(Pharm) Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents

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." "Have blood levels drawn in one week." "Avoid sun exposure, or apply high-SPF sunscreen." "Eat small, frequent meals to reduce gastrointestinal upset."

"Avoid drinking alcohol while taking meperidine." Explanation: Drinking alcohol during narcotic treatment can exacerbate CNS depression. Narcotics do not necessitate monitoring of serum levels and they do not cause photosensitivity. Most clients do not experience significant dyspepsia; constipation is by far the most common GI effect.

A client uses sumatriptan for treating her migraine headaches. Which statement by the client indicates to the nurse that she understands how to take this drug? "I can repeat a dose in 15 minutes for a total of four doses." "I should repeat the dose in 30 minutes for a total of three doses." "I can take another dose 2 hours after the first one." "I can take another dose in about 4 hours, if needed."

"I can take another dose 2 hours after the first one." Explanation: With sumatriptan, the client should take the first dose at the first sign of a headache and then repeat the dose, if needed, in approximately 2 hours.

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 medication causes bronchiole constriction." "The medication impairs the reuptake of norepinephrine." "It relaxes smooth muscles of the cardiovascular system."

"It produces vascular constriction of cranial blood vessels." Explanation: Sumatriptan binds to the serotonin receptors 5-HT1D, producing vascular constriction of the cranial blood vessels and relieving the pain of a migraine headache. It also relieves the nausea, vomiting, photophobia, and phonophobia that accompany the migraine headache. Sumatriptan does not cause bronchiole constriction or impair the reuptake of norepinephrine. It does not relax smooth muscles of the cardiovascular system.

A 50-year-old woman has been prescribed sumatriptan for the treatment of migraines. What instructions should then the nurse provide to the patient about the safe and effective use of this drug? "Take a dose of sumatriptan each morning when you suspect there's a chance of having a migraine." "Take this drug as soon as you feel the first signs of a migraine." "Lie down when you feel a migraine coming on and take some sumatriptan around 30 minutes later." "Take a dose of sumatriptan after you feel that you're unable to endure the pain of your migraine."

"Take this drug as soon as you feel the first signs of a migraine." Explanation: Administer sumatriptan as soon as the headache begins. Sumatriptan is more efficacious when given before the headache escalates. However, it is not normally taken on a prophylactic basis.

A client has sought care for the treatment of migraines that have become increasingly severe. The care provider has prescribed abortive therapy. What should the nurse teach the client about this drug regimen? "Take your medication at the first sign of a migraine." "If you miss one of your daily doses, don't take a double dose." "Be sure to take your medication at around the same time each day." "You might want to use a weekly pill organizer so you don't forget a dose."

"Take your medication at the first sign of a migraine." Explanation: Abortive therapy for migraines is taken with the onset of symptoms, not on a scheduled basis as with preventive therapy. For this reason, teaching about the daily timing of the medication, missed doses and weekly organizing are irrelevant.

A client who is receiving morphine reports nausea after every dose of medication. What is the nurse's best response to this client? "I'm sorry. That means you won't be able to have any more pain medication." "This is a common side effect of the medication. I will try to make sure you have something to eat when you take the morphine." "I will mark your chart that you are allergic to morphine." "I will ask the health care provider if I can give you acetaminophen for the pain instead of the morphine.

"This is a common side effect of the medication. I will try to make sure you have something to eat when you take the morphine." Explanation: Nausea is a common side effect of morphine. Giving it with food helps to reduce the occurrence of the problem.

A client who is receiving morphine reports nausea after every dose of medication. What is the nurse's best response to this client? "I'm sorry. That means you won't be able to have any more pain medication." "This is a common side effect of the medication. I will try to make sure you have something to eat when you take the morphine." "I will mark your chart that you are allergic to morphine." "I will ask the health care provider if I can give you acetaminophen for the pain instead of the morphine."

"This is a common side effect of the medication. I will try to make sure you have something to eat when you take the morphine." Explanation: Nausea is a common side effect of morphine. Giving it with food helps to reduce the occurrence of the problem.

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 takes the place of pain medication." "It can be taken before ingesting alcohol." "It helps with the side effects of alcohol abuse." "This medication decreases the desire to drink alcohol."

"This medication decreases the desire to drink alcohol." Explanation: Naltrexone is an opioid antagonist that acts in the brain to prevent opiate effects. It is commonly prescribed for substance abuse because it decreases the desire to drink alcohol. Naltrexone is not used as a pain medication. It should not be taken before ingesting alcohol. Naltrexone does not help reduce the side effects of alcohol abuse.

A client who has been prescribed sumatriptan as abortive therapy for migraines reports, "I took that pill about an hour-and-a-half ago, but I feel like a headache is returning. Can I take another pill?" How should the nurse respond? "Wait at least half-an-hour before you take another pill." "Yes, it's likely safe to take one more dose of your sumatriptan." "You should probably go to the emergency department." "You can take another pill now and one more in 1 hour, but then no more."

"Wait at least half-an-hour before you take another pill." Explanation: Clients can take a second dose of oral sumatriptan when symptoms return but no sooner than 2 hours after the first tablet. There's no evidence that the client needs to go to the emergency department.

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? "When did this pain begin?" "Would you like me to get you something?" "In the past, what has helped your pain?" "Where exactly are you hurting?"

"Where exactly are you hurting?" Explanation: To begin the pain assessment, first determine the location of the pain. Location gives possible clues to the source of the pain and can help identify whether the pain is acute or of a more chronic nature. Questions about preferred treatments and the timing of the pain are appropriate and important, but it is normally necessary to first ascertain the location of the client's pain.

The client is to take almotriptan 6.25 mg orally for a migraine. Almotriptan is sent to the unit from the pharmacy in 12.5-mg tablets. The nurse will administer how many tablet(s)?

