Nokea
A client is given a postoperative opioid drug for pain relief. The nurse observes that the drug has slowed the client's breathing pattern. Which of the following reasons would the nurse most likely identify as the cause of the lowered breathing pattern?
- A. Anxiety
- B. Somnolence
- C. Nausea
- D. Anorexia
Correct Answer: B
Rationale: The nurse should identify somnolence as a cause of slowing of the client's breathing pattern. Sometimes the somnolence and pain relief produced by the opioid drug can slow the client's breathing pattern. Anxiety, nausea, and anorexia are not known to be responsible for slowing down a client's breathing pattern when the client is administered an opioid drug.
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Which of the following can occur if the nurse administers naloxone (Narcan) as a rapid IV bolus?
- A. Withdrawal
- B. Intense pain
- C. Vomiting
- D. Hypotension
- E. Respiratory depression
Correct Answer: A,B,C
Rationale: Withdrawal, return of intense pain, and vomiting may occur if the nurse administers naloxone (Narcan) as a rapid IV bolus.
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.
Which of the following would a nurse most likely be ordered to give to a client experiencing opioid-induced respiratory depression?
- A. Naloxone
- B. Nalbuphine
- C. Naltrexone
- D. Naproxen
- E. Nitroglycerin
Correct Answer: A
Rationale: Naloxone is an opioid antagonist specifically developed to reverse respiratory depression associated with opioids. Naltrexone may also be used, but its primary use is in the treatment of alcohol dependence. Nalbuphine is an agonist-antagonist used for severe chronic pain. Naproxen is an NSAID. Nitroglycerin is used for angina.
A nurse must be careful when administering opioid antagonists to clients taking which of the following?
- A. Codeine for cough
- B. Zolpidem for sleep
- C. Oxycodone for analgesia
- D. Naproxen for analgesia
- E. Diphenoxylate for diarrhea
Correct Answer: A,C,E
Rationale: Opioid antagonists may prevent the action or intended use of opioids like codeine for cough, oxycodone for analgesia, or diphenoxylate for diarrhea, so administration of opioid antagonists in clients taking these medications must be monitored carefully.
A client who has been receiving naloxone suddenly starts grimacing and moaning, moving his arms back and forth across his body, and drawing his legs up to his abdomen. Prior to administration the client was sleepy and calm. