p.1
osteoarthritis, rheumatoid arthritis, gout, and fibromyalgia relationship to pain and inflammation
What is the relationship between pain and inflammation?
Pain often accompanies inflammation as a response to injury or infection.
p.1
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What are the cardinal signs of inflammation?
Redness, heat, swelling, pain, and loss of function.
p.1
osteoarthritis, rheumatoid arthritis, gout, and fibromyalgia relationship to pain and inflammation
How does inflammation contribute to pain?
Inflammation can sensitize nerve endings, leading to increased pain perception.
p.1
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What role do cytokines play in inflammation?
Cytokines are signaling molecules that mediate and regulate immunity and inflammation.
p.1
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What is the purpose of the inflammatory response?
To eliminate the initial cause of cell injury and to initiate the healing process.
p.7
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What are the cardinal signs of inflammation?
Redness, heat, swelling, pain, and loss of function.
p.37
Discuss nursing interventions related to opioid and non-opioid analgesics
What is the role of NSAIDs in pain management?
To reduce inflammation and relieve pain.
p.37
Discuss nursing interventions related to opioid and non-opioid analgesics
What is the primary use of opioids?
To manage moderate to severe pain.
p.17
characteristics and treatment
What are some common symptoms of fibromyalgia?
Fatigue, sleep disturbances, depression, irritable bowel syndrome, headaches, and memory problems.
p.14
Gout and its management
What complications can arise from gout related to the kidneys?
Nephropathy and nephrolithiasis.
p.13
Gout and its management
How is chronic diuretic use related to gout?
It is linked to an increased risk of developing gout.
p.38
Discuss nursing interventions related to opioid and non-opioid analgesics
How do opioid analgesics work in the body?
They bind to opioid receptors in the brain and spinal cord to reduce the perception of pain.
p.15
characteristics and treatment
How many trigger points have been identified in fibromyalgia?
18 trigger points throughout the body.
p.22
Discuss nursing interventions related to opioid and non-opioid analgesics
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.4
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What triggers the inflammatory response?
Damage or trauma to tissue.
p.32
Gout and its management
How does anti-gout medication work?
It stops the inflammation process by interfering with interleukin production.
p.29
Explain the use of disease-modifying anti-rheumatic drugs
What does DMARDs stand for?
Disease-Modifying Antirheumatic Drugs.
p.3
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What is the significance of loss of function in inflammation?
It serves as a protective mechanism to prevent further injury.
p.5
characteristics and treatment
What is the Kinen System?
The Kinen System is a concept discussed in the Karch textbook, specifically on page 261.
p.35
characteristics and treatment
What are the five types of receptors in the human body?
Mechanoreceptors, Chemoreceptors, Thermoreceptors, Photoreceptors, Nociceptors.
p.20
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What are some contraindications for using salicylates?
Allergy to drug or NSAIDs, bleeding abnormalities, impaired renal function, chickenpox or flu, pregnancy/lactation, and GI ulcers.
p.35
characteristics and treatment
Where are pain receptors located?
In the skin, bones, and internal organs.
p.20
Discuss nursing interventions related to opioid and non-opioid analgesics
What should be monitored when a patient is on salicylates?
Pain and temperature, CNS status, vital signs (HR, BP), and CBC.
p.35
characteristics and treatment
What happens to pain receptors after extended exposure to stimuli?
They stop generating impulses.
p.37
Discuss nursing interventions related to opioid and non-opioid analgesics
What are the two main categories of pain medications?
Opioid and non-opioid analgesics.
p.17
characteristics and treatment
What factors can influence the clinical manifestations of fibromyalgia?
Weather, stress, fatigue, physical activity, and time of day.
p.35
characteristics and treatment
What is the role of pain in the human body?
It serves as a protective mechanism (warning system).
p.7
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What are inflammatory disorders?
Conditions characterized by inflammation, which is the body's response to injury or infection.
p.37
Discuss nursing interventions related to opioid and non-opioid analgesics
What are some common non-opioid analgesics?
Acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs).
p.37
Discuss nursing interventions related to opioid and non-opioid analgesics
What is a major concern when using opioids?
Risk of addiction and dependence.
p.17
characteristics and treatment
What type of pain is commonly experienced in fibromyalgia?
