"AH I am in PAIN!"
A 56-year-old patient with COPD arrives at the Emergency Room after a suspected Opioid overdose. What is our primary concern at this moment?
Respiratory Depression
What's that type of anesthesia!: Applied to the skin and mucous membranes?
Local/Topical Anesthesia
Name that phenomenon!: Brief warning preceding seizure episode, flash of light, sound, or smell?
Aura
What are the three ingredients of Excedrin Migrane?
1. Aspirin, 250mg
2. Acetaminophen, 250mg
3. Caffeine, 60 mg
What are two important nursing considerations for all patients taking muscle relaxers?
2. Do not combine with alcohol or other CNS depressants
What's that drug!: Schedule III drug, metabolized into Hydromorphone (Dilaudid) in the body, only available in combination with acetaminophen or ibuprofen?
Hydrocodone
Once a dose of Bupivacaine was injected, the patient reports immediate confusion, tinnitus, numbness, tachycardia, hypotension, and ventricular arrhythmias. What is the most appropriate action as the nurse?
Ensure a patent airway!
A pregnant woman is in need of medication for her epileptic disorder during the next nine months. Which medication is the least safe anti-epileptic drug during pregnancy?
Valproic Acid (Depakote)
A patient complains of an inability to sleep, tremors, palpitations, and restlessness after taking Excedrin Migraine. What ingredient can we contribute these adverse effects too?
Caffeine, 60 mg
A patient is taking Carisoprodol (Soma) for musculoskeletal conditions, what is important to educate them regarding?
Take with food to reduce GI upset, habit forming, abrupt discontinuation can cause withdrawal symptoms
A patient is in an outpatient surgical setting for a procedure. What opiate medication do you anticipate to be combined with Midazolam (Versed) for moderate sedation?
Fentanyl
After receiving Benzocaine (Hurricane), a patient begins to complain of headache, dizziness, dyspnea and poor muscle coordination. When looking at the patient, there is a bluish-tinge around the lips and extremities. What is the reaction known as?
Methemoglobinemia
A patient taking Phenobarbital (Luminal) reports blistering, peeling, flu-like symptoms, joint pain, and a headache. What is the priority nursing action?
STOP the causative agent!!!
A patient is taking Ergotamine Tartrate (Ergomor) for cluster headaches to promote vasoconstriction of the cranial and peripheral nerves or vessels. What patient education is important to teach?
1. Report any darkened, discoloration of extremities
2. Avoid grapefruit juice
What TWO adverse effects are unique to Baclofen (Lioresal)?
1. Urinary frequency
2. Hyperglycemia
In the Emergency Department, a 26-year-old was brought in due to difficulty arousing, slow and shallow breathing, and cyanosis of the lips. When looking at their body, you see track marks on the arms. What is the priority action as the nurse?
Administer Naloxone (Narcan) IV or Intranasal!
After the administration of Inhalation Anesthetics, the patient has tachycardia, elevated temperature, mottling, body rigidity, and sweating. What is the appropriate first action as the nurse?
Administer IV dantrolene sodium!
A patient with a prescription for Phenytoin (Dilatin) for tonic-clonic seizures arrives at the emergency room with confusion, nausea, drowsiness, unsteadiness, and slurred speech. What serum Phenytoin level matches the signs and symptoms?
What is the BBW for Ergot Alkaloids?
cerebral/limb ischemia, CPY3A4 enzyme
What two side effects are unique to Cyclobenzaprine Hydrochloride (Flexeril)?
1. Anticholinergic effects
2. Serotonin Syndrome
What is proper patient teaching for a 65-year-old patient with chronic pain from arthritis taking Tramadol?
Do not combine with SSRIs (risk of serotonin syndrome)!
A patient is preparing to undergo surgery. What aspects in their medical records would contraindicate the use of inhalation anesthetics, such as Isoflurane (Forane)?
1. Severe PONV
2. Hepatic Dysfunction
3. Family or personal history of malignant hypothermia
What is important to monitor for patients on Lacosamide (Vimpat)?
Signs of aggression, sudden personality changes
Besides the pain of a migraine headache, what other symptoms are relieved by Sumatriptan (Imitrex)?
What's that drug!: Depresses motor activity of brainstem and spinal cord to produce muscle relaxation?
Cyclobenzaprine Hydrochloride (Flexeril)