Nursing 230, Clinical Pharmacology I

Analgesics 

Questions for Group 1

Mrs. Pregnant, age 22, is in her eighth month of pregnancy. She is on unpaid pregnancy leave from her job and she is worried about money. Her husband is an alcoholic. She has been getting tension headaches every day this past week. This afternoon, the headache is worse than usual. In the medicine cabinet, she finds the Motrin IB that she used to take for menstrual cramps. Explain why she should NOT take the Motrin IB for her headache.

Questions for Group 2

Mrs. Ache, age 73, tripped on an uneven sidewalk and turned her ankle yesterday. It is swollen but she can walk on it a little. She refuses to go see her physician because, "He charges too much," and "I don't have time; I have to get my garden planted." Mrs. Ache has some Aleve tablets, 220 mg, that her daughter left at her house. She also has some samples of Advil that came in the mail. Yesterday afternoon, Mrs. Ache took the Aleve, following the dosage instructions on the box. After 15 minutes, her ankle still hurt badly, so she took the Advil, following the dosage instructions on its package. Afterward, she fell asleep while sitting with her foot elevated and missed her usual dinner hour. She was so drowsy when she awoke that she drank a glass of milk and went to bed without dinner.

This morning, she sees you, her neighbor, and hobbles over to talk, leaning on her shovel. Focus on the medication issues and think about what information you want from her. List three to five questions you want to ask her. Then make a list of the six most important teaching points for her.

Questions for Group 3

Mr. Orelhos, age 65, says, "That pain pill the doctor ordered doesn't have aspirin in it does it? I can't take aspirin. I'm allergic to it. It makes my ears buzz." Should he avoid aspirin because he is allergic to it? Explain your answer. 

Questions for Group 4

Mr. Chester Pain, age 57, is having crushing chest pain* at his office. He called the doctor who told him to chew an aspirin and have someone drive him to the nearest hospital emergency department. What is the reason for taking an aspirin in this situation? Why should he chew it?

*Background information: Crushing chest pain is one of the symptoms of a heart attack. A heart attack (myocardial infarction) occurs when the coronary arteries are not supplying enough blood to the heart muscle to meet the muscle's need for oxygen. This often occurs because an atherosclerotic plaque in a coronary artery ruptures and a clot forms that blocks the artery.

Questions for Group 5

Mr. Toradol, age 34, has been receiving ketorolac by intramuscular (IM) injection for 3 days in the hospital. As a nursing student, you are assisting with his care. His nurse asks you to test his feces for occult blood, using a Hemoccult test. Use your Drug Guide to find an adverse reaction of ketorolac that can be life-threatening. If the drug is given by IM injection, is that still a risk? Explain your answer. Why is this drug not to be used for more than 5 days total, for all routes combined?

Questions for Group 6

Gregg Smythe, age 29, injured his knee during soccer practice and went to the urgent care clinic. He has been started on ibuprofen and propoxyphene. As he leaves the clinic, he says, "Well, I'll have to miss Saturday's game, but at least I can join in the post-game beer party." Why was the ibuprofen prescribed? Why was the propoxyphene prescribed? Given his comment about the post-game party, what does he need to know? Explain your answer.

L. Felver, 2004; revised 2007