Chapter 49: Drug Therapy With Opioids

A nurse is teaching a client about the use of a PCA infusion pump. The nurse determines the teaching is successful when the client correctly indicates which factor about the system?

The control button activates administration of the drug.

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

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

codeine

A client who is receiving morphine reports nausea after every dose of medication. What is the nurse's best response to this client?

"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."

The client is having surgery this week. What information should the nurse give the client concerning the use of pain medication after surgery?

Ask for pain medication before the pain gets severe.

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 nurse is assessing a client's pain level. Which would be the most appropriate method?

Have the client rate it on a scale of 0 to 10.

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.)

For clients who can't verbalize pain, the nurse assesses the client's facial expression, limb movements, guarding, and grimacing.

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.

The nurse assesses that the client is having pain. The nurse asks the client to rate his pain on the pain scale. The client is unable to rate the pain, stating that it just hurts so bad he can't think. What is the most appropriate response of the nurse?

Medicate the client for pain.-

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

A client with respiratory depression is administered an opioid antagonist by the nurse. What ongoing assessment should the nurse perform when prioritize?

Monitor vital signs every 5 to 15 minutes.

The nursing student is learning about agonist-antagonist. For which clients would the use of narcotic agonists-antagonists be appropriate? Select all that apply.

These drugs have three functions: (1) relief of moderate-to-severe pain, (2) adjuncts to general anesthesia, and (3) relief of pain during labor and delivery. For a pregnant client, alternatives should be tried before using narcotic agonists-antagonists due to the risks associated with fetal exposure. A client whose respiratory rate is too low for narcotic administration should not be given an agonist-antagonist because it will cause further respiratory depression.

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

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

A nurse is caring for two clients who are status postoperative for abdominal surgery. What is the best way to evaluate pain response after administering analgesia?

Use a pain assessment tool before and 30 minutes after medication administration.

A client is to receive a narcotic cough syrup. The nurse would expect this preparation to contain:

codeine

Opioid antagonists may produce withdrawal symptoms in clients physically dependent on which substance?

opioids

After obtaining the history of a client who is prescribed opioid therapy, the nurse determines that the client is opioid naive. The nurse would be especially alert for which effect after the client receives the prescribed opioid?

respiratory depression

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

withdrawal symptoms