Pnur 129 Final Exam Detailed Questions And
Expert Answers
Somatic vs. Visceral pain - ANS Somatic- easy to localize; arises from activation of
nociceptors in the skeletal muscles, fascia, ligaments, vessels, or joints; usually
localized, constant, and may be described as aching or throbbing
Visceral- origin in smooth musculature or sympathetically innervated organ
systems; often difficult to localize since it is dull and aching and may also be
referred (spread of pain to an uninjured area); abdomen pain, etc.
Nociceptive pain - ANS arises from mechanical, thermal, or chemical noxious
stimuli to the A-delta and afferent nociceptors
neuropathic pain - ANS occurs from abnormal processing of sensory stimuli by CNS
or PNS and is linked with insults to nervous system
pharmacokinetics vs pharmacodynamics - ANS kinetics: what the body does to the
drug (absorption, distribution, metabolism, excretion)
dynamics: what the drug does to the body
why might older adults not take their meds? - ANS eyesight changes, changes to
taste and smell, decreased manual dexterity, cog. decline and memory loss, don't
know how to take meds...
,WHO 3 step pain ladder - ANS -non-opioid
-opioid and non-opioid
- stronger opioid with non-opioid
*guide when treating cancer
*does not work for everyone
A/E of opioids (common and less frequent) - ANS common:
Constipation, Nausea, Sedation, Dry Mouth
less frequent:
resp. depression, urinary retention, pruritis, confusion, agitation, allergy (rare)
except codeine
What is tolerance? - ANS decreasing response to repeated drug doses
what is dependence? - ANS when the body becomes dependent/accustomed to a
drug and its taken for longer than intended
Calcium Channel Blockers
prototype, action, uses, A/E or S/E - ANS prototype: Nifedipine (adalat)
action: blocks calcium channels in myocardial and vascular smooth muscle
uses: angina, HTN, dysrhythmias
A/E: hypotension, dizziness, headache
,Potassium-Sparing Diuretics
prototype, action, uses, A/E or S/E - ANS prototype: Spironolactone (aldactone)
action: decrease reabsorption of sodium and increases production and excretion
of urine, but retains more potassium
uses: mild-moderate HTN, HF
A/E: hyperkalemia, increased uric acid levels
Classification of atorvastatin - ANS therapeutic: lipid lowering agent
pharmacologic: HMG-CoA reductase inhibitors
Contraindications of ipratropium - ANS Contraindications of ipratropium
hypersensitivity to ipratropium, atropine, belladonna alkaloids, or bromide. Avoid
using during acute bronchospasm
How does a potassium-sparing diuretic (like Spironolactone) block sodium
reabsorption? - ANS Since aldosterone is responsible for increasing the renal
absorption of sodium in exchange for potassium (causing water retention),
potassium-spring diuretics inhibit aldosterone secretion to increase excretion of
sodium and water, leaving the body to retain more potassium
Loop Diuretics
prototype, action, uses, A/E or S/E - ANS prototype: Furosemide (Lasix)
, action: decrease reabsorption of sodium and increase in production and excretion
of urine
uses: mild-moderate HTN, HF
A/E: ototoxicity, hyperglycemia, increased uric acid levels, hypotension,
dehydration
PROSTAGLANDINS
prototype, action, uses, A/E or S/E - ANS prototype: Misoprostol
action: inhibits gastric acid secretion and stimulate production of protective mucus
uses: prevention of ulcers in clients taking NSAIDs
A/E: not listed
Nursing Responsibilities of ipratropium - ANS assess for allergy. Assess resp. status
before admin and @ peak of med. If admin w/ other inhalant meds, admin
adrenergic bronchodilators first, followed by ipratropium, then corticosteroids
T or F
STATINS are used as a hyperlipidemic agent - ANS TRUE
prototype: atorvastatin
they interfere w the synthesis of cholesterol in the liver.
NO GRAPEFRUIT
prototype and action of loop diuretics? - ANS prototype: furosemide