Widespread pain, often described as a constant dull muscle ache.
p.12
Gout and its management
What is gout?
Recurrent joint inflammation caused by hyperuricemia.
p.9
characteristics and treatment
What are Heberden’s nodes?
Bony growths that develop on the distal joints of the fingers in osteoarthritis.
p.15
characteristics and treatment
Is there any apparent inflammation or degeneration in fibromyalgia?
No apparent inflammation or degeneration is noted.
p.30
Discuss nursing interventions related to opioid and non-opioid analgesics
What should be monitored in patients taking DMARDs?
Function/mobility level and CBC (Complete Blood Count).
p.23
characteristics and treatment
What is known about the analgesic effects of acetaminophen?
The action related to its analgesic effects is not well understood.
p.3
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What are the cardinal signs of inflammation?
Redness, heat, swelling, pain, and loss of function.
p.21
Explain the use of disease-modifying anti-rheumatic drugs
How do NSAIDs work?
By inhibiting prostaglandin synthesis.
p.21
Explain the use of disease-modifying anti-rheumatic drugs
What properties do NSAIDs possess?
Antiinflammatory, analgesic, and antipyretic properties.
p.24
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What are contraindications for acetaminophen?
Allergy to the drug, hepatic dysfunction, chronic alcoholism.
p.29
Explain the use of disease-modifying anti-rheumatic drugs
What is the administration route for DMARDs like anakinra?
SQ (subcutaneous) daily injection.
p.10
osteoarthritis, rheumatoid arthritis, gout, and fibromyalgia relationship to pain and inflammation
What is synovitis?
Inflammation of the synovial membrane caused by rheumatoid arthritis.
p.19
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What are some adverse effects of salicylates?
Nausea, dyspepsia, epigastric discomfort, GI ulcers/bleed.
p.11
rheumatoid arthritis, gout, and fibromyalgia relationship to pain and inflammation
What are common clinical manifestations of rheumatoid arthritis?
Fatigue, malaise, anorexia, low-grade fever.
p.7
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What can trigger inflammatory disorders?
Infections, injuries, autoimmune diseases, and exposure to irritants.
p.9
characteristics and treatment
What is a common clinical manifestation of osteoarthritis?
Joint pain and tenderness.
p.38
Discuss nursing interventions related to opioid and non-opioid analgesics
What is an important nursing intervention when administering opioid analgesics?
Monitor the patient for signs of respiratory depression.
p.45
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What are the adverse effects of opioid antagonists?
Abstinence syndrome, tachycardia, and tachypnea.
p.45
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What symptoms are included in abstinence syndrome?
Cramping, hypertension, vomiting, fever, and anxiety.
p.3
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What is inflammation?
A biological response to harmful stimuli, such as pathogens, damaged cells, or irritants.
p.47
characteristics and treatment
What is the primary function of local anesthetics?
To relieve pain in a localized area.
p.43
Discuss nursing interventions related to opioid and non-opioid analgesics
What are analgesics?
Medications used to relieve pain.
p.28
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What is a significant black box warning associated with Tumor Necrosis Factor Blockers?
Fatal infections and lymphoma/leukemia development.
p.29
Explain the use of disease-modifying anti-rheumatic drugs
How do DMARDs work in the context of rheumatoid arthritis (RA)?
They block the increased interleukin-1 which degrades cartilage.
p.42
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What symptoms are associated with abstinence syndrome?
Cramping, hypertension, vomiting, fever, and anxiety.
p.40
Discuss nursing interventions related to opioid and non-opioid analgesics
What should be monitored in patients receiving opioid agonists?
Respiratory rate, oxygen saturation, and level of consciousness.
p.42
Discuss nursing interventions related to opioid and non-opioid analgesics
What nursing implications should be considered when administering agonist-antagonist opioids?
Monitor respiratory rate, oxygen saturation, level of consciousness, assess fall risk, taper off the medication, and have naloxone and emergency equipment nearby.
p.46
characteristics and treatment
What is the function of glucocorticoids like prednisone in pain management?
To improve appetite and decrease pain from intracranial pressure, spinal cord compression, and rheumatoid arthritis.
p.46
characteristics and treatment
What do bisphosphonates like etidronate manage?