0.5 Explanation: 6.25/12.5 = 0.5 or 1/2 tablet

A hospice patient has been ordered morphine (Roxanol) 5 mg every 2 hours. Roxanol contains 10 mg/mL. How many mL will be administered? 0.25 mL 0.5 mL 1 mL 2 mL

0.5 mL Explanation: 5 mg/X=10 mg/mL. The calculation results in .5 mL. The administration of 0.25, 1, or 2 mL is incorrect.

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 Explanation: 6 mg ÷ 10 mg/mL = 0.6 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 10 to 15 minutes 15 to 30 minutes 30 to 60 minutes

1 to 2 minutes Explanation: Naloxone is capable of restoring respiratory function within 1 to 2 minutes of administration. The shorter the time to restoring respiration the less time the client has to depend on manual or mechanical ventilation and the better the outcome for the client.

At 1030, the nurse administers morphine 5 mg IV as prescribed for a client in pain. The nurse should expect to assess for the drug's maximum effect at what time? 1035 1050 1105 1120

1050 Explanation: When given intravenously, morphine levels peak in 20 minutes. Since the drug in this scenario is administered at 1030, the peak should occur at 1050.

The nurse administers morphine 15 mg oral solution to a client with cancer pain at 0930. When should the nurse reassess the client for peak effect? 1000 1200 1300 1100

1100 Explanation: With oral administration, peak activity occurs in about 60 minutes. The duration of action is 5 to 7 hours.

The nurse is caring for four clients. For which client would the nurse question the health care provider's order of IV morphine? A 78-year-old with osteoarthritis A 45-year-old, 1-day postoperative mastectomy An 8-year-old with a fractured femur A 17-year-old, 1-day postoperative appendectomy

A 78-year-old with osteoarthritis Explanation: Older clients are more likely to experience the adverse effects associated with these drugs, including central nervous system, gastrointestinal, and cardiovascular effects.

The nurse knows that, of the following clients, who is least likely to be prescribed transdermal fentanyl? A woman 85 years of age A man 25 years of age A man 50 years of age A woman 35 years of age

A woman 85 years of age Explanation: The transdermal route of medication administration is dependent upon the amount of subcutaneous tissue present for medication distribution. Subcutaneous tissue is reduced as a result of the aging process. Therefore, the client 85 years of age would be least likely to be prescribed a transdermal medication. The clients 25, 35 and 50 years of age would have adequate subcutaneous tissue for medication distribution.

The anatomy and physiology instructor is talking about pain sensations. What responds to stimulation by generating nerve impulses that produce pain sensations? A fiber sensory nerves A-delta sensory nerves Mu receptors Sigma-receptors

A-delta sensory nerves Explanation: Two small-diameter sensory nerves, A-delta and C fibers, respond to stimulation by generating nerve impulses that produce pain sensations. Large-diameter sensory nerves, A fibers, transmit sensations associated with touch and temperature. Mu-receptors are primarily pain-blocking receptors and sigma-receptors cause papillary dilation and may be responsible for the hallucinations, dysphoria, and psychoses that can occur with narcotic use.

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? After surgery, a client may feel nauseated as a side effect of the anesthesia. Abrupt reversal of opioid-induced respiratory depression may cause vomiting. This is a precaution in case the client begins to choke when resuming a general diet. Suction equipment should be placed in all client rooms as a standard of care postoperatively.

Abrupt reversal of opioid-induced respiratory depression may cause vomiting. Explanation: It is important to keep suction equipment readily available because abrupt reversal of opioid-induced respiratory depression may cause vomiting. None of the other rationales provided is a valid reason for adding suction equipment to the room of a client who requires a dose of naloxone.

A client is diagnosed with a tension headache. What are the expected therapies for this condition? Acetaminophen Relaxation techniques Nonsteroidal anti-inflammatory agents Beta adrenergic antagonists Aspirin

Acetaminophen Relaxation techniques Nonsteroidal anti-inflammatory agents Aspirin Explanation: Treatment for tension headaches entails the use of non-pharmacological methods such as rest, relaxation techniques, or stress-reduction strategies as well as pharmacological therapy of acetaminophen, aspirin, and nonsteroidal anti-inflammatory agents. Beta adrenergic antagonists are used for prevention of migraines.

A client's post-surgical pain is severe and persistent. The client states that recent doses of morphine IV have "helped only a little bit." The client has a PRN dose of morphine available, and wants to receive the medication. The client's respiratory rate is 14 breaths per minute. What is the nurse's best action? Offer an ice pack and reassess the client's respiratory status in 30 minutes Inform the client that morphine would cause excessive respiratory depression and offer non-pharmacologic interventions Administer the morphine as prescribed and monitor the client's respiratory status closely Contact the care provider to seek direction

Administer the morphine as prescribed and monitor the client's respiratory status closely Explanation: A respiratory rate of 14 breaths per minute is lower than expected, but is not low enough to warrant withholding a client's medication. The nurse should give the medication and monitor the client closely. There is no clear need to contact the provider.

The client is having surgery this week. What information should the nurse give the client concerning the use of pain medication after surgery? Take as little pain medication as possible to prevent addiction. Ask for pain medication before the pain gets severe. Request your pain medication whenever it is available to you. Wait as long as possible for pain medication; it will work more effectively.

Ask for pain medication before the pain gets severe. Explanation: The nurse should emphasize the importance of pain control, stressing to the client that pain relief is greater if the medication is taken when pain is not very severe. If the client waits too long for pain medication, it will be much harder to control the pain. Also, the client should not take pain medication whenever it is available, but only when it is needed. It is rare for a client to become addicted to pain medication when it is taken for the relief of pain. The need for the pain medication goes away when the pain subsides.

The nurse is caring for a postoperative client taking an opioid medication for pain. The nurse assesses the client to have bradypnea and an oxygen saturation value of 90%. Which actions should the nurse perform before administering the ordered opioid antagonist? Assess the client's other vital signs. Call for a respiratory therapy consult. Reassess the client's level of pain. Reposition the client for comfort.

