Pharm Module 5 Chapter 15 PrepU

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

Which of the following clients is more likely to have respiratory depression when receiving an opioid medication, requiring administration of an opioid antagonist?

A surgical client who is not used to taking opioid analgesics

A hospital client's pain is rated at 9/10, and the nurse is preparing to administer 4 mg hydromorphone PO as prescribed. What are the appropriate interventions by the nurse prior to administering the medication?

Assess the client's baseline respiratory rate.

A client who is receiving an opioid develops a slowed breathing pattern due to the drug's effect of somnolence and pain relief. When providing care to this client, which would be important for the nurse to do?

Coach the client to breathe.

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

Duration of action will be prolonged.

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

Fentanyl (Duragesic)

What action should the nurse take when administering meperidine 75 mg IM every 4 hours to a young adult?

Give the medication as prescribed.

A client who was recently diagnosed with cancer is now receiving morphine for pain. Since this client has been receiving morphine for only a short time, he is best described by which term?

Opiate naive

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.)

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

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. Explanation: Onset of action is generally rapid and may be seen within one to five minutes. Additional doses may be required to achieve optimal effects

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.

In the PACU the nurse must take into consideration which before giving pain medicine to the postoperative client?

continued pain relief and client's ability to breathe

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

The nurse identifies which expected outcomes for a client who has been administered Narcan for respiratory depression? Select all that apply.

normal respiratory rate normal respiratory depth normal respiratory rhythm

Which client would the nurse identify as being opioid naive?

one who does not routinely take opioids

The client who does not use opioids regularly and suffers respiratory depression after given an opioid during a surgical procedure is described as which?

opioid naive

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

opioids

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

withdrawal symptoms

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.

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

Meperidine

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 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.

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

Level of consciousness (LOC) Explanation: Opioids will produce decreased LOC. Oliguria is not a result of the administration of an opioid. Edema is not a result of the administration of an opioid. Tachycardia is not a result of the administration of an opioid.

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?"

If a client begins to experience somnolence after receiving an opioid, the first action the nurse should take is:

rouse the client and coach the breathing pattern.

The client is brought to the emergency department in respiratory arrest after overdosing on heroin. The person accompanying the client says he has been using heroin for years. After being administered one dose of naloxone, the client begins to breathe spontaneously but remains nonresponsive to stimuli so another dose is prescribed. The nurse should monitor for what signs and symptoms of acute narcotic abstinence syndrome? Select all that apply.

tachycardia hypertension vomiting