritis (RA)?
They block increased interleukin-1, which degrades cartilage.
p.37
Nursing Interventions for Pain Management
What is the importance of monitoring patients on opioid medications?
To prevent misuse and manage side effects.
p.26
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What are some health conditions that contraindicate the use of gold compounds?
Severe diabetes mellitus, heart failure, renal or hepatic impairment, hypertension, blood dyscrasias, recent radiation therapy.
p.3
Inflammatory Response Mechanisms
What is inflammation?
A biological response to harmful stimuli, such as pathogens, damaged cells, or irritants.
p.17
Fibromyalgia Characteristics and Treatment
What type of pain is commonly experienced in fibromyalgia?
Widespread pain, often described as a constant dull muscle ache.
p.15
Fibromyalgia Characteristics and Treatment
How many trigger points have been identified in fibromyalgia?
18 trigger points throughout the body.
What type of condition is rheumatoid arthritis?
A systemic autoimmune condition.
p.43
Pain Classification and Types
What are analgesics?
Medications used to relieve pain.
p.46
Pain Classification and Types
What is the purpose of adjuvant therapy for pain?
To alleviate pain in addition to opioids.
p.43
Opioid and Non-Opioid Analgesics
What is the difference between opioid and non-opioid analgesics?
Opioid analgesics are derived from opium and are typically stronger, while non-opioid analgesics include medications like acetaminophen and NSAIDs.
p.36
Pain Classification and Types
What is pain threshold?
The perception of pain and the level at which it is sensed.
p.31
Anti-Inflammatory Medications
How do corticosteroids work?
They depress inflammatory and infectious/immune responses.
p.43
Pain Classification and Types
What is the mechanism of action for NSAIDs?
They inhibit the enzyme cyclooxygenase (COX), reducing the production of prostaglandins that cause inflammation and pain.
p.47
Nursing Interventions for Pain Management
What are some contraindications for using local anesthetics?
SVT or AV blocks, and caution in women in labor, liver and kidney disease, heart failure, and myasthenia gravis.
p.46
Pain Classification and Types
What conditions can glucocorticoids like prednisone help with?
They improve appetite and decrease pain from intracranial pressure, spinal cord compression, and rheumatoid arthritis.
p.37
Opioid and Non-Opioid Analgesics
How do non-opioid analgesics typically work?
By inhibiting the production of prostaglandins.
p.46
Pain Classification and Types
What types of pain do NSAIDs like ketorolac and ibuprofen treat?
Inflammation, fever, and mild to moderate pain.
p.36
Pain Classification and Types
What is neuropathic pain?
Pain from damage to peripheral nerves through disease or injury.
p.41
Opioid and Non-Opioid Analgesics
What is a key advantage of agonist-antagonist opioids?
They are less likely to have side effects and have a low potential for abuse.
p.14
Gout and Its Management
What symptoms accompany joint pain in gout?
Joint swelling and erythema.
p.3
Inflammatory Response Mechanisms
What are the main signs of inflammation?
Redness, heat, swelling, pain, and loss of function.
p.5
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What is the Kinen System?
A system referenced in the Karch textbook, specifically on page 261.
p.6
Inflammatory Response Mechanisms
What causes heat in the area of inflammation?
Increased blood flow to the affected area.
p.6
Inflammatory Response Mechanisms
What role does pain play in the inflammatory response?
It serves as a warning signal to the body.
p.35
Pain Classification and Types
What is the role of pain in the human body?
It serves as a protective mechanism (warning system).
p.7
Inflammatory Response Mechanisms
Can inflammatory disorders affect multiple systems in the body?
Yes, they can impact various systems, including joints, skin, and organs.
p.22
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What are the indications for using NSAIDs?
Mild to moderate pain, rheumatoid arthritis (RA), osteoarthritis (OA), primary dysmenorrhea, fever reduction.
p.47
Adverse Effects of Pain Medications
What are some adverse effects of local anesthetics?