Assess the client's other vital signs. Explanation: Blood pressure, pulse, and respirations are important assessments to make prior to administering an opioid antagonist. It is unnecessary to call for a respiratory therapy consult because the cause of the respiratory depression is known. While assessing and managing pain are important postoperative interventions, the respiratory depression-management interventions are the most important ones to be addressed.

The nurse observes that a new client's medication regimen includes sumatriptan. What assessment should the nurse prioritize? Assessing the client for migraine pain Assessing the client for narcotic withdrawal syndrome Assessing the client for respiratory depression Assessing the client's lying, sitting and standing blood pressure

Assessing the client for migraine pain Explanation: Sumatriptan is indicated for the treatment of acute migraine and cluster headaches. As such, the nurse should assess the client for indications of this health problem, more so than respiratory status or blood pressure. Narcotic withdrawal syndrome is unrelated.

To decrease the risk of injury to a client taking an opioid, what should the nurse do? (Select all that apply.) Keep the lights in the client's room turned down. Assist client from their bed to the toilet. Assist client with rising from a lying position. Assist client with hall-walking activities. Advise the client to stay in bed all night.

Assist client from their bed to the toilet. Assist client with rising from a lying position. Assist client with hall-walking activities. Explanation: To decrease the risk of injury to a client taking an opioid, the nurse should assist the client with ambulatory activities and with rising from a sitting or lying position. The nurse should also keep the client's room well-lit during daytime hours, keep the client's room free of clutter, and advise the client to seek assistance when getting out of bed at night.

A client suffering from migraine headaches is prescribed sumatriptan. What is the action of the drug? Binding to phospholipids to diminish anxiety Interrupting the calcium intake in the neuron Binding to serotonin to produce vasoconstriction Reducing inflammation in the temporal arteries

Binding to serotonin to produce vasoconstriction Explanation: Sumatriptan binds to the serotonin receptors in the intracranial blood vessels, resulting in vasoconstriction. Sumatriptan does not bind to phospholipids to diminish anxiety. Sumatriptan does not interrupt the calcium intake in the neuron. Sumatriptan does not reduce inflammation in the temporal arteries.

When describing the action of ergot derivatives, the nurse would incorporate understanding of: Blockage of alpha-adrenergic receptors Interference with dopamine Inhibition of opioid receptors Interference with cerebral enzyme systems

Blockage of alpha-adrenergic receptors Explanation: Ergot derivatives block alpha-adrenergic and serotonin receptor sites in the brain to cause constriction of cranial vessels, a decrease in cranial artery pulsation, and a decrease in the hyperperfusion of the basilar artery bed.

What is a priority nursing assessment of a client prescribed oral sumatriptan? Blood pressure Urinary output Head to toe assessment Glasgow coma scale

Blood pressure Explanation: After administration of sumatriptan, the nurse should assess for adverse effects. These include increased blood pressure as well as chest pain, shock, dizziness and vertigo. Urine output and head to toe assessment are not warranted. The Glasgow comas scale is used to determine best neurological function and not migraine pain.

Prior to the administration of an opioid antagonist, what must the nurse obtain? (Select all that apply.) Blood pressure Blood glucose Pulse Pain assessment Respiratory rate

Blood pressure Pulse Respiratory rate Explanation: Prior to the administration of an opioid antagonist, the nurse must obtain the client's blood pressure, pulse, and respiratory rate.

The nurse has administered a dose of naloxone and the client's respiratory depression improved within five minutes. When the nurse reassessed the client two hours later, the client demonstrates symptoms of respiratory depression. Which action should the nurse perform next? No further action is required because the naloxone has already been administered. Call the provider as another dose of opioid antagonist may be necessary. Administer a second dose and then notify the provider to obtain an order. Continue to monitor the client's vital signs and oxygen saturation levels.

Call the provider as another dose of opioid antagonist may be necessary. Explanation: The effects of some opioids may last longer than the effects of naloxone. A repeat dose of naloxone may be ordered if results obtained from the initial dose are unsatisfactory. Therefore, calling for an order would be an appropriate response. Taking no action in light of respiratory depression, or merely continuing to monitor the client, could lead to deterioration in the client's condition. No medication should be administered without a provider order.

A nurse is teaching a client about the prescription for acetaminophen to be taken at home. This medication consists of acetaminophen and what other likely drug that enhances the analgesic effect of acetaminophen? Codeine Acetylsalicylic acid Methadone Tramadol

Codeine Explanation: Codeine is often given with acetaminophen for additive analgesic effects. None of the other medications are used in combination with acetaminophen.

A nurse is caring for a client with renal impairment. The client has been prescribed an opioid analgesic. Which nursing intervention would be most appropriate? Provide aggressive bowel program. Administer the drug through the IV route. Consult with the prescriber about lowering the dosage of the drug. Administer an antacid with the drug.

Consult with the prescriber about lowering the dosage of the drug. Explanation: The nurse should lower the dosage of the drug when caring for a client with renal impairment who has been prescribed an opioid analgesic, but only after consulting with the prescriber and obtaining a prescription to do so. The nurse has to provide an aggressive bowel program to clients who experience an adverse reaction on their GI system due to the action of the opioid analgesics. Use of an antacid is recommended only if prescribed by the primary health care provider under specific circumstances. The nurse need not administer the drug through the IV route for a client with renal impairment who has been prescribed opioid analgesics.

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? The medication can be very irritating to mucous membranes. The crushed medication can permanently stain teeth. Crushing the medication may precipitate an overdose. Crushing the medication interferes with its absorption.

Crushing the medication may precipitate an overdose. Explanation: Health care providers and clients must be cautioned to avoid crushing or chewing the tablets or opening capsules because immediate release of the drug constitutes an overdose. None of the other answers apply.

