Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher |  Registered Nurse (RN) School Study Aid
Pain Assessment
- Acute Pain
 - Chronic Pain
 - Onset
 - Provoking or Palliative
 - Quality
 - Radiation
 - Severity
 - Timing
 - Subjective Findings
 - Objective Findings
 - Reassessment of Pain
 
Aspirin (Acetylsalicylic Acid)
- Inhibits Platelet Aggregation
 - NSAID
 - Thrombotic Event Prevention
 - General Pain
 - Inflammatory Conditions
 - Fever
 - Pancytopenia
 - GI Ulcers
 - Bleeding
 - Withhold Before Surgery 7-10 Days
 - Reye's Syndrome
 
Ibuprofen (Advil, Motrin)
- NSAID
 - COX Inhibitor
 - General Pain
 - Fever
 - Inflammatory Conditions
 - GI Ulcers
 - Nephrotoxicity
 - Rash
 - Avoid with Alcohol
 - Risk of Thrombotic Event
 
NSAIDs
- Anti-inflammatory
 - Analgesic
 - Fever
 - Closure of Patent Ductus Arteriosus 
 - Reversible Inhibition of COX-1 and COX-2
 - Block Prostaglandin Synthesis
 - Interstitial Nephritis
 - Gastric Ulcer
 - Renal Ischemia
 
Celecoxib
- Rheumatoid Arthritis
 - Osteoarthritis
 - Pain
 - NSAID
 - Selectively Inhibits COX-2
 - Sulfa Allergy
 - Increased Risk of Thrombosis
 - GI Bleed
 - Pregnancy > 30 Weeks
 
Acetaminophen
- Fever
 - Pain
 - Reversibly Inhibits COX
 - Acts Primarily in CNS
 - Hepatic Necrosis
 - N-acetylcysteine Antidote
 
Morphine
- Opioid Receptor Agonist
 - Pain
 - Myocardial Infarction
 - Nausea and Vomiting
 - CNS Depression
 - Biliary Colic
 - Constipation
 - Increased Intracranial Pressure (ICP)
 - Pupillary Constriction
 - Hypotension
 
Codeine
- Opioid Receptor Agonist
 - Mild to Moderate Pain
 - Cough Suppressant
 - Sedation
 - Constipation
 - Miosis
 - Close Monitoring When Breast Feeding
 - Often Combined with Non-Opioids
 
Butorphanol
- Migraine
 - Severe Pain
 - Labor
 - Partial Agonist at Mu and Full Agonist at Kappa Receptors
 - Less Respiratory Depression
 - Withdrawal Symptoms
 
Meperidine (Demerol)
- Opioid Receptor Agonist
 - Moderate to Severe Pain
 - Post Anesthesia Shivering
 - Tremors
 - Constipation
 - CNS Depression
 - Sedation
 - Short Term Administration
 - Increased Risk Serotonin Syndrome
 - Does NOT cause Miosis
 - Renal Failure Increases Toxicity Risk
 
Naloxone (Narcan)
- Competitive Opioid Receptor Antagonist
 - Opioid Induced CNS Depression
 - Severe Nausea and Vomiting
 - Excitable State
 - Opioid Withdrawal Symptoms
 - Repeated Dosing Often Required
 
Prednisone (Glucocorticoids)
- Glucocorticoid
 - Inflammatory Conditions
 - Organ Transplant Rejection
 - Cataracts and Glaucoma
 - Cushing's Syndrome
 - Osteoporosis
 - Immunosuppression
 - Hyperglycemia
 - Ulcers
 - Adrenal Insufficiency
 - Taper Gradually
 
IV Anesthetics
- Barbiturates
 - Benzodiazepines
 - Respiratory Depression
 - Hypotension
 - Ketamine
 - NMDA Receptor Antagonist
 - Hallucinations
 - Opioids
 - Propofol
 - Potentiates GABA-A
 
Bupropion
- Depression
 - Smoking Cessation
 - Increase Dopamine and NE
 - Stimulant Side Effects
 - Seizure
 
Tricyclic Antidepressants (TCAs)
- Inhibits Reuptake of Norepinephrine and Serotonin
 - Depression
 - Bipolar Disorder
 - Fibromyalgia
 - Sedation
 - Orthostatic Hypotension
 - Anticholinergic Effects
 - Cardiac Toxicity
 - Delayed Effect
 - Do Not Stop Abruptly
 
