What are common adverse side effects of chronic, unrelieved pain?
Depression , unnecessary suffering/agony , sleep alteration/insomnia , suppressed immune system , irritation/tiredness.
What is the highest risk factor for osteoarthritis?
Obesity/weight gain.
What drug is commonly used for gout, and what significant side effect should be monitored with labs?
Allopurinol. It causes bone marrow suppression (myelosuppression), so monitor platelet levels (for decreased count).
A patient with lupus is going home on steroid therapy. What are key signs/symptoms to educate them on?
Infection , need for sun protection , need for annual eye exams (as the drug can affect eyesight) , and monitoring for GI bleeding (abdominal pain/black tarry stool).
Which pain scale is appropriate for a PACU patient who is in a lot of pain and very sleepy (having a hard time waking up from surgery)?
CPOT scale.
What type of pain is Gabapentin prescribed for?
Neuropathic pain.
A patient with significant jaundice has an order for oxycodone with acetaminophen. Why would you question this order?
You would question the order because acetaminophen is metabolized by the liver, and jaundice indicates liver impairment.
Why is a loading dose given when starting a patient on a PCA (Patient-Controlled Analgesia) pump?
It provides immediate pain relief to get the patient to a better state before starting a basal rate to maintain a steady pain control.
What skin manifestations might you see in a patient with lupus?
Butterfly rash , alopecia , dry hair , and ulcerations in the mouth and nose.
What lifestyle changes would you recommend for a patient with gout going home?
Avoid alcohol (especially those with nitrates like wine and beer) , follow a low-sodium diet , decrease organ meats , and increase fluid intake.
For a patient with generalized chronic pain and depression that prevents them from activities like golfing, what would be a key focus of the care plan?
To decrease their pain and help them return to the activities they enjoy.
What drug, besides an antibiotic, is often given to a patient with a UTI to help with burning, pain, and decreased urinary frequency?
Phenazopyridine
For a confused and incontinent patient who can get up, what is a high-priority intervention?
Take them to the bathroom every 2 hours
How should the diet of a patient with end-stage kidney disease be altered to enhance dialysis?
Low sodium , fluid restriction , decrease protein before starting dialysis, and increase protein after starting dialysis
A patient on a 1200 mL fluid restriction has their wife repeatedly bringing them fluids. What steps should the nurse take?
Educate the patient and wife on the importance of adhering to the fluid restriction, establish a plan with both of them, inform the MD, and document noncompliance in the intake sheet and nursing note.
An HIV patient is becoming more confused and experiencing cognitive, behavioral, and motor issues. What is a likely cause?
Infection – HIV encephalopathy.
What is the first step if a nurse accidentally gets stuck with a needle while caring for an HIV patient?
Thoroughly wash hands with soap and water.
How would you treat loose stools in an HIV patient?
Administer an antidiarrheal.
What type of precautions are required for a patient with TB?
Standard and Airborne precautions.
A patient with osteoarthritis has difficulty walking due to pain. What interventions would you recommend in a care plan to help them ambulate?
Medicate with analgesics to help them get around, recommend weight loss, and weight-bearing exercises.
What is a concern when a patient is prescribed many medications?
Drug interactions (polypharmacy).
What is the key difference between Rheumatoid Arthritis (RA) and Osteoarthritis (OA)?
RA is an inflammation of the synovial membrane, which encases the structure of the immune system. OA results from injury or wear and tear on the body.
What is a key consideration for patients on Prednisolone regarding drug duration?
Drugs like Prednisolone should be used for the shortest amount of time possible.
What is the main symptom seen in patients with lupus, and why?
Fatigue , because patients are chronically anemic.