The nurse receives a phone call from a male client who has become constipated while taking the opioid analgesic prescribed for his pain. The nurse instructs the client to do what to help relieve this problem? (Select all that apply.) Eat a diet low in fiber Drink 2 to 3 quarts of water per day Take a daily stool softener Take a laxative twice a day Try to establish a regular bowel routine

Drink 2 to 3 quarts of water per day Take a daily stool softener Try to establish a regular bowel routine Explanation: Constipation is a common problem that occurs with the use of opioids. The client should be encouraged to eat a high-fiber diet, drink 2 to 3 quarts of water, take daily stool softener and laxative (if OK'd by a health care provider), and establish a bowel routine

A client diagnosed with impaired renal function has been prescribed morphine. How will the client's underlying condition affect the pharmacokinetics of the drug? Duration of action will be prolonged. Onset of desired effect will be shortened. The peak drug effect will occur earlier. Desired effect will be lessened.

Duration of action will be prolonged. Explanation: Clients with renal impairment should take minimal doses of morphine for the shortest effective time because usual doses may produce profound sedation and a prolonged duration of action. Desired effect, onset, and peak are not concerns.

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

Fentanyl Explanation: Fentanyl is available as a transdermal patch.

Naloxone (Narcan) will reverse the effects of which drug? Fentanyl (Duragesic) Lorazepam (Ativan) Valproic Acid (Depakote) Warfarin (Coumadin)

Fentanyl (Duragesic) Explanation: Naloxone (Narcan) is an opioid antagonist, which means it will only reverse the effects of opioids like fentanyl (Duragesic).

Because of the physiologic changes that occur as we age, older patients are more likely to experience what adverse effects of these drugs? Diarrheal Peripheral somatosensory Gastrointestinal Sensory perceptual

Gastrointestinal Explanation: Older patients are more likely to experience the adverse effects associated with these drugs, including central nervous system, gastrointestinal, and cardiovascular effects.

What action should the nurse take when administering meperidine 75 mg IM every 4 hours to a young adult? Give the medication as prescribed. Administer half the dose. Call the health care provider for a smaller dose. Give the dose by mouth.

Give the medication as prescribed. Explanation: The client should be administered the full dose of medication, which is within dosing recommendations. A client with adequate hepatic and renal function should not receive a lower dose of meperidine without specific instruction from the prescribing care provider. There is no apparent reason to change the route of administration, and such action cannot be implemented without the instruction of the prescribing care provider.

A nurse is assessing a client's pain level. Which would be the most appropriate method? Ask the client to describe their pain in their own words. Have the client rate it on a scale of 0 to 10. Palpate the area where the client says the client has pain. Review the client's vital signs for changes.

Have the client rate it on a scale of 0 to 10. Explanation: The most appropriate method for assessing pain is to have the client rate his pain by using some type of scale. This provides objective evidence of the severity of the pain and provides a basis for comparison later on.

The health care provider is preparing a prescription for sumatriptan for a client diagnosed with migraine headaches. What information in the client history would contraindicate this medication? Allergy to NSAIDs Renal impairment History of myocardial infarction Connective tissue disorder

History of myocardial infarction Explanation: Because of their vasoconstrictive properties, triptans are contraindicated in clients with a history of angina pectoris, myocardial infarction, or uncontrolled hypertension. Caution is required in clients with renal impairment, but the condition is not an outright contraindication. Connective tissue disorder and allergy to NSAIDs are not contraindications.

A client diagnosed with a migraine has been prescribed naproxen. What is the nurse's priority when the client reports being allergic to aspirin? Hold the medication. Discuss the allergy with the client. Give the medication as prescribed. Call the pharmacy for clarification.

Hold the medication. Explanation: The nurse's priority is to hold the medication. Contraindications to naproxen or naproxen sodium include a known allergy to aspirin or other nonsteroidal anti-inflammatory drugs. The nurse should not discuss this with the client but with the prescriber. The nurse should not give the medication or call the pharmacy for clarification.

The nurse is explaining to a client about the analgesic and its possible adverse effects. The client is receiving an opioid analgesic. What would be important to teach this client is a possible adverse effect of this drug? Ataxia Blurred vision Hypotension arrhythmias

Hypotension Explanation: Orthostatic hypotension is commonly seen with some narcotics. Ataxia, blurred vision, and arrhythmias are not generally adverse effects of an opioid analgesic.

The nurse is caring for a client taking pentazocine/naloxone. What would be an appropriate nursing diagnosis for this client's care plan? Diarrhea related to GI effects Disturbed kinesthetic perception related to CVS effects Powerlessness due to low dosage Impaired gas exchange related to respiratory depression

Impaired gas exchange related to respiratory depression Explanation: The correct nursing diagnosis includes impaired gas exchange related to respiratory depression. Appropriate nursing diagnosis does not include diarrhea or disturbed perception related to CVS effects.

Although naloxone is given to counter opioid medication side effects such as respiratory depression, what additional issues (if any) may result from administration of an opioid antagonist? Increase in the client's pain rating Decrease in the client's pain rating No change in the client's pain rating None of these options

Increase in the client's pain rating Explanation: An opioid antagonist will counter not only the negative effects of an opioid medication but the beneficial effects of the opioid (such as pain relief) as well, resulting in an increase in the client's pain rating. It would not result in a decrease or lack of change in the pain rating.

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. It is a drug that has a special caution because use of this drug is more likely to have adverse effects. It is a drug that no longer has a patent and can be sold by its generic name. It is a drug that reduces the likelihood of drug abuse and dependence.

It is a valuable drug to use because dosage can be increased to relieve pain when pain increases or tolerance develops. Explanation: A drug with no ceiling effect is one in which there is no upper limit to the dosage that can be given to clients who have developed tolerance to previous dosages. This characteristic is especially valuable in clients with severe cancer-related pain because drug dosage can be increased and titrated to relieve pain when pain increases or tolerance develops. None of the other statements explain the terminology.

