NU220 pharmocology chapter 49 drug therapy with opioids

A client's healthcare provider has prescribed meperidine 75 mg PO q4h PRN for the client's chronic pain. What education should the nurse provide to this client regarding this medication?

"Avoid drinking alcohol while taking meperidine."

A client has been prescribed morphine 4 - 6 mg IV q4h PRN. The client reports pain rated at 8/10 and the nurse verifies on the MAR that the client has most often required 6-mg doses. The nurse chooses to administer 6 mg. The drug is available in ampules containing 10mg/mL. How many mL should the nurse withdraw and administer?

0.6

Which client would the nurse identify as being opioid naive?

one who does not routinely take opioids

The nurse is caring for a patient who is receiving an opioid analgesic. What would be a priority assessment by the nurse?

Level of consciousness and respiratory rate

A nurse is caring for a patient who is on morphine therapy. An expected outcome of the morphine therapy would be that the patient has

adequate pain control with minimal adverse effects.

The nurse administers morphine 15 mg oral solution to a client with cancer pain at 09:30. What time should the nurse reassess the client for peak analgesic effect?

10:30

A client's family asks why the nurse has placed suction equipment in the room immediately after administering a dose of naloxone. Which explanation by the nurse is correct?

Abrupt reversal of opioid-induced respiratory depression may cause vomiting.

The nurse is caring for a client who has been admitted to the emergency department after a fall. An x-ray indicates that the client has fractured his ankle. Because of a previous stroke, the client does not speak. What other method will the nurse use to assess this client's pain? (Select all that apply.)

Facial expressions Movement of arms and hands Guarding of the leg

The nurse notes a client prescribed an extended-release opioid requests that all medications be crushed to facilitate the administration. What information about this form of opioid presents a problem respecting the client's request?

Crushing the medication may precipitate an overdose.

A client is to receive a narcotic that will be applied transdermally. The nurse identifies this as which agent?

Fentanyl

Naloxone (Narcan) will reverse the effects of which drug?

Fentanyl (Duragesic)

When teaching a client about patient-controlled analgesia (PCA), which would the nurse integrate into the teaching plan?

Many postoperative clients require less opioid when PCA is used.

A client is undergoing inpatient addiction rehabilitation following many years or addiction to heroin. What medication would be the most useful adjunct to treatment?

Methadone

Which of the following terms would the nurse expect health care professionals to use to describe drugs used in pain management?

Opioids

A geriatric client received a narcotic analgesic before leaving the postanesthesia care unit to return to the regular unit. What is the priority nursing intervention for the nurse receiving the client on the regular unit?

Put side rails up and place bed in low position.

The nurse is caring for a client who is receiving a prescribed opioid analgesic. What reactions that could be related to the drug therapy should prompt the nurse to contact the health care provider immediately? Select all that apply:

Respiratory rate of less than 10 breaths/min Decrease in pulse Blood pressure of 95/65 mmHg

Keith, 12 years old, is seen in the emergency department for a severe sunburn. He reports pain, which he rates 7/10. What type of pain is he suffering from?

Superficial somatic pain

Clients diagnosed with chronic pain should be given what information regarding opioids' effectiveness?

They should be given on a regular schedule, around the clock.

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.

The nurse is describing potential adverse effects to a client who has been prescribed an opioid agonist. The nurse would indicate that effects on what body systems are potentially life threatening? Select all that apply.

central nervous (CNS) respiratory

A nurse will be prepared to administer naloxone (Narcan) to a patient who has had an overdose of morphine. Repeated doses of Narcan will be necessary because Narcan

has a shorter half-life than morphine.

A family member of a client in the emergency department reports that the client has been illegally using fentanyl. The nurse should prioritize assessment of what vital sign to assess for overdose?

respiratory rate