Chapter 49 Opioids

A female client is crying and states that everyone thinks she is a "drug addict," and that no one will listen to her. She states she has abdominal pain and must have something for the pain. What is the best response of the nurse? "Tell me more about your pain." "Your behavior drives our perception." "Do you take a lot of pain medication." "You do not seem to be in pain right now."

"Tell me more about your pain."

A client, admitted to the surgical division after a mastectomy, has a PCA pump and states being fearful about being overdosed on morphine. Which response is most appropriate when addressing the client's concern of being overmedicated? "The device will give you a placebo when you press it often." "If you follow the instructions, that won't happen to you." "The device is preset, so you cannot receive more than you need." "The pump will administer all of the doses, so you don't have to worry."

"The device is preset, so you cannot receive more than you need."

A hospice client has been prescribed morphine 5 mg sub-Q every 2 hours. The medication vial reads "10 mg/mL." How many milliliters will be administered? 1 mL 0.25 mL 0.5 mL 2 mL

0.5 mL

Naloxone 2 mg IM has been ordered for a post surgical client. The pharmacy has sent to the floor naloxone 1 mg/mL. How many milliliters of naloxone will the client receive? Record the answer as a whole number.

2

A client is receiving an opioid analgesic following abdominal surgery. On assessment the nurse notes the client has been in a chair, ambulating with assistance, fluids and food intake is good with active bowel sounds with minimal bowel movement. Which nursing diagnosis would be most appropriate? Deficient Knowledge Malnutrition: Less Than Body Requirements Injury Risk Constipation

Constipation

The nurse is administering morphine to a trauma client for acute pain. What is a common side effect of morphine? Occipital headache Increased intracranial pressure Drowsiness Paresthesia in lower extremities

Drowsiness

the client is postsurgical and is receiving opioid analgesics for pain management. The nurse should encourage the client to do which? Select all that apply. Keeping the lights dim to prevent eye strain Get out of bed (e.g., ambulation) Cough/deep breathing every two hours Remaining supine in semi-Fowler's position Limiting fluid intake

Get out of bed (e.g., ambulation) Cough/deep breathing every two hours

The nurse is reviewing the discharge instructions with the client going home on an opioido for pain management. What would the nurse include in the instructions? Select all that apply. Take a laxative/stool softener. Avoid driving Rise slowly from a sitting or lying position. Limit fluid intake. Eat frequent small meals

Take a laxative/stool softener. Avoid driving Rise slowly from a sitting or lying position. Eat frequent small meals

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.) Client reports decreased urinary output. Client reports decreased bowel movements. Therapeutic response is achieved and discomfort is reduced. Client maintains adequate nutritional status. An adequate breathing pattern is maintained.

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

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? If a family member is present, ask him or her if the medication worked. Use a pain assessment tool before and 30 minutes after medication administration. The nurse should observe the client when the client is not aware the nurse is watching. Ask the non-licensed personnel (aide) to find out if the medication worked.

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

An opioid-naïve client experiences acute pain after surgery and is prescribed opioid therapy. The nurse would be especially alert for the development of which reactions? Respiratory depression Severe headache Pruritus Urticaria

respiratory depression

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. Find a pain scale the client can use. Keep trying to have the client use the pain scale. Ask a family member if he or she can assist.

Medicate the client for pain

A client is admitted to the emergency department for an opioid overdose. What would the nurse expect to administer to this client? Corticosteroids Normeperidine Naloxone Oxycodone

Naloxone

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

Crushing the medication may precipitate an overdose.

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

Level of consciousness (LOC)