Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents

A client is prescribed sumatriptan. Which statement should be included in the teaching plan regarding how the medication works?

"It produces vascular constriction of cranial blood vessels."

The nurse enters the client's room to see how the client's pain level is because PRN Demerol can be given. The client is sitting up in bed laughing and visiting with family. The client states that the pain is a "10" on a pain scale of 0 to 10. What is the best response by the nurse?

Administer the pain medication as ordered.

A nurse has entered a client's room at the beginning of a shift to quickly assess the client's airway, breathing, circulation, and consciousness. The nurse observes that the client is wincing, stating, " Oh, I am in so much pain right now." What initial question should the nurse ask this client?

"Where exactly are you hurting?"

The nurse is caring for a patient who is suffering from postoperative pain. The physician orders 2.5 mg of morphine IV q2h. Morphine is supplied in 10 mg/mL vials. How many mL will the nurse administer in each dose?

0.25 mL

When describing the onset of action of naloxone, the nurse would explain that the drug achieves its effect in which amount of time?

1 to 2 minutes

The nurse is reviewing medications prescribed for a client. For which condition(s) will the nurse expect morphine to be prescribed? Select all that apply.

1) Traumatic injuries 2)acute myocardial infarction

While caring for a client who is prescribed an opioid antagonist for treatment of respiratory depression caused by opioid therapy, the nurse would assess the client for which adverse reaction?

1) Tremors 2) Nausea 3) Tachycardia

The nurse is preparing to administer a dose of ergotamine to a client. After administration, what assessments should the nurse prioritize to assure safe care? Select all that apply.

1) heart rate 2)blood pressure

The nurse suspects opioid overdose in a client after surgery. What interventions must the nurse initiate for this client?

1)Administer naloxone 2)Notify the health care provider 3)Prepare for endotracheal intubation

When evaluating the plan of care for a client receiving opioid analgesics for pain management, the nurse considers the plan successful when what occurs?

1)Therapeutic response is achieved and discomfort is reduced. 2)An adequate breathing pattern is maintained. 3)Client maintains adequate nutritional status.

The nurse knows that, of the following clients, who is least likely to be prescribed transdermal fentanyl?

A woman 85 years of age

The nurse is giving instructions to a client who has just been prescribed sumatriptan for the treatment of migraine headaches. The client will be instructed to take this medication at what time?

At the onset of migraine symptoms

A client suffering from migraine headaches is prescribed sumatriptan. What is the action of the drug?

Binding to serotonin to produce vasoconstriction

While studying pharmacology, the nursing student learns that a naturally occurring narcotic drug with analgesic and antitussive effects is:

Codeine

What action should the nurse take when administering meperidine 75 mg IM every 4 hours to a young adult?

Give the medication as prescribed.

A client is prescribed zolmitriptan for migraine headaches. The nurse should instruct the client to administer this drug by which route?

Oral

A nurse is caring for a client diagnosed with a migraine. The client received acetaminophen-aspirin-caffeine by mouth. Which method should be used to assess for the therapeutic effects of the medication?

Pain scale

The nurse is providing education to a client who has been prescribed sumatriptan. In order to maximize therapeutic benefit while reducing the risk of adverse effects, the nurse should encourage the client to implement which intervention?

Take the medication as soon as the earliest symptoms of migraine are sensed.

A group of students is reviewing various methods for assessing pain. The students demonstrate understanding of the material when they identify what as the most reliable method?

Using a pain rating scale

The nurse has just administered an opioid antagonist to a client who had been experiencing respiratory depression. How soon can the nurse expect to see improvement in the client's respiratory function?

Within one to five minutes, an effect may be seen.

When administering an opioid antagonist drug to a client, the primary goal of the therapy is to provide:

a return to normal respiratory rate, rhythm, and depth.

A woman has presented to the emergency department after cutting her hand badly on the blade of a food processor. The pain that this woman is currently experiencing is the result of

activation of the woman's delta and C nociceptors.

A trauma client has been receiving frequent doses of morphine in the 6 days since his accident. This pattern of analgesic administration should prompt the nurse to carefully monitor the client's what?

bowel patterns.

A 60-year-old client tearfully explains to the nurse how her husband downplays her frequent migraines and tells her that she needs to "just push through a headache." She describes how her migraines have limited her ability to provide childcare for her young grandchildren and explains that she is unable to keep up her garden. The nurse should identify what nursing diagnosis when planning this client's care?

ineffective role performance related to migraine headaches

The client tells the nurse that the health care provider described a drug as having "no ceiling effect." How should the nurse respond when the client asks what that means?

It is a valuable drug to use because dosage can be increased to relieve pain when pain increases or tolerance develops.

Which client would the nurse identify as being opioid naive?

one who does not routinely take opioids

What beta-adrenergic antagonist is used for migraine prophylaxis?

propranolol

Which medications are opioids for which naloxone may be given to counter the effects?

Meperdine

Prior to administering morphine, the nurse checks the client's medication history. The nurse will contact the health care provider and hold the morphine if the nurse notes the client is currently taking which medication?

Monoamine oxidase (MAO) inhibitor

The nurse notes a respiratory rate of 6 breaths/min in a client in the postanesthesia recovery unit. Which drug would the nurse anticipate being given immediately?

Naloxone

A client with a history of chronic alcohol use is prescribed naltrexone. Which teaching will the nurse provide to the client about this medication?

"This medication decreases the desire to drink alcohol."

The nurse observes that a new client's medication regimen includes sumatriptan. What assessment should the nurse prioritize?

Assessing the client for migraine pain

A client has been administered an opioid. For what effect should the nurse regularly assess?

Level of consciousness (LOC)

A client diagnosed with migraines expresses interest in taking an over-the-counter acetaminophen, aspirin, and caffeine combination drug. Which information presented in the client's history should prompt the nurse to discourage the client from taking the drug?

The client has a diagnosis of liver cirrhosis.

The nurse is caring for a postoperative client with a history of opioid abuse who has been ordered to receive a dose of an opioid antagonist medication. Which issues should the nurse be prepared to address?

The client may begin to demonstrate symptoms of withdrawal.

When diagnostic testing reveals a bone fracture, what type of pain is the client experiencing?

acute somatic pain

Morphine, an opioid agonist, is administered for both acute and chronic pain. Along with the administered dosage, what determines the patient's response to morphine?

route of medication