CNS excitation, hypotension, cardiosuppression, allergic reactions, spinal headache, and urinary retention.
What is a major risk factor for developing osteoarthritis?
Age, particularly being older than 40.
p.36
Pain Classification and Types
What is the difference between somatic pain and visceral pain?
Somatic pain originates from skin, muscles, and joints, while visceral pain comes from internal organs.
What types of arthritis are discussed in relation to pain and inflammation?
Osteoarthritis, rheumatoid arthritis, gout, and fibromyalgia.
p.36
Pain Classification and Types
What is intractable pain?
Chronically progressing pain that is unrelenting and debilitating.
p.30
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What conditions are DMARDs indicated for?
Rheumatoid arthritis and other types of arthritis.
p.42
Adverse Effects of Pain Medications
What is a common adverse effect of agonist-antagonist opioids?
Sedation and respiratory depression.
p.31
Nursing Interventions for Pain Management
What should be monitored while a patient is on corticosteroids?
Blood sugar and CBC (Complete Blood Count).
p.42
Nursing Interventions for Pain Management
What safety measures should be taken when using agonist-antagonist opioids?
Have naloxone and emergency equipment nearby, and do not operate heavy machinery.
p.20
Nursing Interventions for Pain Management
What should be monitored when a patient is taking salicylates?
Pain and temperature, CNS status, vital signs (HR, BP), and CBC.
p.4
Inflammatory Response Mechanisms
Which cells are activated in the immune system during inflammation?
Lymphocytes, including T cells, B cells, and NK cells.
p.24
Pain Classification and Types
What are the indications for using acetaminophen?
Mild to moderate pain, fever, cold, and sinus symptoms.
p.16
Fibromyalgia Characteristics and Treatment
What is enhanced in fibromyalgia that affects pain perception?
Temporal summation of second pain.
p.16
Fibromyalgia Characteristics and Treatment
What type of pain is commonly experienced in fibromyalgia?
Delayed, longer-lasting pain.
p.47
Pain Classification and Types
How do local anesthetics work?
They block the conduction of pain impulses in a localized area.
p.25
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What are the pharmacokinetics of gold compounds?
They have varying absorption rates and are excreted in urine and feces.
p.43
Opioid and Non-Opioid Analgesics
What are some common non-opioid analgesics?
Acetaminophen, ibuprofen, and aspirin.
What is pannus formation?
Granulation tissue that forms in rheumatoid arthritis.
p.37
Opioid and Non-Opioid Analgesics
What is the role of non-opioid analgesics in pain management?
To treat mild to moderate pain and reduce inflammation.
p.38
Pain Classification and Types
Can opioid analgesics be used for chronic pain management?
Yes, but with caution due to risks of dependence.
p.18
Anti-Inflammatory Medications
What is the primary purpose of anti-inflammatory medications?
To reduce inflammation and relieve pain.
p.40
Nursing Interventions for Pain Management
What should be monitored in patients taking opioid agonists?
Respiratory rate, oxygen saturation, and level of consciousness.
p.2
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What is the purpose of disease-modifying anti-rheumatic drugs (DMARDs)?
To slow the progression of rheumatic diseases.
p.18
Anti-Inflammatory Medications
How do NSAIDs work to reduce inflammation?
By inhibiting the production of prostaglandins.
p.26
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What precautions should be taken when using gold compounds during pregnancy?
Must use barrier methods during sex.
What is the half-life of TNF blockers?
Very long, ranging from 4 days to 2 weeks.
p.40
Adverse Effects of Pain Medications
What activity should be avoided by patients taking opioid agonists?
Operating heavy machinery.
p.39
Opioid and Non-Opioid Analgesics
What is hydromorphone used for?
To treat moderate to severe pain.
What long-term consequence can occur in joints affected by rheumatoid arthritis?
Contractures and joint deformity.
p.32
Gout and Its Management
What should be included in nursing implications for anti-gout medication?