A hospital client has been prescribed morphine for the treatment of post-surgical pain. The client tells the nurse, "I'm determined to push through my pain if I can, because there's no way I want to end up addicted to narcotics." What should the nurse teach the client? It is extremely unlikely that the client would become addicted to narcotics used for this purpose Narcotics used in health care settings are non-addictive and are unrelated to drugs used recreationally Any addiction that the client develops can be treated prior to discharge from the hospital The client's need for pain control should be a higher priority than the fear of addiction

It is extremely unlikely that the client would become addicted to narcotics used for this purpose Explanation: A client's risk of becoming addicted to narcotics that are used for medical purposes is exceedingly low. However, the drugs themselves are capable of causing addiction and many have a potential for abuse. It is paternalistic to state that a client must prioritize pain control over a fear of addiction.

A client has been administered an opioid. For what effect should the nurse regularly assess? Oliguria Level of consciousness (LOC) Edema Tachycardia

Level of consciousness (LOC) Explanation: Opioids will produce decreased LOC. Oliguria is not a result of the administration of an opioid. Edema is not a result of the administration of an opioid. Tachycardia is not a result of the administration of an opioid.

The nurse is caring for a patient who is receiving an opioid analgesic. What would be a priority assessment by the nurse? Pain intensity and blood glucose level Level of consciousness and respiratory rate Respiratory rate and electrolytes Urine output and pain intensity

Level of consciousness and respiratory rate Explanation: The nurse should assess respiratory rate and level of consciousness because respiratory depression and sedation are adverse effects of opioid analgesics. Blood glucose levels, electrolytes, and urine output are not priority assessments with opioid ingestion.

Which medications are opioids for which naloxone may be given to counter the effects? Meperidine Acetaminophen Ibuprofen Naproxen

Meperidine Explanation: Meperidine is an opioid medication for which naloxone is an opioid antagonist, and for which naloxone counters the effects. Acetaminophen is not an opioid medication and naloxone would have no effect on a client receiving this medication. Ibuprofen and naproxen are nonsteroidal anti-inflammatory drugs, and naloxone would have no effect on a client receiving these medications.

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 Oxycodone Oxymorphone Tramadol

Methadone Explanation: Methadone is used for detoxification and temporary maintenance treatment of narcotic addiction. Oxycodone is used for the relief of moderate to severe pain in adults. Oxymorphone is used for the relief of moderate to severe pain in adults, preoperative medication, and obstetrical analgesia. Tramadol is used for the relief of moderate to moderately severe pain, and its use should be limited in clients with a history of addiction.

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? Antibiotic Antihypertensive Monoamine oxidase (MAO) inhibitor NSAID

Monoamine oxidase (MAO) inhibitor Explanation: The client should not receive morphine within 14 days of receiving an MOA inhibitor.

A 40-year-old male client with arthritis of the knee joint has been prescribed an analgesic to relieve the pain. Which medication is a narcotic analgesic? Aspirin Ibuprofen Celecoxib Morphine

Morphine Explanation: Morphine is a narcotic analgesic. Aspirin, ibuprofen, and celecoxib are nonnarcotic analgesics. Aspirin is classified as a salicylate and ibuprofen as a nonsteroidal anti-inflammatory drug (NSAID). Celecoxib is a newer NSAID that acts by inhibiting the cyclo-oxygenase-2 (COX-2) enzyme.

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? Acetaminophen and diphenhydramine Epinephrine Butorphanol Naloxone

Naloxone Explanation: Naloxone has long been the drug of choice to treat respiratory depression caused by an opioid. Therapeutic effects occur within minutes after IV, IM, or sub-Q injection and last 1 to 2 hours. Butorphanol would worsen respiratory depression. Acetaminophen and diphenhydramine are used to treat headache. Epinephrine may be prescribed for an allergic reaction but not for respiratory depression.

A client is to receive naltrexone. The nurse would expect to administer this drug by which route? Oral Subcutaneous Intramuscular Intravenous

Oral Explanation: Naltrexone is administered orally.

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

Oral Explanation: Zolmitriptan is administered by either the oral route or intranasally. It is not currently available by either a transdermal patch or subcutaneous injection.

What would the nurse expect to assess in a client receiving a narcotic for pain relief? Dilation of the pupils Diarrhea Orthostatic hypotension Tachypnea

Orthostatic hypotension Explanation: Narcotics are associated with orthostatic hypotension, pupil constriction, constipation, and respiratory depression with apnea.

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? Vital signs Pain scale Glasgow coma scale Subjective assessment

Pain scale Explanation: The method the nurse should prioritize in this situation is using the pain scale. Following the administration of the acetaminophen-aspirin-caffeine combination, the client should exhibit diminished pain. The nurse assesses for pain using the pain scale. A subjective assessment would involve more than just the pain scale. Assesing vital signs would be an objective assessment and not necessarily confirm therapeutic effects The Glasgow coma scale would not be indicated for migraine headache.

What factors affect how the patient will experience and respond to pain? Select all that apply. Past experience with pain Cultural expectation about how one should respond to pain Learned behavior from childhood It is a conscious response that the patient has a choice about.

Past experience with pain Cultural expectation about how one should respond to pain Learned behavior from childhood Explanation: The experience of pain is personal and subjective; however, how people respond to painful stimuli reflects what they have learned about pain from their families, society, and cultures of origin. Learned messages about pain are indirect, and people react to them subconsciously. These messages include reasons that people experience pain and what are considered appropriate responses to it.

A male client is given regular doses of morphine for a period of 6 months. His dosage now needs to be reduced gradually. The health care provider advises the nurse to pay attention to the clinical management of the client's pain to allow proper agonist coverage during the change in drug dosage. Why is the client likely to suffer unnecessary pain and discomfort if proper management is not ensured? Tolerance to the drug Physical dependence on the drug Addiction to the drug Adverse effects of the drug

Physical dependence on the drug Explanation: If morphine use lasts longer than 3 months, then physical dependence will occur. Dependence is characterized by a withdrawal or abstinence syndrome when morphine is discontinued; it represents an exaggerated rebound from its acute effects. Physical dependence is not the same as tolerance or addiction. Tolerance means that the body has become accustomed to the effects of a substance and that the client must use more of it to achieve the desired effect, while addiction involves compulsive use of the drug for a secondary gain, not for pain control.

