Analgesics and Pain Management Medications > Pharmacology
Exam Review
Acetaminophen
Total Questions : 5
Showing 5 questions, Sign in for moreA nurse is reviewing the medication history of a client who has a prescription for acetaminophen.
Which of the following medications should the nurse identify as increasing the risk of hepatotoxicity when taken with acetaminophen?
Explanation
Carbamazepine is an anticonvulsant drug that can induce the activity of cytochrome P450 enzymes in the liver.These enzymes are responsible for metabolizing acetaminophen into a toxic intermediate called N-acetyl-p-benzoquinone imine (NAPQI), which can cause liver injury by depleting glutathione and covalently binding to cellular proteins. Therefore, taking carbamazepine with acetaminophen can increase the risk of hepatotoxicity by enhancing the formation of NAPQI.
Choice A is wrong because warfarin is an anticoagulant drug that does not affect the metabolism of acetaminophen.However, acetaminophen can increase the anticoagulant effect of warfarin by inhibiting its metabolism, which can increase the risk of bleeding.
Choice C is wrong because furosemide is a diuretic drug that does not interact with acetaminophen.However, furosemide can cause dehydration and electrolyte imbalance, which can affect liver function and increase the susceptibility to acetaminophen-induced liver injury.
Choice D is wrong because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that does not affect the metabolism of acetaminophen.However, ibuprofen can cause gastrointestinal irritation and renal impairment, which can also increase the risk of acetaminophen-induced liver injury.Additionally, taking both acetaminophen and ibuprofen can increase the risk of overdose and toxicity.
A nurse is teaching a client who has a new prescription for acetaminophen about the signs of overdose.
Which of the following statements by the client indicates an understanding of the teaching?
Explanation
This statement indicates that the client understands that abdominal pain and nausea are signs of acetaminophen overdose, which can cause liver damage.
The client should seek medical attention immediately if these symptoms occur.
Choice B is wrong because drinking plenty of fluids does not prevent kidney damage from acetaminophen overdose.In fact, dehydration can worsen the toxicity of acetaminophen.
Choice C is wrong because acetaminophen does not cause hypoglycemia (low blood sugar).Hypoglycemia is more likely to occur with drugs that lower blood sugar, such as insulin or sulfonylureas.
Choice D is wrong because acetaminophen does not cause dry mouth or sore throat.These are not signs of acetaminophen overdose and do not require medical attention.
A nurse is caring for a client who has arthritis and takes acetaminophen daily for pain relief. The client asks the nurse why acetaminophen does not reduce the inflammation in his joints.
Which of the following responses should the nurse give?
Explanation
Acetaminophen works by blocking prostaglandins in your brain, but not in your peripheral tissues. Prostaglandins are substances that cause pain and inflammation. By blocking them in the brain, acetaminophen reduces the perception of pain, but does not affect the inflammation in the joints.
Choice B is wrong because acetaminophen does not inhibit cyclooxygenase-2 (COX-2) enzyme, which is involved in the synthesis of prostaglandins. COX-2 inhibitors are a different class of drugs that can reduce both pain and inflammation.
Choice C is wrong because acetaminophen does not decrease the production of leukotrienes, which are another type of inflammatory mediators. Leukotriene inhibitors are used to treat asthma and allergic rhinitis.
Choice D is wrong because acetaminophen does not reduce the activity of natural killer cells, which are part of the immune system and can destroy infected or abnormal cells.
Natural killer cells are not directly related to pain or inflammation.
A nurse is administering acetaminophen to a child who has a fever caused by immunization.
Which of the following forms of acetaminophen should the nurse use?
Explanation
The nurse should use oral liquid acetaminophen to administer the drug to a child who has a fever caused by immunization.This is because oral liquid is easier to swallow and measure for children than oral tablets or capsules.Oral liquid acetaminophen also has a faster onset of action than rectal suppositories.
Choice A is wrong because oral tablets are not suitable for children who may have difficulty swallowing pills.Crushing the tablets may alter the drug’s effectiveness or cause adverse effects.
Choice C is wrong because rectal suppositories are not the preferred route of administration for acetaminophen in children.Rectal suppositories may cause irritation, leakage, or expulsion of the drug.They also have a slower onset of action and variable absorption than oral liquid.
Choice D is wrong because intravenous injection is not an over-the-counter form of acetaminophen.Intravenous injection is a prescription form that is used for severe pain or fever in hospitalized patients.It also requires special equipment and monitoring that are not available at home.
A nurse is preparing to administer acetaminophen to a client who has a fever.
Which of the following actions should the nurse take? (Select all that apply)
Explanation
• Choice B: Assess the client’s liver function tests.This is correct because acetaminophen is metabolized by the liver and can cause liver injury in the case of overdose or in patients with compromised liver function.Therefore, the nurse should check the client’s baseline liver function tests and monitor them for any signs of hepatotoxicity, such as elevated liver enzymes.
• Choice C: Verify the dosage with another nurse.This is correct because acetaminophen is a high-alert medication that requires a second nurse to verify the dosage calculation prior to administration.
This is to ensure client safety and prevent medication errors, such as giving too much or too little of the drug.
• Choice D: Ask the client about any allergies.This is correct because acetaminophen can cause allergic reactions in some people, such as rash, itching, swelling, or anaphylaxis.
Therefore, the nurse should ask the client about any history of allergies to acetaminophen or other medications before giving the drug.
• Choice E: Monitor the client’s temperature.This is correct because acetaminophen is used to reduce fever, and the nurse should monitor the client’s temperature to evaluate the effectiveness of the drug and adjust the dosage accordingly.
• Choice A: Check the client’s blood pressure.This is wrong because acetaminophen does not affect blood pressure significantly, and checking the client’s blood pressure is not a priority action when administering acetaminophen for fever.
The nurse should focus on other vital signs, such as temperature, pulse, and respiratory rate.
Normal ranges for liver function tests are:
• AST: 10 to 40 U/L
• ALT: 7 to 56 U/L
• ALP: 45 to 115 U/L
• Bilirubin: 0.1 to 1.2 mg/dL
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