Chapter 15-Prep U
The client is postsurgical and is receiving opioid analgiesics for pain management. The nurse should encourage the client to do which?
Cough/deep breathing every two hours
When evaluating the plan of care for a client receiving opioid analgesics for pain management, the nurse considers the plan successful when what occurs?
Client maintains adequate nutritional status.
The client has difficulty swallowing and requests the nurse to crush all the medications. 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 who is 84 years old is experiencing chronic lower back that has not responded to NSAIDs. The provider has prescribed a transdermal fentanyl patch. What should the nurse do to ensure safe and effective care?
Keep the client's bed in the lowest position
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 explains to the client that pain medications work by what action in the neurological system?
They alter the brain's perception of the pain.
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
The nurse should monitor the client more frequently and notify the primary health care provider immediately if a client's respiratory rate falls below how many breaths per minute when an opioid analgesic is administered?
10 breaths/min
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?
1030
A client with severe diarrhea is receiving opioid therapy. The nurse would be alert for the development of which adverse effect?
palpitations
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 reagarding this medication?
"Avoid drinking alcohol while taking meperidine."
A nurse has entered a client's room at the beginning of a shift to quickly assess the clent'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?"
What client characteristic may contraindicate the use of tramadol for the treatment of a client's pain following traumatic injuries?
The client has a history of crack cocaine addiction
A hospital client's pain is rated at 9/10 and the nurse is preparing to administer 4 mg hydromorphone PO as prescribed. Before administering the medication, the nurse should:
assess the client's baseline respiratory rate.
A client with a viral respiratory infection has an intense headache and cough. What drug will best address both of this client's symptoms?
codeine
The client returns from the post-anesthesia recovery unit. The nurse notes a respiratory rate of 6. Which drug would the nurse anticipate being given immediately?
narcan
Which of the following terms would the nurse expect health care professionals to use to describe drugs used in pain management?
opioids
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?
pneumonia
When should the nurse obtain the client's blood pressure, pulse, respiratory rate and pain rating after oral administration of an opioid analgesic?
30 minutes
A client with severe diarrhea is receiving opioid therapy. The nurse would be alert for the development of which adverse effect?
bradycardia
A nurse is teaching a client about her prescription for acetaminophen that she will take at home. This medication consists of acetaminophen and what other likely drug that enhances the analgesic effect of acetaminophen?
codeine
While studying pharmacology, the nursing student learns that a naturally occurring narcotic drug with analgesic and antitussive effects is:
codeine
The nurse works in a long-term care facility. When administering narcotics to clients, the nurse must monitor for which side effect?
constipation
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 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?
morphine
A client is in the end of life and has developed increased respiratory secretions and labored breathing. The health care provider will order which medication to decrease these symptoms?
morphine sulfate
A group of nursing students are reviewing information about opioid analgesics. The students demonstrate understanding of the information when they identify which as the gold standard in pain management?
morphine sulfate
A postsurgical client has been provided with a morphine patient-controlled analgesic (PCA) but has expressed reluctance to use it for fear of becoming addicted. How can the nurse best respond to this client's concerns?
"It is not uncommon to develop a dependence on pain medications, but this usually takes place over a long period and is not the same as addiction."
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 is preset, so you cannot receive more than you need."
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?
Administer the morphine as prescribed and monitor the client's respiratory status closely
When evaluating the plan of care for a client receiving opioid analgesics for pain management, the nurse considers the plan successful when what occurs?
An adequate breathing pattern is maintained.
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.
A class of new nursing students is learning how to administer medications to clients. What should the instructor teach the students about giving opiates?
Assess the respiratory rate before giving a dose of opiates.
How will a client's impaired renal function affect the pharmacokinetics of morphine?
Duration of action will be prolonged.
A client who is 84 years old is experiencing chronic lower back that has not responded to NSAIDs. The provider has prescribed a transdermal fentanyl patch. What should the nurse do to ensure safe and effective care?
Ensure the client has access to the call light
The client is postsurgical and is receiving opioid analgiesics for pain management. The nurse should encourage the client to do which?
Get out of bed (e.g., ambulation)
A 30-year-old male client has been ordered Demerol 100 mg IM every 4 hours for 2 days after a fractured femur. What action should the nurse take?
Give the medication as ordered.
What action should the nurse take when administering meperidine 75 mg IM every 4 hours to a young adult?
Give the medication as prescribed.
The client in labor receives morphine every 2 hours to manage labor pain. After 22 hours of labor the woman delivers a healthy neonate. What is the nurse's priority action related to the newborn?
Monitor for opioid effects.
A client who is 84 years old is experiencing chronic lower back that has not responded to NSAIDs. The provider has prescribed a transdermal fentanyl patch. What should the nurse do to ensure safe and effective care?
Monitor the client's respiratory status closely
A client has been ordered a fentanyl patch for chronic pain. What client teaching should be provided to the client and family upon discharge?
Remove the patch every 3 days.
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?
Respiratory rate
Of the following clients, which one will be most likely to develop physical dependence upon the opioid analgesic they are receiving for pain management?
The client living with a chronic noncancer-related illness
When evaluating the plan of care for a client receiving opioid analgesics for pain management, the nurse considers the plan successful when what occurs?
Therapeutic response is achieved and discomfort is reduced.
The nurse is administering morphine to a trauma client for acute pain. What is a common side effect of morphine?
drowsiness
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?
hypotension
A terminally ill client has developed increased respiratory secretions and labored breathing. Which medication is prescribed to decrease these symptoms?
morphine sulfate
A client has been administered an opioid. What effect should the client be regularly assessed for?
level of consciousness (LOC)
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?
make sure the side rails are up.
A client with severe diarrhea is receiving opioid therapy. The nurse would be alert for the development of which adverse effect?
tachycardia
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:
there is risk of an extremely high dose available all at once if the tablet is crushed.
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