Evaluation of the patient's response to the medication.
p.44
Opioid and Non-Opioid Analgesics
Name an example of an opioid antagonist.
Naloxone (Narcan), naltrexone, or methylnaltexone.
p.3
Inflammatory Response Mechanisms
What are common causes of inflammation?
Infections, injuries, autoimmune disorders, and exposure to irritants.
p.4
Inflammatory Response Mechanisms
What triggers the inflammatory response?
Damage or trauma to tissue.
p.35
Pain Classification and Types
What happens to pain receptors after extended exposure to stimuli?
They stop generating impulses.
p.16
Fibromyalgia Characteristics and Treatment
What neurotransmitters are decreased in individuals with fibromyalgia?
Serotonin and norepinephrine.
p.17
Fibromyalgia Characteristics and Treatment
Which autoimmune diseases are often associated with fibromyalgia?
Rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and ankylosing spondylitis.
p.22
Adverse Effects of Pain Medications
What are common adverse effects of NSAIDs?
Nausea, dyspepsia, GI pain, constipation, diarrhea, flatulence, GI bleeding, headache, dizziness, somnolence, fatigue, rash, anaphylaxis, renal impairment.
p.7
Inflammatory Response Mechanisms
What role does the immune system play in inflammatory disorders?
The immune system triggers inflammation as a response to injury or infection.
p.25
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
How does gold compound therapy work?
It inhibits phagocytosis and blocks the release of lysosomal enzymes.
What is osteoarthritis?
A degenerative joint disease characterized by the deterioration of articulating cartilage and underlying bone.
p.22
Adverse Effects of Pain Medications
What are some contraindications for NSAIDs?
Allergy to drug or salicylate, hypertension or cardiovascular dysfunction, pregnancy/lactation, GI ulcers.
p.22
Nursing Interventions for Pain Management
What nursing implications should be considered when administering NSAIDs?
Monitor pain and temperature, CNS status, vital signs (HR, BP), and CBC; take with food.
p.30
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What are DMARDs used for?
To treat rheumatoid arthritis and other types of arthritis.
p.45
Adverse Effects of Pain Medications
What symptoms are associated with abstinence syndrome?
Cramping, hypertension, vomiting, fever, and anxiety.
p.46
Pain Classification and Types
How do CNS stimulants like methylphenidate help in pain management?
They augment analgesia and decrease sedation.
p.21
Anti-Inflammatory Medications
How do Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) work?
By inhibiting prostaglandin synthesis.
p.28
Adverse Effects of Pain Medications
What are the adverse effects of Tumor Necrosis Factor Blockers?
Fatal infections, lymphoma/leukemia development, myocardial infarction (MI), heart failure, and hypotension.
p.12
Gout and Its Management
What leads to the build-up of uric crystals in joints?
Increased uric acid in the blood.
p.15
Fibromyalgia Characteristics and Treatment
What role does substance P play in fibromyalgia?
It is a neurotransmitter responsible for pain sensation.
p.33
Gout and Its Management
What is the primary function of anti-gout medications?
They lower blood levels of uric acid in symptomatic patients.
p.46
Pain Classification and Types
What type of pain can gabapentin, an anticonvulsant, relieve?
Neuropathic pain and neuralgia.
p.19
Adverse Effects of Pain Medications
What are some adverse effects of salicylates?
Nausea, dyspepsia, epigastric discomfort, GI ulcers/bleed.
p.29
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What does DMARDs stand for?
Disease-Modifying Antirheumatic Drugs.
p.43
Adverse Effects of Pain Medications
What are the potential side effects of non-opioid analgesics?
Gastrointestinal issues, liver damage (with acetaminophen), and allergic reactions.
p.19
Adverse Effects of Pain Medications
What severe complications can arise from salicylate toxicity?
