CHAPTER 26: OPIOID AGONISTS, OPIOID ANTAGONISTS, AND ANTI-MIGRAINE 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."

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."

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."

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?

"Where exactly are you hurting?"

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

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 enters the client's room to see how the client's pain level is because PRN Demerol can be given. The client is sitting up in bed laughing and visiting with family. The client states that the pain is a "10" on a pain scale of 0 to 10. What is the best response by the nurse?

Administer the pain medication as ordered.

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

What is a priority nursing assessment of a client prescribed oral sumatriptan?

Blood pressure

Beta receptors react with endorphins in the periphery to modulate pain transmission.

False

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)

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

Oral

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

In 2008, methylnaltrexone bromide was approved for the treatment of opioid-induced constipation in patients who are receiving palliative care and who no longer respond to traditional laxatives. How is methylnaltrexone bromide given?

Sub q

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 route of administration

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.

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

codeine

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

codeine

A nurse should not administer an opioid antagonist to a client with which finding?

hypersensitivity to naloxone

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 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 admitted to the emergency department for an opioid overdose. What would the nurse expect to administer to this client?

Naloxone

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?

Naloxone

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."

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 observes that a new client's medication regimen includes sumatriptan. What assessment should the nurse prioritize?

Assessing the client for migraine pain

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 57-year-old client is given morphine for myocardial ischemic pain. The nurse needs to monitor the client frequently for which adverse effect?

Decreased respiratory rate

A nurse administrates an opioid medication to a client. For what side effect should the nurse assess?

Drowsiness

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 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 a diagnosis of liver cirrhosis.