Tricyclic Antidepressants (TCAs) Indications
- Major Depression
 - Bedwetting
 - Fibromyalgia
 - OCD
 - -Iptyline or -Ipramine Suffix
 - Amitriptyline
 - Desipramine
 - Clomipramine
 - Imipramine
 - Nortriptyline
 
Local Anesthetic Overview
- Minor Procedures
 - Epidurals
 - Blocks Na+ Channels
 - State Dependent
 - Combined with Vasoconstrictors
 - Infected Tissue Requires Higher Dose
 - Esters
 - Amides
 - Arrhythmias
 - Cardiotoxicity
 
Lidocaine
- Blocks Na+ Channels
 - Ventricular Arrhythmia
 - Anesthetic
 - Paresthesias
 - Seizures
 - Respiratory Depression
 - Drowsiness
 - Anesthetic Effects Extended with Epinephrine
 
Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
- Depression
 - Diabetic Peripheral Neuropathy
 - Duloxetine
 - Panic and Anxiety
 - Venlafaxine
 - Inhibits Reuptake of Serotonin and NE
 - Hypertension
 - Insomnia
 - Nausea and Vomiting
 - Decreased Libido
 
Gabapentin
- Seizure Treatment
 - Peripheral Neuropathy
 - Postherpetic Neuralgia
 - Bipolar Disorder
 - Migraine Prophylaxis
 - Inhibits Voltage-Gated Ca2+ channels
 - Designed as a GABA Analog
 - Ataxia
 - Sedation
 
Pregabalin (Lyrica)
- GABA Analog
 - Seizures
 - Neuropathic Pain
 - Fibromyalgia
 - Headache
 - Dizziness
 - Ataxia
 - Somnolence (Fatigue)
 - Weight Gain
 - Angioedema
 - Rhabdomyolysis
 - Dependence
 
Phenytoin (Dilantin)
- Blocks Na+ Channels
 - Tonic-clonic Seizures
 - Ataxia
 - Nystagmus
 - Sedation
 - Gingival Hyperplasia
 - Purple Glove Syndrome
 - Hirsutism
 - Rash
 - Anemia
 - Individualized Dosing
 
Carbamazepine (Tegretol)
- Inactivates Na+ Channels
 - Seizures
 - Bipolar Disorder
 - Trigeminal Neuralgia
 - Nystagmus
 - Ataxia
 - Hepatotoxicity
 - Blood Dyscrasias
 - Water Retention
 - Stevens-Johnson Syndrome
 - Avoid Grapefruit Juice
 
Lamotrigine (Lamictal)
- Blocks Na+ Channels
 - Seizures
 - Bipolar Disorder
 - Diplopia
 - Stevens-Johnson Syndrome
 - Headache
 - Aseptic Meningitis
 - Nausea and Vomiting
 - Screen for Suicide Risk
 
Peak and Trough
- Peak
 -  Highest Concentration
 - Trough
 - Lowest Level of Therapeutic Range
 - Obtain Before Next Dose
 - Half-Life
 
5 Rights of Delegation
- Right Task
 - Right Circumstance
 - Right Person
 - Right Direction/Communication
 - Right Supervision/Evaluation
 
Routes of Administration Part One
- Oral
 - Sublingual
 - Buccal
 - Rectal
 - Tubes
 - Transdermal
 - Drops/Spray
 - Vaginal
 - Inhalation
 
Routes of Administration Part Two (Parenteral)
- Intradermal
 - Subcutaneous
 - Intramuscular (IM)
 - Intravenous
 - Epidural
 - Intrathecal
 - Intraosseous
 - Intraperitoneal
 
Opioid Use Disorder and Withdrawal Assessment (Formerly Opioid Abuse and Withdrawal Assessment)
- Euphoria
 - Miosis
 - CNS Depression
 - Yawning
 - Gooseflesh
 - Sweating
 - Rhinorrhea
 - Kicking Movements
 - Naloxone
 
Substance Use Disorder Assessment (Formerly Substance Abuse Assessment)
- Changes in Mood
 - Poor Hygiene
 - Odd Sleep Patterns
 - Frequent Injuries
 - Relationship or Job Difficulty
 - Poor Performance
 - Anorexia OR Weight Loss
 - Social Isolation
 - Financial Problems