Pulmonary edema, convulsions, tetany, metabolic acidosis, fever.
p.38
Opioid and Non-Opioid Analgesics
What are some examples of opioid analgesics?
Morphine, oxycodone, and hydrocodone.
p.28
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What conditions are indications for using Tumor Necrosis Factor Blockers?
Rheumatoid arthritis, other arthritis, ankylosing spondylitis, and plaque psoriasis.
p.29
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What is the administration route for DMARDs like anakinra?
SQ (subcutaneous) daily injection.
p.45
Adverse Effects of Pain Medications
What cardiovascular symptoms can occur with opioid antagonist use?
Tachycardia and tachypnea.
p.27
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What is the route of administration for TNF blockers?
Given subcutaneously (SQ).
p.42
Nursing Interventions for Pain Management
What should be monitored in patients taking agonist-antagonist opioids?
Respiratory rate, oxygen saturation, and level of consciousness.
How does advancing age relate to rheumatoid arthritis?
It is a risk factor, except in cases of juvenile RA.
p.39
Opioid and Non-Opioid Analgesics
What is oxycodone commonly prescribed for?
Moderate to severe pain relief.
What is a common physical finding in the joints of rheumatoid arthritis patients?
Swollen and boggy joints.
p.23
Opioid and Non-Opioid Analgesics
How does acetaminophen work?
It acts directly on the thermoregulatory cells in the hypothalamus to cause sweating and vasodilation.
p.37
Opioid and Non-Opioid Analgesics
What is the primary use of opioid analgesics?
To manage moderate to severe pain.
p.38
Opioid and Non-Opioid Analgesics
How do opioid analgesics work in the body?
They bind to opioid receptors in the brain and spinal cord.
p.37
Adverse Effects of Pain Medications
What are some potential adverse effects of opioid medications?
Respiratory depression, constipation, and addiction.
p.45
Nursing Interventions for Pain Management
What vital signs should be monitored when administering opioid antagonists?
Respiratory rate, oxygen saturation, and level of consciousness.
p.29
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
When are DMARDs used?
When conventional treatment does not work.
p.43
Pain Classification and Types
What is the role of adjuvant analgesics?
They are used to enhance the effects of primary analgesics or to treat specific types of pain.
p.19
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What are the indications for using salicylates?
Mild to moderate pain, inflammatory conditions, reduce risk of CVA (stroke), and reduce risk and management of MI (heart attack).
p.27
Inflammatory Response Mechanisms
How do TNF blockers work?
They inhibit phagocytosis and block the release of lysosomal enzymes.
p.33
Gout and Its Management
What nursing implication should be considered when evaluating anti-gout treatment?
Initially give with colchicine due to an increase in attacks.
p.18
Anti-Inflammatory Medications
Can anti-inflammatory medications be used for conditions other than arthritis?
Yes, they can be used for various inflammatory conditions.
p.41
Opioid and Non-Opioid Analgesics
What are agonist-antagonist opioids used for?
To treat moderate to severe pain.
p.26
Nursing Interventions for Pain Management
What nursing implication is important when administering gold compounds?
Monitor pain and function level.
p.42
Nursing Interventions for Pain Management
What is a critical nursing implication when administering agonist-antagonist opioids?
They must be tapered off to avoid withdrawal symptoms.
p.41
Opioid and Non-Opioid Analgesics
How do agonist-antagonist opioids work?
They act as antagonists on mu receptors and agonists on kappa receptors.
What are the characteristics of affected joints in rheumatoid arthritis?
Warmth, tenderness, and stiffness.
p.16
Fibromyalgia Characteristics and Treatment
How is endogenous opioid activity altered in fibromyalgia?
There is altered endogenous opioid analgesic activity.
p.45
Opioid and Non-Opioid Analgesics
What are opioid antagonists used for?
To reverse the effects of opioid overdose.
p.45
Adverse Effects of Pain Medications
What is a common adverse effect of opioid antagonists?
