NUR 2092 Pharm Ch 26 Drugs

The anatomy and physiology instructor is talking about pain sensations. What responds to stimulation by generating nerve impulses that produce pain sensations?

A-delta sensory nerves

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 client with a history of migraine headaches self-medicates with an over-the-counter (OTC) medication that contains a common combination of drugs. The nurse recognizes the client is medicating with a combination of which drugs? Select all that apply.

Acetaminophen Aspirin Caffeine

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

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 nurse is caring for a patient who is suffering from postoperative pain. The physician orders 2.5 mg of morphine IV q2h. Morphine is supplied in 10 mg/mL vials. How many mL will the nurse administer in each dose?

0.25 mL

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 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?

0.5 mL

A hospice patient has been ordered morphine (Roxanol) 5 mg every 2 hours. Roxanol contains 10 mg/mL. How many mL will be administered?

0.5 mL

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

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

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

A woman 85 years of age

Identify a reason a narcotic agonist may be prescribed?

Analgesia during anesthesia

The nurse is caring for a postoperative client taking an opioid medication for pain. The nurse assesses the client to have bradypnea and an oxygen saturation value of 90%. Which actions should the nurse perform before administering the ordered opioid antagonist? You Selected: Call for a respiratory therapy consult.

Assess the client's other vital signs.

To decrease the risk of injury to a client taking an opioid, what should the nurse do? (Select all that apply.)

Assist client with hall-walking activities. Assist client with rising from a lying position. Assist client from their bed to the toilet.

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

Binding to serotonin to produce vasoconstriction

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

A nurse is teaching a client about the prescription for acetaminophen to be taken at home. This medication consists of acetaminophen and what other likely drug that enhances the analgesic effect of acetaminophen?

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 nurse is caring for a client with renal impairment. The client has been prescribed an opioid analgesic. Which nursing intervention would be most appropriate?

Consult with the prescriber about lowering the dosage of the drug.

Larger doses of narcotic antagonists are needed to reverse the effects of morphine than for pentazocine.

False

Naloxone (Narcan) will reverse the effects of which drug?

Fentanyl (Duragesic)

The nurse is reviewing the medication history of a client newly diagnosed with cluster headaches. The client's concurrent use of what medication would contraindicate treatment with frovatriptan?

Fluoxetine

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 pathophysiology of pain begins with a signal from what source?

Nociceptors

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

A nurse is caring for a patient with chronic pain who has been prescribed epidural analgesia. The nurse should monitor the patient for which condition after insertion of the epidural catheter and throughout the therapy?

Respiratory depression

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

Opioid analgesics are used primarily for the treatment of what issues? (Select all that apply.)

Severe acute pain Moderate chronic pain Opioid dependence

Which assessment finding would support a client's report of migraine headaches?

Severe unilateral pulsating pain

The nurse is to administer an opioid antagonist. The nurse knows that the valid reasons for administering this type of medication include what reasons? (Select all that apply.)

Suspected or known acute opioid overdosage Postoperative acute respiratory depression Adverse effects related to opioid administration

Which condition should the nurse monitor for in the patient receiving an opioid antagonist?

Sweating

A nurse has administered a scheduled dose of naproxen to a hospital client who has been taking the drug for several weeks. What assessment finding should cause the nurse to suspect that the client is experiencing adverse effects of long-term therapy?

The client's stool tests positive for occult blood.

A client admitted for a severe migraine reports taking ergotamine tartrate at home. What is most essential information for the nurse to obtain?

The number of ergotamine tablets the client took at home

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

A client diagnosed with migraines associated with the menstrual cycle has been prescribed estradiol. When providing client teaching, what preferred route of administration will the nurse describe?

Transcutaneous

Identify one indicator for a narcotic antagonist to be prescribed?

Treatment of narcotic dependence

Identify one indicator for a narcotic antagonist to be prescribed? Treatment of narcotic dependence

Treatment of narcotic dependence

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

After administration of sumatriptan, the client reports experiencing nausea. Which drug does the nurse anticipate the prescriber to order?

chlorpromazine

A group of nursing students are reviewing information about how pain is classified. The group demonstrates understanding when they identify which type based on duration? Select all that apply.

chronic acute

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

codeine.

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

hypersensitivity to naloxone

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 client diagnosed with a migraine has been prescribed naproxen. What is the nurse's priority when the client reports being allergic to aspirin?

Hold the medication.

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

Although naloxone is given to counter opioid medication side effects such as respiratory depression, what additional issues (if any) may result from administration of an opioid antagonist?

Increase in the client's pain rating

The client tells the nurse that the health care provider described a drug as having "no ceiling effect." How should the nurse respond when the client asks what that means?

It is a valuable drug to use because dosage can be increased to relieve pain when pain increases or tolerance develops.

A woman has presented to the emergency department after cutting her hand badly on the blade of a food processor. The pain that this woman is currently experiencing is the result of

injury to woman's afferent fibers. Correct response: activation of the woman's delta and C nociceptors.

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 23-year-old woman reports vision loss interspersed with flashing lights before the onset of a very painful headache. During the assessment, she informs the nurse that she has been experiencing these symptoms for the last three months on a weekly basis. These symptoms are those of:

migraine headache.

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

opioids

Pain may be classified according to:

origin, duration, or cause.

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 beta-adrenergic antagonist is used for migraine prophylaxis?

propranolol

A nurse is providing health education to a client who has been recently diagnosed with migraines. What should the nurse include in the teaching?

the importance of avoiding foods that may precipitate migraines

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

withdrawal symptoms

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

Prior to administering morphine, the nurse checks the client's medication history. The nurse will contact the health care provider and hold the morphine if the nurse notes the client is currently taking which medication?

Monoamine oxidase (MAO) inhibitor

In the healthcare setting, the nurse knows that which opioid analgesic drugs are used? Select all that apply.

Morphine Meperidine Methadone Codeine

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

What factors affect how the patient will experience and respond to pain? Select all that apply.

Cultural expectation about how one should respond to pain Past experience with pain Learned behavior from childhood

What is an action of Ergotamine?

Decreases hypoperfusion of basilar artery vascular bed

A client diagnosed with impaired renal function has been prescribed morphine. How will the client's underlying condition affect the pharmacokinetics of the drug?

Desired effect will be lessened. Correct response: Duration of action will be prolonged.

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 male client is given regular doses of morphine for a period of 6 months. His dosage now needs to be reduced gradually. The health care provider advises the nurse to pay attention to the clinical management of the client's pain to allow proper agonist coverage during the change in drug dosage. Why is the client likely to suffer unnecessary pain and discomfort if proper management is not ensured?

Physical dependence on the drug

When a client is prescribed ergotamine tartrate, what information should be included in the teaching plan regarding the administration of the medication?

Take this medication with meals. Correct response: Tablet is placed under the tongue to dissolve.

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.

A female client tells the nurse that the first thing she does when she gets a headache is drink a caffeinated beverage. The nurse is aware that caffeine is known to decrease the pain of migraine headaches by what mechanism?

Vasoconstriction of blood vessels

The nurse educates the client who has just been given a prescription for ergotamine to call the health care provider if the client develops which symptoms? (Select all that apply.)

Weakness Chest pain Palpitations

The nurse has just administered an opioid antagonist to a client who had been experiencing respiratory depression. How soon can the nurse expect to see improvement in the client's respiratory function?

Within one to five minutes, an effect may be seen.

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

acute somatic pain