NCLEX : Anti-Inflammatory and Pain Treatments
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Example Question #121 : Nclex
You are the nurse taking care of a patient with severe lower back pain. He is being treated with oxycodone and hydromorphone. Which of the following analgesic medications produces dilated pupils?
Morphine
Oxycodone
Meperidine
Acetaminophen
Hydromorphone
Meperidine
The correct answer is "meperidine." Meperidine, a potent opioid analgesic, also known as Demerol, is one of the only opioids that produces dilated pupils, rather than constricted, "pinpoint" pupils. A way to remember this is to remember the phrase, "Demerol Dilates." The other choices are incorrect. Acetaminophen has no known effect on pupil size. Morphine, oxycodone, and hydromorphone, all opioid analgesics, are known to constrict the pupils.
Example Question #121 : Pharmacology
You are the nurse taking care of a patient who is hospitalized for severe lower back pain. The patient also has a medical history significant for multiple gastrointestinal bleeds and peptic ulcer disease. Which of the following medications should be used with extreme caution in this patient given his medical history?
Oxycodone
NSAIDs
Acetaminophen
Morphine
Hydromorphone
NSAIDs
The correct answer is "NSAIDs." This is the correct answer because NSAIDs are known to be irritants of the gastrointestinal tract, and prolonged and/or extensive use of NSAIDs can increase the risk of developing gastrointestinal ulcers, as well as consequent gastrointestinal bleeds in the setting of ulcers. Given this patient's medical history, which already contains multiple gastrointestinal bleeds and peptic ulcer disease, NSAIDs should be used very, very carefully, if at all, in this patient.
The other choices are incorrect. Acetaminophen is not known to increase the risk of gastrointestinal bleeding or peptic ulcer formation. Morphine, oxycodone, and hydromorphone are all opioid analgesics and are not known to increase the risk of gastrointestinal bleeding or peptic ulcer formation.
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