Hypercalcemia and bone pain.
p.31
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What should be monitored in patients receiving corticosteroids?
Blood sugar and CBC (Complete Blood Count).
p.12
Gout and its management
What causes the build-up of uric crystals in joints?
Increased uric acid in the blood.
p.26
characteristics and treatment
When are gold compounds indicated?
For rheumatoid arthritis if intolerant or insufficient response to NSAIDs.
p.16
fibromyalgia relationship to pain and inflammation
What neurotransmitters are decreased in individuals with fibromyalgia?
Serotonin and norepinephrine.
p.16
fibromyalgia relationship to pain and inflammation
What is enhanced in fibromyalgia that affects pain perception?
Temporal summation of second pain.
p.30
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What is a significant adverse effect of DMARDs?
Increased risk of infection.
p.23
characteristics and treatment
How does acetaminophen work?
It acts directly on the thermoregulatory cells in the hypothalamus to cause sweating and vasodilation.
p.18
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What is the primary purpose of anti-inflammatory medications?
To reduce inflammation and relieve pain.
p.4
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What are the mediators involved in the inflammatory response?
Histamines and prostaglandins.
p.4
Explain the inflammatory response inclusive of the cardinal signs of inflammation
Which cells are activated in the immune system during inflammation?
Lymphocytes, including T cells, B cells, and NK cells.
p.47
characteristics and treatment
What are some indications for using local anesthetics?
Pain relief for dental procedures, minor surgical procedures, labor and delivery, diagnostic procedures, and regional anesthesia (spinal, epidural).
p.41
characteristics and treatment
How do agonist-antagonist opioids affect respiratory depression?
They cause less respiratory depression compared to traditional opioids.
p.2
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What are the cardinal signs of inflammation?
Redness, heat, swelling, pain, and loss of function.
p.43
Discuss nursing interventions related to opioid and non-opioid analgesics
What is a common use for acetaminophen?
To relieve mild to moderate pain and reduce fever.
p.32
Gout and its management
What are some contraindications for anti-gout medication?
Pregnancy, breastfeeding, severe renal and hepatic disease.
p.2
Differentiate between intractable, chronic, and acute pain
What is the difference between intractable, chronic, and acute pain?
Intractable pain is resistant to treatment, chronic pain persists over time, and acute pain is short-term and often related to injury.
p.32
Gout and its management
What should be included in nursing implications for anti-gout medication?
Evaluation of the patient's response and side effects.
p.19
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What severe conditions can result from salicylate toxicity?
Pulmonary edema, convulsions, tetany, metabolic acidosis, fever.
p.7
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What role does inflammation play in the body?
It helps to protect and heal the body by removing harmful stimuli and beginning the healing process.
p.25
Explain the use of disease-modifying anti-rheumatic drugs
What are the pharmacokinetics of gold compounds?
They have varying absorption rates and are excreted in urine and feces.
p.6
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What role does heat play in the inflammatory response?
Heat is a sign of increased blood flow to the affected area.
p.36
Differentiate between intractable, chronic, and acute pain
What is pain threshold?
The perception of pain and the level at which it is sensed.
p.41
characteristics and treatment
What are agonist-antagonist opioids used for?
To treat moderate to severe pain.
p.8
characteristics and treatment
How does trauma affect the risk of osteoarthritis?
Trauma to joints increases the risk of developing the disease.
p.27
Explain the use of disease-modifying anti-rheumatic drugs
What is the usual first line of treatment for arthritis?
Tumor Necrosis Factor Blockers.
p.10
osteoarthritis, rheumatoid arthritis, gout, and fibromyalgia relationship to pain and inflammation
What characterizes the course of rheumatoid arthritis?
Exacerbations and remissions.
p.28
Discuss nursing interventions related to opioid and non-opioid analgesics
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.
p.43
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What are corticosteroids used for in pain management?
To reduce inflammation and pain in conditions like arthritis.
p.10
osteoarthritis, rheumatoid arthritis, gout, and fibromyalgia relationship to pain and inflammation
What is ankylosis in the context of rheumatoid arthritis?
Joint fixation and deformity.
p.37
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What are potential side effects of NSAIDs?
