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Important tasks associated with caring for the client with pain includes
early and ongoing assessment and intervention to promote healing
-
to treat pain effectively
the nurse needs agood understanding of the client’s pain experience
-
It is essential for the nurse to conduct a _____ in order to understand a client’s pain.
thorough pain assessment
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The 5th vital is pain. What things are important to assess in the client with pain?
the client’s subjective description of the pain, location, intensity, duration, scale of pain (1-10), percipitating/alleviating factors, pattern of coping, previous experience, nurse’s observation of client’s behavior.
-
intensity of pain is referred to as ____ data
subjective
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The Wong Baker is a tool used in assessing ___ in children. It relies on ____ instead of numbers.
pain,
pictures of faces
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Salicylates are drugs derived form
salicylic acid
-
uses of salicylates
analgesic, antipyretic, anti-inflammatory
-
-
-
salicylate
Ecotrin, Ecotrin enteric coated
-
diflunisal, Dolobid
salicylate
-
salicylate
magnesium salicylate, Bufferin
-
salicylate
Amigesic, Disalcid
-
-
nausea, vomiting, epigastric distress, GI bleeding, tinnitus, allergic and anaphylactic reactions, overuse are common adverse reactions to
asprin, diflunsal, magnesium salicylate, salsalate
-
Lower body temperature by dialating peripheral BV
salicylate
-
The analgesic action of salicylates is due to the inhibition of
prostaglandins
-
prostaglandins
present in fatty tissues and body fluids and increase the sensitivity of pain receptors in the tissues
-
more potently inhibits prostaglaindin synthesis and has greater anti-inflammatory effects than other salicylates
asprin
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Clients taking asprin are at risk for increased _____. Other salicylates do not have this effect. This effect can last for the ____ days.
bleeding times,
7-10 day (the life of a platelet)
-
This herbal treatment is used as an analgesic, antipyretic and anti-inflammatory agent.
willow bark
-
Upon assessment of the client with peptic ulcers, you find that they have been using Willow bark. What should the nurse tell the client regarding this use in conjunction with peptic ulcers?
Willow bark has fewer adverse reactions than those associated with salicylates. Although adverse reactions are rare, willow bark should be used ith caution and not in conjunction with other salicylates.
-
This salicylate is a nonopiod analgesic which is NOT used as an antipyretic
diflunisal (Dolobid)
-
Asprin (acetylsalicylic acid) is useful in
decreasing myocardial infarction, transient ischemic attacks or strokes
-
When taking salicylates, it is important to note a loss ___
blood in stool.
With normal use, the amount of blood loss may be insignificant. With overuse or even normal use over and extened time, blood loss in the stool may be noted.
-
A client presents with hives, rash, angioedema, bronchospasms with asthma-like symtoms and anaphylactiod reactions. What may the client be experiencing?
an allergy
-
If an allergy to NSAIDs is noted, what other nonopiod alalgesic should be avoided?
salicylates: Asprin, diflunisal, magnesium salicylate
-
Contraindications for salicylates
Clients with GI bleeding, blood dyscrasis, those on anticoagulants or antineoplastics, children with chicken pox or influenza
-
A child is suffering from an itchy rash, vomiting and lethargy in which is progressing into a coma. The child is running a fever and has been given an Asprin to treat it. What might be happening to the child?
The rash and fever may be associated with chickenpox. The vomiting and lethargy are associated with Reye’s Syndrome. Asprin is contraindicated in children due to the possibility of developing Reye’s Syndrome.
-
salicylates should be used cautiously (but NOT contraindicated) in clients with
renal or hepatic disease, lacation, pregnancy, hypothrombinemia, peptic ulcers, GI irratations and vitamin K deficiency
-
Those with gout or mild diabetes should use ___ with caution.
salicylates
-
Salicylism
condition related to the overuse of salicylates. Symptoms include dizziness, tinnitus, impaired hearing, nausea, vomiting, flushing, sweating, rapid and deep breathing, tachycardia, diarerhea, confusion
-
Clients should be warned that these foods contain salicylates
curry powder, paprika, licorice, prunes, raisins and tea
-
Antacids may ____ the effects of salicylates
decrease
-
Carbonic inhibitors (used to reduce intraocular pressure and used as a diuretic) may _____ when used with salicylates
increase the risk for salicylism
-
acetaminophen (APAP)
Tempra, Tylenol
-
Nonsalicylate
APAP, Tempra, Tylenol
-
The drug of choice to treat children with fever and flu like symptoms
APAP (acetaminophen)
-
The most widely used asprin substitute for those allergic to asprin or those who experience extreme GI upset when taking asprin
APAP
-
Acetaminophen does not inhibit ______.
- platelet aggregation
- APAP is the analgesic of choice when bleeding tendencies are an issue.
-
uses for Acetaminophen
treatment of mild-moderate pain,
antipyretic,pain and discomfort related to arthritic disorders
-
This drug is useful in the treatment of those with asprin alergies, peptic ulcers, bleeding disorders, hemophilia, those on antocoagulation therapy or those in which have had recent monor surgical procedures
Acetaminophen
-
Adverse reactions with acetaminophen are rare when used as directed. But when doseage is exceeded, they would include
skin eruptions, urticaria, hemolytic anemia, pancytopenia, hypoglycemia, jaundice and hepatic failure
-
Acetaminophen can damage ___ and ___ when taken in excess.
liver and pancreas
-
Acetaminophen and alcohol can result in
hepatotoxicity
-
Acetaminophen should not be taken cocurrently with ____, ____ or ____.
alcohol, NSAIDs or salicylates
-
If ____ damage is present in the geriatric client, then ____should be used ith caution.
liver,
Acetaminophen
-
Acetaminophen (APAP) should be used with caution in those taking ____,____, ____ and those who abuse ____ due to the possibilty of producing toxicity.
anticonvulsants (hydantoids)
TB medications (isoniazid and rifampin)
loop diuretics
alcohol
-
What nursing intervention is to be considered when treating the diabetic client with Acetaminophen?
Blood glucose testing.
Acetaminophen may alter test results. False low values may result in the inaccurate dosing of antodiabetic medications.
-
A nurse explains that the anti-infammatory actions of the salicylates are most likely due to
the inhibition of prostagalndins
-
A nurse would expect to find what symptoms in the client with salicylism?
dizziness, tinnitus, mental confusion
-
Salicylates should be given with
food or milk
-
Clients taking Acetaminophen and alcohol should be assessed for ______ when monitoring for toxicity.
liver tenderness
-
What drug is the nurse most likely to give a child with fever?
Acetaminophen
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