Prep U Pathopharmacology

A client prescribed sumatriptan as abortive therapy for migraines reports, "I took that pill about an hour-and-a-half ago, and I still don't feel any better. Can I take another?" How should the nurse respond?

"Wait at least half-an-hour before you take another pill."

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?

Assess the client's other vital signs.

To decrease the risk of injury to a client taking an opioid, what should the nurse do?

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

When describing the action of ergot derivatives, the nurse would incorporate understanding of:

Blockage of alpha-adrenergic receptors

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.

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.)

Chest pain Weakness Palpitations

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.

The nurse is caring for a client taking pentazocine/naloxone. What would be an appropriate nursing diagnosis for this client's care plan?

Impaired gas exchange related to respiratory depression

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

At 1030, the nurse administers morphine 5 mg IV as prescribed for a client in pain. The nurse should expect to assess for the drug's maximum effect at what time?

1050

The nurse administers an oral dose of morphine to a client at 3:00 PM. The nurse would expect the drug to peak at which time?

4:00 PM

The nurse is caring for four clients. For which client would the nurse question the health care provider's order of IV morphine?

A 78-year-old with osteoarthritis

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.

The nurse is caring for a client who has been prescribed a nonopioid analgesic in addition to a narcotic analgesic. What effect will the nurse expect?

Additive effect

A nurse is caring for a client diagnosed with migraine headaches. Which nursing intervention should be implemented during an acute headache?

Administer subcutaneous sumatriptan succinate (Imitrex).

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

The pathophysiology of pain begins with a signal from what source?

Nociceptors

The nurse is providing health education to a client prescribed almotriptan for the treatment of migraines. The nurse should caution the client about what potential adverse effects?

Numbness and chest tightness

A client is to receive naltrexone. The nurse would expect to administer this drug by which route?

Oral

Which adverse reactions may occur as a result of administering an opioid antagonist?

Sweating, tachycardia, and increased blood pressure

The nurse should teach the client prescribed chlorpromazine hydrochloride that this medication is likely to cause what reaction?

reduction of light-sensitivity experienced during migraines

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 on long-term naproxen therapy is experiencing adverse effects of this treatment?

The client's stool tests positive for occult blood.

Morphine, the prototype drug for opioid analgesics, is given for both acute and chronic pain. The patient's response to the drug depends on the:

route of administration.

When teaching the client how to safely administer prochlorperazine, the nurse should emphasize what teaching point?

the importance of taking the pill whole and not crushing or splitting it

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.

The nurse is educating a young adult client diagnosed with migraine headaches about the prescribed acetaminophen-aspirin-caffeine combination for abortive therapy. Which statement made by the client establishes the need for further clarification?

"I can take my over-the-counter cold remedies in addition to this drug for cold symptoms."

A client with a history of migraines has been prescribed sumatriptan. What education should the nurse provide about the safe and effective use of this drug?

"Take your medication as soon as you first sense a migraine coming."

A client has sought care for the treatment of migraines that have become increasingly severe. The care provider has prescribed abortive therapy. What should the nurse teach the client about this drug regimen?

"Take your medication at the first sign of a migraine."

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."

The nurse should question the health care provider's IV morphine prescription for which client?

An 88-year-old client with failure to thrive

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

Fentanyl (Duragesic)

The client is taking sumatriptan (Imitrex) for migraine headaches. For which client is this medication contraindicated?

For clients with a history of angina pectoris, myocardial infarction, or uncontrolled hypertension

"I can take my over-the-counter cold remedies in addition to this drug for cold symptoms."

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

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

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

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

A health care provider suggests opioid treatment for a client with respiratory depression. The nurse should be aware of which condition that can occur during an abrupt reversal of opioid respiratory treatment?

Vomiting

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

activation of the woman's delta and C nociceptors.

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.

acute chronic

A 30-year-old client experiences migraines that appear closely linked to her menstrual cycle. What pharmacologic treatment is most specific to this client's particular experience of migraines?

estradiol

Naloxone will reverse the effects of which drugs? Select all that apply.

fentanyl codeine

A client has been prescribed naproxen for the treatment of migraines. The nurse who will administer the medication is aware that the black box warning that accompanies this drug will consequently prioritize what assessment?

heart rate and rhythm

The nurse should recognize that naproxen achieves a therapeutic effect through which means?

inhibiting the synthesis of COX-1 and COX-2

How do opioid analgesics relieve moderate-to-severe pain?

inhibiting the transmission of pain signals from peripheral tissues to the brain

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 nurse suspects that a client who has been receiving morphine is exhibiting early symptoms of abstinence syndrome. Which finding would the nurse most likely be assessing?

yawning rhinorrhea sweating