Pain & Fever
This non-opioid medication reduces pain and fever but has little anti-inflammatory effect.
What is acetaminophen?
Nursing pearl: Key concern: excessive exposure can cause serious liver injury.
This opioid analgesic primarily activates mu receptors and requires reassessment of pain, sedation, and respiratory status.
What is morphine?
Nursing pearl: Mu activation provides analgesia but can also depress respiration.
This medication is used for neuropathic pain and seizures and commonly causes dizziness and somnolence.
What is gabapentin?
Nursing pearl: Watch CNS depression, especially when combined with other CNS depressants.
This benzodiazepine enhances GABA-A activity and is commonly used for rapid control of status epilepticus.
What is lorazepam (Ativan)?
Nursing pearl: After administration, prioritize airway, breathing, oxygenation, LOC, BP, and seizure activity.
This ophthalmic nonselective beta blocker decreases elevated intraocular pressure in open-angle glaucoma or ocular hypertension.
What is timolol ophthalmic?
Nursing pearl: It blocks beta-1 and beta-2 receptors.
This NSAID decreases prostaglandin production and is commonly used for pain, fever, and inflammation.
What is ibuprofen?
Nursing pearl: Think GI, renal, and bleeding risks common to NSAIDs.
This potent opioid, often used for severe pain, is also a mu-receptor agonist and can cause respiratory depression.
What is hydromorphone?
Nursing pearl: Do not confuse hydromorphone with morphine; both require careful respiratory reassessment.
This antiseizure medication binds the SV2A synaptic vesicle protein.
What is levetiracetam (Keppra)?
Nursing pearl: Monitor for behavioral or mood changes as well as seizure control.
This benzodiazepine also enhances GABA-A activity and is available in rescue formulations for seizures.
What is diazepam (Valium)?
Nursing pearl: Major concerns include sedation and respiratory depression.
Even though timolol is an eye drop, systemic absorption can cause this cardiac effect.
What is bradycardia?
Nursing pearl: Topical ophthalmic medication does not mean effects are limited to the eye.
This potent NSAID is used only short-term for moderately severe acute pain and should not be combined with other NSAIDs.
What is ketorolac?
Nursing pearl: High-yield point: total ketorolac therapy is limited to 5 days in adults.
After giving naloxone, why must the nurse continue close respiratory monitoring?
What is recurrence of opioid toxicity after naloxone wears off?
Nursing pearl: Some opioids may outlast naloxone, so repeat assessment is essential.
This antiseizure medication reduces repetitive neuronal firing by acting on voltage-gated sodium channels.
What is phenytoin (Dilantin)?
Nursing pearl: Think neurologic toxicity and gingival overgrowth; therapeutic monitoring may be needed.
Lorazepam and diazepam increase the effect of this major inhibitory neurotransmitter.
What is GABA?
Nursing pearl: More GABA-mediated inhibition rapidly suppresses excessive neuronal activity.
Because timolol blocks beta-2 receptors, this respiratory complication is especially concerning in patients with asthma.
What is bronchospasm?
Nursing pearl: Timolol ophthalmic is contraindicated in bronchial asthma and severe COPD.
Ibuprofen and ketorolac reduce which local chemical messengers associated with pain, inflammation, and fever?
What are prostaglandins?
Nursing pearl: Reduced protective prostaglandins also help explain GI and renal adverse effects.
This opioid antagonist can rapidly reverse opioid-induced respiratory depression.
What is naloxone?
Nursing pearl: Priority outcome: adequate ventilation, not simply full wakefulness.
A patient taking Keppra becomes unusually irritable and aggressive. Which medication-related concern should the nurse recognize?
What is a behavioral adverse effect of levetiracetam?
Nursing pearl: Behavior and mood are important reassessment areas with levetiracetam.
A seizure stops after IV lorazepam. Which assessment becomes an immediate priority because of the same CNS-depressant mechanism?
What is respiratory status / airway and breathing?
Nursing pearl: Therapeutic effect and harm are linked: CNS inhibition stops the seizure but can suppress respiration.
For a patient receiving ophthalmic timolol, name three useful reassessment areas.
What are intraocular pressure, heart rate/blood pressure, and respiratory status?
Nursing pearl: Connect local benefit with possible systemic beta-blockade.