Gastrointestinal issues, kidney problems, and increased bleeding risk.
p.15
characteristics and treatment
What are the main characteristics of fibromyalgia?
Widespread muscular pains and fatigue.
p.15
characteristics and treatment
Which body parts are affected by fibromyalgia?
Joints, muscles, tendons, and surrounding tissues.
p.30
Explain the use of disease-modifying anti-rheumatic drugs
What are DMARDs primarily used for?
To treat rheumatoid arthritis and other types of arthritis.
p.44
Discuss nursing interventions related to opioid and non-opioid analgesics
Name an example of an opioid antagonist.
Naloxone (Narcan), naltrexone, or methylnaltrexone.
p.6
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What is erythema?
Redness of the skin, a sign of inflammation.
p.30
Evaluate nursing interventions related to opioid and non-opioid analgesics
What is the evaluation process for patients on DMARDs?
Monitor function/mobility level and CBC.
p.28
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What are some adverse effects of Tumor Necrosis Factor Blockers?
Fatal infections, lymphoma/leukemia development, myocardial infarction (MI), heart failure, hypotension.
p.18
Explain the use of disease-modifying anti-rheumatic drugs
What is the role of corticosteroids in inflammation management?
To suppress the immune response and reduce inflammation.
p.36
Differentiate between intractable, chronic, and acute pain
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.
p.8
characteristics and treatment
Is osteoarthritis more common in men or women?
It occurs equally in men and women.
p.28
characteristics and treatment
What are some contraindications for using Tumor Necrosis Factor Blockers?
Acute infection, cancer, myelosuppression, demyelinating diseases (like MS), allergy to Chinese hamster ovary products, pregnancy/lactation.
p.41
characteristics and treatment
What is a disadvantage of agonist-antagonist opioids?
They have less analgesic effect.
p.10
osteoarthritis, rheumatoid arthritis, gout, and fibromyalgia relationship to pain and inflammation
What is pannus formation in rheumatoid arthritis?
Granulation tissue that forms in the joints.
p.43
Discuss nursing interventions related to opioid and non-opioid analgesics
What is a risk associated with long-term use of opioids?
Development of tolerance and potential for addiction.
p.11
rheumatoid arthritis, gout, and fibromyalgia relationship to pain and inflammation
How does advancing age relate to rheumatoid arthritis?
It is a risk factor, except in cases of juvenile RA.
p.11
rheumatoid arthritis, gout, and fibromyalgia relationship to pain and inflammation
What are the characteristics of joints affected by rheumatoid arthritis?
Warmth, tenderness, stiffness, swollen and boggy joints.
p.33
Gout and its management
What is the primary function of anti-gout medications?
To lower blood levels of uric acid in symptomatic patients.
p.14
Gout and its management
What are tophi in relation to gout?
Tophi are deposits of uric acid crystals that can form in the skin and tissues.
p.14
Gout and its management
What are common clinical manifestations of gout?
Joint pain, joint swelling, erythema, and low-grade fever.
p.22
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What are some contraindications for NSAIDs?
Allergy to the drug or salicylate, hypertension or cardiovascular dysfunction, pregnancy/lactation, and GI ulcers.
p.6
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What are the clinical manifestations of the inflammatory response?
Pain, redness (erythema), swelling (edema), and heat.
p.39
Discuss nursing interventions related to 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.6
Explain the inflammatory response inclusive of the cardinal signs of inflammation
How is pain related to the inflammatory response?
Pain is a common symptom that arises due to inflammation.
p.46
characteristics and treatment
What is the purpose of adjuvant therapy for pain?
To alleviate pain in addition to opioids.
p.28
characteristics and treatment
What conditions are Tumor Necrosis Factor Blockers indicated for?
Rheumatoid arthritis, other arthritis, ankylosing spondylitis, plaque psoriasis.
p.40
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
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
characteristics and treatment
How do antihistamines like hydroxyzine help in pain management?
They decrease anxiety, prevent insomnia, and relieve nausea/vomiting.
p.32
Gout and its management
What serious risk is associated with anti-gout medication?
Fatal overdoses have occurred.
p.40
characteristics and treatment
What should patients avoid while taking opioid agonists?
Operating heavy machinery.
p.19
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What are the indications for using salicylates?