Both categories of migraine abortive drugs (ergot alkaloids and serotonin agonists) exert powerful vasoconstrictive effects and also have what potential? Lower blood pressure Manage hypertension Raise blood pressure Manage hypotension

Raise blood pressure Explanation: Both categories of migraine abortive drugs (e.g., ergot alkaloids and serotonin agonists) exert powerful vasoconstrictive effects and have the potential to raise blood pressure.

A nurse is caring for a patient with chronic pain who has been prescribed epidural analgesia. The nurse should monitor the patient for which condition after insertion of the epidural catheter and throughout the therapy? Abdominal pain Respiratory depression Fever Nervousness

Respiratory depression Explanation: The nurse should closely monitor the patient for respiratory depression after insertion of the epidural catheter and throughout the therapy. Patients using epidural analgesics for chronic pain are monitored for respiratory problems with an apnea monitor. The patient may also experience sedation, confusion, nausea, pruritus, or urinary retention. The nurse need not monitor the patient for abdominal pain, fever, and nervousness because they do not occur as a result of the administration of epidural analgesia.

The client has had a myocardial infarction. The nurse is administering morphine sulfate for the pain. What vital sign would the nurse monitor that directly relates to the use of this narcotic? Heart rate Respiratory rate Temperature Pulse

Respiratory rate Explanation: The first sign of narcotic overdose is often respiratory depression. Therefore, monitoring the client's vital signs, particularly respirations, is extremely important when administering narcotics.

What are nonpharmacological methods that can be used for tension headaches? Select all that apply. Rest Exercise Diet of fruits and vegetables Deep breathing exercises Stress reduction strategies

Rest Deep breathing exercises Stress reduction strategies Explanation: Nonpharmacological methods that can be used for tension headaches include rest, relaxation techniques such as deep breathing, or stress-reduction strategies. Exercise and diet do not impact tension headaches.

Opioid analgesics are used primarily for the treatment of what issues? (Select all that apply.) Severe acute pain Mild acute pain Moderate chronic pain Mild chronic pain Opioid dependence

Severe acute pain Moderate chronic pain Opioid dependence Explanation: Opioid analgesics are used primarily for the treatment of moderate to severe acute pain and chronic pain and in the treatment and management of opioid dependence.

Which assessment finding would support a client's report of migraine headaches? Severe unilateral pulsating pain Sharp steady eye pain Dull band of pain around the head Onset occurring during sleep

Severe unilateral pulsating pain Explanation: Migraine headaches are associated with severe unilateral pulsating pain on one side of the head. Sharp steady eye pain with an onset usually during sleep is associated with cluster headaches. A dull band of pain around the head suggests a tension headache.

Which adverse reactions may occur as a result of administering an opioid antagonist? Diarrhea, cramping, and increased pain rating Decreased blood pressure and decreased pulse Increased temperature and decreased oxygen saturation Sweating, tachycardia, and increased blood pressure

Sweating, tachycardia, and increased blood pressure Explanation: Side effects of opioid antagonists include nausea and vomiting, sweating, increased blood pressure, and tremors. All other side effects listed are not side effects of opioid antagonists.

When a client is prescribed ergotamine tartrate, what information should be included in the teaching plan regarding the administration of the medication? Tablet is placed under the tongue to dissolve. Ingest 8 ounces of water with the medication. Chewing the tablet can aid in the medication working faster. Take this medication with meals.

Tablet is placed under the tongue to dissolve. Explanation: Administration of ergotamine is sublingual, and the tablets should be dissolved under the tongue. It is important that tablets not be crushed, chewed or swallowed whole. The client should not drink, eat, or smoke while the medication is being dissolved.

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 before breakfast each day. Take the medication on days when migraines may be anticipated. Take the medication as soon as the earliest symptoms of migraine are sensed. Take the medication when the pain of a migraine becomes too much to bear.

Take the medication as soon as the earliest symptoms of migraine are sensed. Explanation: It is important to administer sumatriptan at the onset of migraine symptoms. The drug is not taken on a daily, scheduled basis and is not used as a preventative treatment.

Naproxen has been prescribed to a client whose increasingly severe migraines are interfering with work performance and family life. When providing health education to this client, the nurse should instruct the client to consider what intervention? Take the pills with meals to minimize stomach upset. Crush the pills and mix with applesauce to reduce gastritis. Report any new onset of constipation promptly. Arrange for monthly blood work.

Take the pills with meals to minimize stomach upset. Explanation: Naproxen should be taken on a full stomach. The pills should not be crushed. Constipation is not a noted adverse effect, and regular blood work is not warranted.

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 not adhered to previous treatment regimens. The client has a chronic venous ulcer on the lower leg. The client has a diagnosis of liver cirrhosis. The client is a smoker.

The client has a diagnosis of liver cirrhosis. Explanation: Clients diagnosed with hepatic impairment should not receive this combination agent on an ongoing basis. They may not metabolize acetaminophen in this combined medication effectively, leading to hepatotoxicity. Lack of previous adherence, cigarette smoking, and the presence of skin ulcers do not necessarily contraindicate the use of this drug.

A nurse is caring for a client who required an opioid antagonist. Which should the nurse confirm to ensure that administration of the opioid antagonist is not contraindicated in the client? The client is not lactating. The client does not have high blood pressure. The client is not hypersensitive to the opioid antagonist. The client does not have a cardiovascular disease.

The client is not hypersensitive to the opioid antagonist. Explanation: The nurse should confirm that the client is not hypersensitive to the opioid antagonist to ensure that its administration is not contraindicated in the client. Elevated blood pressure is an adverse reaction of opioid antagonists, but administration of these drugs is not known to be contraindicated in clients with high blood pressure. Opioid antagonists are used cautiously in clients who are lactating and in clients who have cardiovascular disease, but presence of these conditions does not contraindicate the use of opioid antagonists.

