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DE LUNA, LORRISSE JOYCE D.

BSN 2-2

DRUGS THAT RELIEVE PAIN AND INFLAMMATION

Review Questions:
1. A client is postoperative day one from a total abdominal hysterectomy and complains
of pain. The nurse should withhold the meperidine hydrochloride (Demerol) based on
which of these observations?
a. BP - 100/72; RR – 14/min; PR - 65/min
b. BP – 98/68; RR – 8/min; PR – 72/min
c. BP – 120/84; RR – 16/min; PR – 90/min
d. BP – 155/98; RR – 23/min; PR – 130/min

Answer: B
Rationale: Knowing a patient's normal vital sign values and monitoring their vital
signs is necessary for avoiding errors in medication administration. It should be hold
the administration of meperidine hydrochloride (Demerol) to the patient that
experiencing hypotension and bradypnea which is a category of hypotensive effect.
 The OPTION A, C and D is incorrect as the administration of meperidine may result
in severe hypotension in the postoperative patient or any individual whose ability to
maintain blood pressure has been compromised by a depleted blood volume or the
administration of drugs such as the phenothiazines or certain anesthetics.

2. A client, age 16, is brought into the emergency room unconscious without any
explanation of causation. Narcotic overdose is suspected, and naloxone
hydrochloride (Narcan) is administered based on which of these observations
a. Dilated pupils, BP- 200/98, RR – 8/min
b. PR – 42/min; RR – 18/min; BP- 118/62
c. Pinpoint pupils, RR – 8/min
d. PR – 88/min; RR – 20/min; BP – 100/65

Answer: C
Rationale: The commonly signs and symptoms of Narcotic overdose are
unconsciousness of the patient, pinpoint pupils that do not respond to changes in
light, and difficulties with breathing that could be also result as respiratory
depression or hypo-tension. In order to help reduce the effects of an narcotic
overdose in just a minute , administering of naloxone hydrochloride (Narcan) must be
given.
 The OPTION A, B, D is incorrect for some instances, if a patient has not taken
opiods, nalozone does not have a significant effect on patients.

3. A migraine headache sufferer is seen frequently in the emergency department

requesting pain relief. Stadol might be administered instead of meperidine
hydrochloride (Demerol) because it is
a. An effective analgesic for moderate pain
b. A narcotic antagonist
c. Better and has few side effects
d. A narcotic agonist-antagonist

Answer: D
Rationale: The opioid agonist-antagonists are a heterogeneous group of compounds
capable of providing analgesia sufficient to treat moderate to severe acute pain.
Additionally, Demerol is no longer considered to be safer than other opiates. It
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appears that risks of addiction, biliary spasm, and renal colic are equal to other
opioids.
OPTION A: Stadol (butorphanol tartrate) is a narcotic pain reliever, similar to morphine used
to treat moderate to severe pain. Compared to Demerol (meperidine) is an oral and
injectable opiod used for treatment of moderate to severe pain.
 OPTION B: A narcotic antogonist of a stadol is respiratory depression noted after
administration of butorphanol to humans by any route is reversed by treatment with
naloxone, a specific opioid antagonist.
 OPTION C:

4. Acetylcysteine (Mucomyst) is used as an antidote for

a. Aspirin overdose
b. Tylenol overdose
c. Demerol overdose
d. NSAID toxicity

Answer: B
Rationale: Acetylycysteine is an effective antidote to prevent or limit liver injury in
patients with potentially toxic acetaminophen (tylenol) levels. Mucomyst is a
pulmonary disorder that has thick secretions of mucous. With the mode of action of
tylenol it breaks the molecule in the mucous to help it become less viscous.
Acetaminophen toxicity should be treated immediatey.
 OPTION A: Acetylsalicyloc Acid (Aspirin) is a nonsteroidal anti-inflammatory drug
used to reduce pain, fever, and/or inflammation, and as an antithrombotic. Specific
inflammatory conditions which aspirin is used to treat include Kawasaki disease,
pericarditis, and rheumatic fever.There is no antidote that can be given safely at
home for aspirin overdose. At a hospital, people may be given an intravenous
injection of sodium bicarbonate to make the urine more alkaline. 
 OPTION C: Naloxone hydrochloride is  a specific antidote against respiratory
depression which may result from overdosage or unusual sensitivity to narcotics,
including meperidine. Symptoms include: extreme dizziness or weakness, trouble
breathing, slow heartbeat or breathing, seizures, or cold, clammy skin. In case of an
overdose, call your doctor right away. The mode of action of nalozone is used to reverse
the life-threatening effects of an overdose.
 OPTION D: There is no specific antidotes for NSAID toxicity. Patients with significant
toxicity who develop severe acidosis may require supportive treatment with
intravenous sodium bicarbonate. Most commonly, the risk of severe GI adverse
effects, including ulceration, bleeding, or perforation is increased with NSAID
consumption. Though these risks can occur at any time in patients of any age, these
adverse events tend to present more commonly in the elderly.

5. Upon discharge with a diagnosis of rheumatoid arthritis, a client should be taught

which of the following for the prevention of side effects with an NSAID product?
a. Take the NSAID q 4 hours and prn
b. Avoid antacids if the medication causes heartburn
c. Cautiously operate machinery because of the sedative effect
d. Report as requested for a CBC and check-up.

Answer: D
Rationale: NSAID products is commonly available without prescription. It helps to
suppress inflammation of synovial membrane in joints affected by arthritis.
 OPTION A,B,C are incorrect. Dependent nursing intervention that should nurses do:
Monitoring of complete blood count for decreases, or createnine elevations, protect
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skin from overexposure to sun and compliance with follow-up visits to the physician.
Additionally, it uses for arthritis and arthritic clients who are not responsive to NSAID
(Non-steroidal anti-inflammatory drugs) theraphy alone.