Mild to moderate pain, inflammatory conditions, reduce risk of CVA (stroke), and management of MI (heart attack).
p.26
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What are the adverse effects of gold compounds?
Inflammation of the GI tract, respiratory tract, skin, allergic reactions, and bone marrow depression.
p.22
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What are common adverse effects of NSAIDs?
Nausea, dyspepsia, GI pain, constipation, diarrhea, flatulence, GI bleeding, headache, dizziness, somnolence, fatigue, rash, anaphylaxis, and renal impairment.
p.22
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What are the indications for using NSAIDs?
Mild to moderate pain, rheumatoid arthritis (RA), osteoarthritis (OA), primary dysmenorrhea, and fever reduction.
p.25
Explain the use of disease-modifying anti-rheumatic drugs
How does gold compound therapy work?
It inhibits phagocytosis and blocks the release of lysosomal enzymes.
p.14
Gout and its management
What symptoms might indicate a gout flare-up?
Joint swelling, erythema, and low-grade fever.
p.30
Discuss nursing interventions related to opioid and non-opioid analgesics
What is an important nursing implication when administering DMARDs?
Conduct cancer screening.
p.18
Differentiate between side effects and adverse reactions of NSAIDs and DMARDs
What is a common side effect of NSAIDs?
Gastrointestinal irritation.
p.3
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What role do white blood cells play in inflammation?
They help to fight infection and initiate the healing process.
p.18
Explain the inflammatory response inclusive of the cardinal signs of inflammation
How do NSAIDs work to reduce inflammation?
By inhibiting the production of prostaglandins.
p.3
Explain the inflammatory response inclusive of the cardinal signs of inflammation
How does pain occur during inflammation?
Due to the release of chemicals that stimulate nerve endings.
p.36
Differentiate between intractable, chronic, and acute pain
What is referred pain?
Pain sensed on the body surface at a distant location.
p.2
osteoarthritis, rheumatoid arthritis, gout, and fibromyalgia relationship to pain and inflammation
What conditions are discussed in relation to pain and inflammation?
Osteoarthritis, rheumatoid arthritis, gout, and fibromyalgia.
p.31
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What is the route of administration for corticosteroids?
Subcutaneous (SQ) daily injection.
p.36
Differentiate between intractable, chronic, and acute pain
What is neuropathic pain?
Pain from damage to peripheral nerves through disease or injury.
p.2
Discuss nursing interventions related to opioid and non-opioid analgesics
What nursing interventions are important for managing opioid analgesics?
Monitoring for side effects, assessing pain levels, and educating patients on safe use.
p.37
Discuss nursing interventions related to opioid and non-opioid analgesics
What is the mechanism of action for opioids?
They bind to opioid receptors in the brain to block pain signals.
p.7
characteristics and treatment
How can inflammatory disorders be treated?
Through medications, lifestyle changes, and sometimes surgery, depending on the disorder.
p.44
Discuss nursing interventions related to opioid and non-opioid analgesics
How do opioid antagonists work?
They act as antagonists on mu receptors and agonists on kappa receptors.
p.16
fibromyalgia relationship to pain and inflammation
What alteration occurs in endogenous opioid activity in fibromyalgia?
Altered analgesic activity.
p.6
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What does edema refer to in the context of inflammation?
Swelling caused by excess fluid in tissues.
p.45
Discuss nursing interventions related to opioid and non-opioid analgesics
What nursing implications should be considered when administering opioid antagonists?
Monitor respiratory rate, oxygen saturation, and level of consciousness; have emergency equipment nearby; may need several doses.
p.8
characteristics and treatment
What is osteoarthritis?
A degenerative joint disease characterized by the deterioration of articulating cartilage and underlying bone.
p.3
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What is the purpose of swelling in inflammation?
To isolate the affected area and prevent the spread of infection.
p.8
characteristics and treatment
What is a major risk factor for developing osteoarthritis?
Age, particularly being older than 40.
p.29
Explain the use of disease-modifying anti-rheumatic drugs
When are DMARDs used?
When conventional treatment does not work.
p.43
Discuss nursing interventions related to opioid and non-opioid analgesics
What is the difference between opioid and non-opioid analgesics?