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? During pain assessment, the client may report less pain. The client may begin to demonstrate symptoms of withdrawal. Double the standard dosage of the medication may be needed. Multiple doses may be needed to be therapeutic.

The client may begin to demonstrate symptoms of withdrawal. Explanation: The client may begin to demonstrate symptoms of withdrawal when he or she has a history of opioid abuse and is administered an opioid antagonist. The other answers are incorrect. In fact, clients will likely have increased pain due to antagonistic effects of the drug. The standard dosage and a single dose will be administered even with a history of opioid abuse.

A nurse has administered a scheduled dose of naproxen to a hospital client who has been taking the drug for several weeks. What assessment finding should cause the nurse to suspect that the client is experiencing adverse effects of long-term therapy? There is an increase in the client's neutrophils but no increase in temperature. The client's stool tests positive for occult blood. The client complains of itchy, dry skin. The client has peripheral edema, and there is a steady increase in the client's weight.

The client's stool tests positive for occult blood. Explanation: Gastrointestinal (GI) bleeding is a significant adverse effect of naproxen. This drug does not typically cause leukocytosis, dry skin, or fluid imbalances.

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? The patient's insistence on receiving the drug The patient's gender The route of administration The patient's disease process

The route of administration Explanation: Patient response to morphine depends on the route of administration and the dosage.

When evaluating the plan of care for a client receiving opioid analgesics for pain management, the nurse considers the plan successful when what occurs? (Select all that apply.) Therapeutic response is achieved and discomfort is reduced. An adequate breathing pattern is maintained. Client reports decreased bowel movements. Client maintains adequate nutritional status. Client reports decreased urinary output.

Therapeutic response is achieved, and discomfort is reduced. An adequate breathing pattern is maintained. Client maintains adequate nutritional status. Explanation: The plan of care is considered effective when therapeutic response is achieved and discomfort is reduced; an adequate breathing pattern is maintained; the number of bowel movements is maintained; and adequate nutritional status is maintained. Urinary output should mirror increased fluid intake (increased fluid in, increased fluid out).

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 Asking a client to describe his or her pain Percussing or palpating the area where pain is identified Assessing the client's vital signs

Using a pain rating scale Explanation: A pain rating scale is the most reliable method because it provides measurable evidence of pain severity. A client's description of pain is useful, but does not provide objective or quantifiable data over time. Although percussing or palpating provides information, it would increase the client's pain and be inappropriate. Vital sign changes occur for numerous reasons and are not the best indicator of pain in clients who can speak.

A female client tells the nurse that the first thing she does when she gets a headache is drink a caffeinated beverage. The nurse is aware that caffeine is known to decrease the pain of migraine headaches by what mechanism? Vasodilation of blood vessels Vasoconstriction of blood vessels Inhibits the synthesis of prostaglandins Satisfies the thirst center in the brain, which aborts the headache

Vasoconstriction of blood vessels Explanation: Caffeine causes vasoconstriction of blood vessels. This helps treat migraine headaches because migraine headaches are caused by vasodilation of cerebral vessels.

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? Improvement will occur within 30 minutes from the time of administration. Slow improvement can be noted throughout the shift. Within one to five minutes, an effect may be seen. Response is highly individualized based upon client weight.

Within one to five minutes, an effect may be seen. Explanation: Onset of action is generally rapid and may be seen within one to five minutes. Additional doses may be required to achieve optimal effects. The other answers are incorrect because they are referring to a time later than onset of action, or refer to a conditional onset of action that is untrue.

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. management of alcohol withdrawal symptoms. a reduction in the client's rating of their pain. alertness and improve memory function.

a return to normal respiratory rate, rhythm, and depth. Explanation: The primary reason for administering an opioid antagonist is because the client is experiencing respiratory depression. Therefore, the goal is to improve the client's respiratory rate, rhythm, and depth. None of the other options is part of the drug therapy.

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 the release of intracellular potassium into the woman's hand. activation of the woman's delta and C nociceptors. the release of gamma-aminobutyric acid (GABA) into the woman's synapses. injury to woman's afferent fibers.

activation of the woman's delta and C nociceptors. Explanation: Nociceptic pain is caused by the activation of the delta and C nociceptors in response to painful stimuli, such as injury. The sensation of pain is not the result of potassium release, though this does occur in cases of tissue trauma. The release of GABA inhibits pain. Pain is not the result of injury to the afferent fibers themselves, though these fibers transmit pain signals.

A group of nursing students are reviewing information about how pain is classified. The group demonstrates understanding when they identify which type based on duration? Select all that apply. acute chronic traumatic postoperative neuropathic

acute chronic Explanation: Pain is classified by duration as acute or chronic. Traumatic refers to injury. Postoperative refers to after surgery, and neuropathic refers to nerve endings and pathways.

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? urine specific gravity. skin integrity. bowel patterns. core body temperature.

bowel patterns. Explanation: Morphine, like most opioid analgesics, creates a risk for constipation. The drug is unlikely to influence the client's temperature, skin integrity, or urine specific gravity.

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

codeine. Explanation: Codeine is a narcotic drug used for its analgesic and antitussive effects. Aspirin, ibuprofen, and acetaminophen do not have antitussive effects.

A 30-year-old client experiences migraines that appear closely linked to her menstrual cycle. What pharmacologic treatment is most specific to this client's particular experience of migraines? estradiol ergotamine almotriptan chlorpromazine

estradiol Explanation: Estrogen in the form of estradiol is a treatment specific to menstrual migraines, which are most likely 2 days prior to menses through the third of bleeding. Adjuvants (such as chlorpromazine) and other abortive treatments (such as ergotamine and almotriptan) may be indicated, but these are not specific to menstrual migraines.

Naloxone will reverse the effects of which drugs? Select all that apply. fentanyl codeine lorazepam valproic acid warfarin

fentanyl codeine Explanation: Naloxone is an opioid antagonist, which means it will only reverse the effects of opioids like fentanyl and codeine. Lorazepam is a benzodiazepine, thus naloxone has no effect on it. Valproic acid is used in the treatment of seizures and is not an opioid. Warfarin is an anticoagulant used to prevent blood clots from forming.