Abstinence syndrome, which includes cramping, hypertension, vomiting, fever, and anxiety.
p.38
Adverse Effects of Pain Medications
What is a risk associated with long-term use of opioid analgesics?
Dependence and addiction.
p.26
Adverse Effects of Pain Medications
What are the adverse effects of gold compounds?
They depend on where they accumulate, causing inflammation of the GI tract, respiratory tract, and skin.
p.45
Adverse Effects of Pain Medications
What precautions should be taken when using opioid antagonists?
Avoid in cases of acute hepatitis or liver failure.
p.36
Pain Classification and Types
What is referred pain?
Pain sensed on the body surface at a distant location.
p.30
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What are some contraindications for using DMARDs?
Allergy to the drug, pregnancy/lactation, and acute infection.
p.2
Inflammatory Response Mechanisms
What are the cardinal signs of inflammation?
Redness, heat, swelling, pain, and loss of function.
p.26
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What condition is indicated for the use of gold compounds?
Rheumatoid arthritis if intolerant or insufficient response to NSAIDs.
p.40
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What precautions should be taken when administering opioid agonists?
Caution in patients with asthma, COPD, pregnancy, during labor, obesity, inflammatory bowel disease, and enlarged prostate.
p.2
Adverse Effects of Pain Medications
How do side effects differ from adverse reactions in NSAIDs and DMARDs?
Side effects are common and often manageable, while adverse reactions are severe and require immediate attention.
p.42
Adverse Effects of Pain Medications
What symptoms are associated with abstinence syndrome?
Cramping, hypertension, vomiting, fever, and anxiety.
p.31
Anti-Inflammatory Medications
What precaution should be taken when administering corticosteroids to a patient with diabetes?
Caution is advised due to potential blood sugar effects.
p.40
Nursing Interventions for Pain Management
What emergency equipment should be available for patients on opioids?
Naloxone and emergency equipment.
p.41
Opioid and Non-Opioid Analgesics
What is a disadvantage of agonist-antagonist opioids?
They have a less analgesic effect.
p.32
Gout and Its Management
What is the onset time for oral anti-gout medication?
It takes effect in 1-2 hours.
p.32
Gout and Its Management
What are some contraindications for anti-gout medication?
Pregnancy, breastfeeding, severe renal and hepatic disease.
p.47
Pain Classification and Types
What are common indications for using local anesthetics?
Pain relief for dental procedures, minor surgical procedures, labor and delivery, diagnostic procedures, and regional anesthesia (spinal, epidural).
p.30
Adverse Effects of Pain Medications
What is a significant adverse effect of DMARDs?
Increased risk of infection.
p.19
Adverse Effects of Pain Medications
What are signs of salicylate toxicity?
Ototoxicity, nausea, vomiting, diarrhea, mental confusion, hyperpnea, tachypnea, hemorrhage, excitement.
p.21
Anti-Inflammatory Medications
What are the properties of NSAIDs?
Antiinflammatory, analgesic, and antipyretic.
p.40
Opioid and Non-Opioid Analgesics
What is a primary indication for opioid agonists?
Relief of moderate to severe pain.
p.36
Pain Classification and Types
What is phantom pain?
Pain that exists after the removal of a body part or amputation.
p.28
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What are some contraindications for Tumor Necrosis Factor Blockers?
Acute infection, cancer, myelosuppression, demyelinating diseases (like MS), allergy to Chinese hamster ovary products, and pregnancy/lactation.
p.2
Pain Classification and Types
What are the three types of pain differentiated in pain management?
Intractable, chronic, and acute pain.
p.42
Opioid and Non-Opioid Analgesics
What are some contraindications for using agonist-antagonist opioids?
Myocardial infarction, kidney or liver disease, respiratory depression, head injury, and physical dependence on opioids.
p.39
Opioid and Non-Opioid Analgesics
What is the primary use of opioid agonists?
To treat moderate to severe pain.
p.14
Gout and Its Management
What are tophi in relation to gout?