Opioids are derived from opium and act on the central nervous system, while non-opioids are typically over-the-counter medications that target pain at the site.
p.24
Discuss nursing interventions related to opioid and non-opioid analgesics
What should be monitored when administering acetaminophen?
Pain and temperature, liver function tests (ALT, AST).
p.43
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What is a potential side effect of NSAIDs?
Gastrointestinal irritation or bleeding.
p.41
characteristics and treatment
How do agonist-antagonist opioids work?
They act as antagonists on my receptors and agonists on kappa receptors.
p.8
characteristics and treatment
What role does genetic predisposition play in osteoarthritis?
Genetic predisposition can increase the risk of developing osteoarthritis.
p.42
characteristics and treatment
What should patients avoid while taking agonist-antagonist opioids?
Operating heavy machinery.
p.19
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What are signs of salicylate toxicity?
Ototoxicity, nausea, vomiting, diarrhea, mental confusion, hyperpnea, tachypnea, hemorrhage, excitement.
p.11
rheumatoid arthritis, gout, and fibromyalgia relationship to pain and inflammation
What can occur due to limited joint range in rheumatoid arthritis?
Contractures and joint deformity.
p.9
characteristics and treatment
What are Bouchard’s nodes?
Bony growths that develop on the proximal joints of the fingers in osteoarthritis.
p.26
characteristics and treatment
What are some contraindications for using gold compounds?
Allergy to gold, pregnancy, severe diabetes mellitus, heart failure, renal or hepatic impairment, hypertension, blood dyscrasias, recent radiation therapy.
p.25
Explain the use of disease-modifying anti-rheumatic drugs
When is gold compound therapy used?
Only in clients that are unresponsive to conventional therapy due to the risk of toxicity.
p.33
Gout and its management
What is a nursing implication when administering anti-gout medication?
Initially give with colchicine due to an increase in attacks.
p.30
Differentiate between side effects and adverse reactions of NSAIDs and DMARDs
What are some contraindications for using DMARDs?
Allergy to the drug, pregnancy/lactation, and acute infection.
p.39
Discuss nursing interventions related to opioid and non-opioid analgesics
List two more examples of opioid agonists.
Meperidine and methadone.
p.32
Gout and its management
What is the onset time for oral anti-gout medication?
It takes effect in 1-2 hours.
p.47
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What are some adverse effects of local anesthetics?
CNS excitation, hypotension, cardiosuppression, allergic reactions, spinal headache, and urinary retention.
p.42
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What is a common adverse effect of agonist-antagonist opioids?
Sedation and respiratory depression.
p.27
Explain the use of disease-modifying anti-rheumatic drugs
How do TNF blockers work?
They inhibit phagocytosis and block the release of lysosomal enzymes.
p.46
characteristics and treatment
What is the role of CNS stimulants like methylphenidate in pain management?
To augment analgesia and decrease sedation.
p.27
Explain the use of disease-modifying anti-rheumatic drugs
What is the onset time for TNF blockers?
Slow onset with a peak of 48-72 hours.
p.17
characteristics and treatment
Which autoimmune diseases are often associated with fibromyalgia?
Rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and ankylosing spondylitis.
p.26
Discuss nursing interventions related to opioid and non-opioid analgesics
What nursing implications should be considered when using gold compounds?
Monitor pain and function level.
p.16
fibromyalgia relationship to pain and inflammation
How is pain experienced in fibromyalgia?
As delayed and longer-lasting.
p.39
Discuss nursing interventions related to opioid and non-opioid analgesics
What is the primary use of opioid agonists?
To treat moderate to severe pain.
p.15
characteristics and treatment
What role does substance P play in fibromyalgia?
It is a neurotransmitter responsible for pain sensation.
p.45
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What are the contraindications for opioid antagonists?
Acute hepatitis or liver failure.
p.47
characteristics and treatment
How do local anesthetics work?
They block the conduction of pain impulses in a localized area.
p.18
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What is a potential adverse reaction to corticosteroids?
Increased risk of infection.
p.39
Discuss nursing interventions related to opioid and non-opioid analgesics
What are two additional examples of opioid agonists?
Oxycodone and hydromorphone.
p.24
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What are the indications for using acetaminophen?
Mild to moderate pain, fever, cold and sinus symptoms.
p.41
characteristics and treatment
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.46
characteristics and treatment
What conditions can amitriptyline treat?
