Nokea
A client is admitted to a local health care facility for alcohol dependence. The nurse knows that the physician is most likely to prescribe which of the following drugs for the client?
- A. Cisapride
- B. Naproxen
- C. Lincosamide
- D. Naltrexone
Correct Answer: D
Rationale: The nurse should administer naltrexone to the client who has alcohol dependence. It is also used to block the effects of suspected opioids if they are being used by the person undergoing treatment for alcohol dependence. Cisapride, naproxen, and lincosamide are not used to treat alcohol dependence.
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A nurse would expect to administer naloxone cautiously to which client?
- A. A client who is pregnant
- B. A client with cardiovascular disease
- C. A client with an alcohol dependency
- D. A client with an opioid dependency
- E. A client with chronic obstructive pulmonary disease
Correct Answer: A,B,D
Rationale: Opioid antagonists like naloxone (Narcan) should be used cautiously in those who are pregnant or lactating, in infants of opioid-dependent mothers, and in clients with an opioid dependency or cardiovascular disease.
After administering naloxone to a client with respiratory depression, the nurse would expect to see the effects of the drug within which time frame?
- A. 1 to 2 minutes
- B. 3 to 4 minutes
- C. 5 to 6 minutes
- D. 7 to 8 minutes
Correct Answer: A
Rationale: Naloxone is capable of restoring respiratory function within 1 to 2 minutes after administration.
A client is receiving an opioid antagonist. The nurse would closely monitor the client for which of the following?
- A. Cramps
- B. Sweating
- C. Low blood pressure
- D. Skin inflammation
Correct Answer: B
Rationale: The nurse should monitor for sweating when caring for the client since it is one of the adverse reactions of opioid antagonists. Other adverse reactions include nausea, vomiting, tachycardia, increased blood pressure, and tremors. The nurse need not monitor for cramps, low blood pressure, or skin inflammation since these conditions are not known to be caused by opioid antagonists.
When administering an opioid antagonist to reverse opioid-induced respiratory depression, which of the following would be most important for the nurse to keep in mind?
- A. Monitoring is less frequent if respiratory depression occurs in the immediate postoperative setting.
- B. The nurse should notify the primary health care provider if any adverse drug reactions occur.
- C. After the client has shown a response to the drug, the nurse monitors vital signs every 30 to 60 minutes.
- D. Monitoring of the client's respiratory status includes rate, rhythm, and depth.
- E. The nurse monitors the client's blood pressure, pulse, and respiratory rate at frequent intervals, usually every 3 minutes, until the client responds.
Correct Answer: B,D
Rationale: As part of the ongoing assessment during the administration of the antagonist, continue to monitor the blood pressure, pulse, and respiratory rate at frequent intervals, usually every 5 minutes, until the client responds. This monitoring should be more frequent if respiratory depression occurs in the immediate postoperative setting. After the client has shown a response to the drug, monitor vital signs every 5 to 15 minutes. Notify the anesthesiologist or primary health care provider if any adverse drug reactions occur because additional medical treatment may be needed. Continue to monitor the respiratory rate, rhythm, and depth; pulse; blood pressure; and level of consciousness until the effects of the opioid wear off.
A client with respiratory depression is administered an opioid antagonist by the nurse. What ongoing assessment should the nurse perform when administering the opioid antagonist to the client?
- A. Monitor vital signs every 5 to 15 minutes.
- B. Review allergy history and other treatment modalities.
- C. Teach different breathing patterns to the client.
- D. Monitor the blood pH level of the client.
Correct Answer: A
Rationale: The ongoing assessment performed by the nurse when administering an opioid antagonist to the client involves monitoring the vital signs of the client every 5 to 15 minutes. Monitoring the blood pH level of the client is not part of the ongoing assessment. Reviewing the allergy history and other treatment modalities and teaching different breathing patterns to the client are preadministration assessments that are performed before the administration of the drug; they are not ongoing assessments.