A nurse should not administer an opioid antagonist to a client with which finding? hypersensitivity to naloxone uncontrolled type 2 diabetes history of opioid abuse history of alcohol abuse

hypersensitivity to naloxone Explanation: The use of opioid antagonists is contraindicated in those with a hypersensitivity to the opioid antagonists; therefore, a client with a hypersensitivity to naloxone should not be given the drug. Naloxone can be given to uncontrolled type 2 diabetics. Having a history of opioid or alcohol abuse does not have any effect on the use of naloxone.

A client has been admitted to the emergency department after overdosing on oxycodone. What nursing diagnosis should the nurse prioritize? impaired swallowing impaired gas exchange ineffective airway clearance ineffective role performance

impaired gas exchange Explanation: The decreased respiratory rate that accompanies opioid overdoses causes impaired gas exchange. This is a priority over considerations such as swallowing and role performance. The airway is not occluded, so ineffective airway clearance is not a priority.

A nurse has just administered an IM injection of meperidine (Demerol) to an elderly client. The priority nursing action for the nurse would be which? close the draperies. make sure the side rails are up. check the temperature of the room. make sure the client is positioned comfortably.

make sure the side rails are up. Explanation: The priority nursing action will be to make sure that the side rails are up. Meperidine can cause dizziness and sedation, which increase the risk of the client falling. The side rails should be up to remind the client that she should not get out of bed without help. Closing the draperies, checking the temperature of the room, and making sure the client is comfortable creates an environment that will enhance the efficacy of the medication therapy but are not the priority actions.

Which client would the nurse identify as being opioid naive? one who does not routinely take opioids person who routinely takes opioids individual who is physically dependent on opioids one who is psychologically dependent on opioids

one who does not routinely take opioids Explanation: Opioid-naive clients are defined as those who do not use opioids or infrequently use them. Those who routinely take and are physically or psychologically dependent on opioids are not considered opioid naive.

Opioid antagonists may produce withdrawal symptoms in clients physically dependent on which substance? opioids alcohol NSAIDs benzodiazepines

opioids Explanation: Opioid antagonists may produce withdrawal symptoms in clients physically dependent on opioids. Naloxone has no effect on benzodiazepines, alcohol, or NSAIDs.

Pain may be classified according to: region, intensity, and duration. age, gender, or cause. location, intensity, and medical history. origin, duration, or cause.

origin, duration, or cause. Explanation: Pain may be classified according to origin in body structures (e.g., somatic, visceral, neuropathic), duration (e.g., acute, chronic), or cause (e.g., cancer). Region, age, gender, and medical history are not included in pain classifications.

A nurse is caring for a 49-year-old client in the intensive care unit. The client was in a motor vehicle accident and is in severe pain. The client has been given morphine. After 2 days in the unit, the nurse can detect nasal congestion when the client speaks to her. The nurse will monitor for which? renal impairment. myocardial infarction. hypersensitivity to the drug. pneumonia.

pneumonia. Explanation: Respiratory depression is a common adverse effect of morphine. If the client gets a cold, as the nasal congestion can be a sign, this respiratory depression could cause retained secretions and put the client at greater risk for developing pneumonia. The drug does not cause myocardial infarction or renal impairment. A common cold is not known to cause hypersensitivity to the morphine.

What beta-adrenergic antagonist is used for migraine prophylaxis? propranolol valproic acid verapamil topiramate

propranolol Explanation: The most commonly administered beta-adrenergic blocking agent for migraine headaches is propranolol. Verapamil is a calcium channel blocker. Valproic acid is a carboxylic acid derivative administered to control seizures and prevention of migraine headaches. Topiramate is a sulfamate-substituted monosaccharide agent used as an antiepileptic agent and to limit migraine frequency.

Morphine has been prescribed for a 28-year-old man with severe pain due to a back injury. The nurse is teaching the client upon discharge to avoid alcohol while taking this medication because it can cause which? respiratory depression over stimulation of the back muscles kidney pain urinary retention

respiratory depression Explanation: The nurse should advise the client to avoid alcohol and any other CNS depressants while taking morphine. These combinations can cause serious respiratory depression and sedation. Over stimulation of back muscles, kidney pain and urinary retention are not know effects of this interaction.

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 blood pressure temperature heart rate

respiratory rate Explanation: All the client's vital signs are important areas of assessment. However, opioids have a profound effect on respiratory rate, and this is a priority assessment.

An 80-year-old man has been prescribed oxycodone for severe, noncancer, chronic pain. He tells the nurse that he has difficulty swallowing and asks if he can crush the tablet before swallowing. The nurse will advise the client that: the tablet would have no effect if crushed and ingested. there is risk of an extremely high dose available all at once if the tablet is crushed. crushing the tablet increases the drug's efficacy. crushing the tablet is a safe option.

there is risk of an extremely high dose available all at once if the tablet is crushed. Explanation: The nurse should caution the client against crushing the tablet before ingesting it. Crushing allows an extremely high dose of the drug to be available all at once, instead of being released slowly over time. Severe adverse effects are possible when it is used in this manner.

Which conditions would occur due to the administration of an opioid antagonist in a client who is physically dependent on opioids? drowsiness hypotension withdrawal symptoms insomnia

withdrawal symptoms Explanation: Opioid antagonists produce withdrawal symptoms in clients who are physically dependent on opioids. Drowsiness, hypotension, and insomnia do not occur in opioid-dependent clients who are administered opioid antagonists.

A nurse suspects that a client who has been receiving morphine is exhibiting early symptoms of abstinence syndrome. Which finding would the nurse most likely be assessing? Select all that apply. yawning rhinorrhea sweating hot and cold flashes severe backache

yawning rhinorrhea sweating Explanation: Yawning, rhinorrhea, and sweating are early symptoms of abstinence syndrome. Hot and cold flashes and severe backache are late symptoms.