Depression, fibromyalgia, and neuropathic pain.
p.8
characteristics and treatment
How does obesity relate to osteoarthritis?
Obesity is a risk factor for developing osteoarthritis.
p.42
characteristics and treatment
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.2
Explain the use of disease-modifying anti-rheumatic drugs
What is the purpose of disease-modifying anti-rheumatic drugs (DMARDs)?
To slow the progression of rheumatic diseases.
p.40
characteristics and treatment
What are some contraindications for using opioid agonists?
Biliary tract surgery, asthma, COPD, pregnancy, labor, extreme obesity, inflammatory bowel disease, and enlarged prostate.
p.40
Discuss nursing interventions related to opioid and non-opioid analgesics
What nursing implications should be considered for patients on opioid agonists?
Monitor abdominal assessment, fall risk, administer antiemetics, stool softeners, increase fluid intake, taper off medication, and have naloxone and emergency equipment nearby.
p.38
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What serious risk is associated with opioid analgesics?
Potential for addiction and overdose.
p.44
Discuss nursing interventions related to opioid and non-opioid analgesics
What is the primary function of opioid antagonists?
To interfere with opioid effects by competing for opioid receptors.
p.9
characteristics and treatment
How does osteoarthritis affect gait?
It can lead to an altered gait.
p.3
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What causes redness and heat during inflammation?
Increased blood flow to the affected area.
p.36
Differentiate between intractable, chronic, and acute pain
What is pain tolerance?
How much pain a person can tolerate.
p.47
characteristics and treatment
What are some contraindications for local anesthetics?
SVT or AV blocks, and caution in women in labor, liver and kidney disease, heart failure, and myasthenia gravis.
p.43
Discuss nursing interventions related to opioid and non-opioid analgesics
What are some common non-opioid analgesics?
Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.
p.40
characteristics and treatment
What is a primary indication for opioid agonists?
Relief of moderate to severe pain.
p.36
Differentiate between intractable, chronic, and acute pain
What is intractable pain?
Chronically progressing pain that is unrelenting and debilitating.
p.2
discuss actions, side effects and adverse reactions related to NSAIDs, corticosteroids, DMARDs, and opioid analgesics
What are some actions and side effects related to NSAIDs?
NSAIDs reduce inflammation and pain but can cause gastrointestinal bleeding and kidney issues.
p.15
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.45
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What is the primary indication for using opioid antagonists?
To reverse the effects of opioid overdose.
p.18
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What are the common types of anti-inflammatory medications?
Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids.
p.24
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What serious condition can acetaminophen cause?
Liver failure/dysfunction.
p.4
Explain the inflammatory response inclusive of the cardinal signs of inflammation
What types of myelocytes are involved in the inflammatory response?
Neutrophils, basophils, eosinophils, and monocytes/macrophages.
p.10
osteoarthritis, rheumatoid arthritis, gout, and fibromyalgia relationship to pain and inflammation
What type of condition is rheumatoid arthritis?
A systemic autoimmune condition.
p.42
characteristics and treatment
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.
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.19
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
How do salicylates work?
They inhibit the synthesis of prostaglandins and platelet aggregation.
p.2
Compare side effects of aspirin and opioids
What are common side effects of aspirin?
Gastrointestinal issues, bleeding, and allergic reactions.
p.36
Differentiate between intractable, chronic, and acute pain
What is phantom pain?
Pain that exists after the removal of a body part or amputation.
p.31
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
How do corticosteroids work?
They depress inflammatory and infectious/immune responses.
p.29
Explain the use of disease-modifying anti-rheumatic drugs
How are DMARDs metabolized and excreted?
Metabolized in tissues and excreted in urine.
p.2
Differentiate between side effects and adverse reactions of NSAIDs and DMARDs
How do side effects differ from adverse reactions in NSAIDs and DMARDs?
Side effects are expected and often manageable, while adverse reactions are severe and potentially harmful.
p.31
side effects, adverse reactions related to NSAIDs, corticosteroid, DMARDs, opioid analgesics
What precaution should be taken when administering corticosteroids to a patient with diabetes?
Caution is advised due to potential effects on blood sugar levels.
