Prep U Chapter 26: Narcotics, Narcotic Antagonists and Antimigraine Agents

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

A caregiver asks the nurse what the caregiver can give a 9-year-old child for a headache. What is the nurse's best response?

"Acetaminophen is appropriate."

When diagnostic testing reveals a bone fracture, what type of pain is the client experiencing?

Acute somatic pain

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

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 knows that, of the following clients, who is least likely to be prescribed transdermal fentanyl?

A woman 85 years of age

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 client suffering from migraine headaches is prescribed sumatriptan. What is the action of the drug?

Binding to serotonin to produce vasoconstriction

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?

Call the provider as another dose of opioid antagonist may be necessary

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

Codeine

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)

An older adult client experiencing recurrent tension headaches reports taking an over-the-counter (OTC) combination of acetaminophen, aspirin, and caffeine several times a week. The nurse should recognize that this combination medication may be contraindicated if the client has a history of what medical condition?

Gastrointestinal (GI) bleeding

Which client would the nurse identify as being opioid naive?

One who does not routinely take opioids

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?

Pain scale

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

A female client states that her pain is unbearable. The nurse has an order for one or two tablets of an opioid analgesic for pain relief. What is the best method that the nurse may use to assess the intensity of the pain?

Use a numerical scale of 0 to 10, with 0 being the least amount of pain

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

The nurse is preparing to administer a dose of ergotamine to a client. After administration, what assessments should the nurse prioritize to assure safe care? Select all that apply.

Heart rate Blood pressure

A 60-year-old client tearfully explains to the nurse how her husband downplays her frequent migraines and tells her that she needs to "just push through a headache." She describes how her migraines have limited her ability to provide childcare for her young grandchildren and explains that she is unable to keep up her garden. The nurse should identify what nursing diagnosis when planning this client's care?

Ineffective role performance related to migraine headaches

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.

Which medications are opioids for which naloxone may be given to counter the effects?

Meperidine

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 nurse should recognize the difference between opioid agonists and the mixed opioid agonists-antagonists. Which are examples of mixed opioid agonist-antagonists? (Select all that apply.)

Nalbuphine (Nubain) Pentazocine (Talwin) Buprenorphine (Buprenex)

Narcotic agonists-antagonists have what function? (Mark all that apply.)

Relief of pain during labor and delivery Relief of moderate to severe pain Adjuncts to general anesthesia

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

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 has been administered an opioid. For what effect should the nurse regularly assess?

Level of consciousness (LOC)

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 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

What is the nursing goal for a client with chronic cancer pain prescribed opioid therapy? Select all that apply.

Promoting rest and relaxation Providing physical comfort Supporting independence

Both categories of migraine abortive drugs (ergot alkaloids and serotonin agonists) exert powerful vasoconstrictive effects and also have what potential?

Raise blood pressure

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?

The client may begin to demonstrate symptoms of withdrawal

The nursing instructor is talking with the junior nursing class about migraine headaches. What would the instructor tell the students is the method of action of sumatriptan?

Vasoconstrictive on cranial blood vessels

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

Withdrawal symptoms