Deposits of uric acid crystals that form under the skin.
p.32
Gout and Its Management
How does anti-gout medication work?
It stops the inflammation process by interfering with interleukin production.
p.32
Gout and Its Management
What is a significant characteristic of anti-gout medication regarding its therapeutic range?
It has a narrow therapeutic range.
p.31
Anti-Inflammatory Medications
What is the route of administration for corticosteroids?
SQ (subcutaneous) daily injection.
p.40
Adverse Effects of Pain Medications
What are common adverse effects of opioid agonists?
Respiratory depression, constipation, orthostatic hypotension, urinary retention, cough suppression, sedation, nausea/vomiting, addictive qualities, and risk of overdose.
p.46
Pain Classification and Types
What is the use of bisphosphonates like etidronate?
To manage hypercalcemia and bone pain.
p.27
Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
What is the usual first line of treatment for arthritis?
Tumor Necrosis Factor Blockers.
p.28
Nursing Interventions for Pain Management
What nursing implications should be considered when administering Tumor Necrosis Factor Blockers?
Monitor function/mobility level, do not give live vaccines, monitor CBC, and perform cancer screening.
What role does genetic predisposition play in osteoarthritis?
Genetic predisposition can increase the risk of developing osteoarthritis.
p.40
Nursing Interventions for Pain Management
What nursing interventions should be implemented for patients on opioids?
Administer antiemetics, stool softeners, increase fluid intake, and evaluate fall risk.
p.40
Nursing Interventions for Pain Management
What should be done if a patient is on long-term opioid therapy?
The dosage must be tapered off.
p.41
Opioid and Non-Opioid Analgesics
How do agonist-antagonist opioids affect respiratory depression?
They cause less respiratory depression compared to traditional opioids.
p.39
Opioid and Non-Opioid Analgesics
How do opioid agonists work?
They attach to receptors (often mu receptors) in the CNS, altering perception and response to pain.
p.30
Nursing Interventions for Pain Management
What should be monitored in patients taking DMARDs?
Function/mobility level and CBC (Complete Blood Count).
p.37
Adverse Effects of Pain Medications
What is a significant risk associated with long-term opioid use?
Development of tolerance and dependence.
p.18
Anti-Inflammatory Medications
What are the two main categories of anti-inflammatory medications?
Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids.
p.42
Opioid and Non-Opioid Analgesics
What are agonist-antagonist opioids used for?
Relief of moderate to severe pain, treatment of opioid dependence, adjunct to balanced anesthesia, and relief of labor pain.
What is the onset time for TNF blockers?
Slow onset with a peak of 48-72 hours.
p.2
Adverse Effects of Pain Medications
What are common side effects of aspirin compared to opioids?
Aspirin may cause gastrointestinal issues, while opioids can lead to sedation and constipation.
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Anti-Inflammatory Medications
What is a common side effect of long-term use of corticosteroids?
Increased risk of infections and osteoporosis.
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Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
How are DMARDs metabolized and excreted?
Metabolized in tissues and excreted in urine.
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Anti-Inflammatory Medications
What should be monitored when a patient is on long-term anti-inflammatory medication?
Kidney function and gastrointestinal health.
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Adverse Effects of Pain Medications
What should be discussed regarding NSAIDs, corticosteroids, DMARDs, and opioid analgesics?
Their actions, side effects, and adverse reactions.
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Nursing Interventions for Pain Management
What nursing interventions are related to opioid and non-opioid analgesics?
Monitoring pain levels, assessing for side effects, and educating patients on medication use.
p.14
Gout and Its Management
What is nephrolithiasis in the context of gout?
The formation of kidney stones due to high uric acid levels.
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Gout and Its Management
What risk is associated with anti-gout medication overdose?
Fatal overdoses have occurred.
Who is the author of the article 'Pain and Inflammation'?
Ashleigh Woods, EdD, RN, CNE.
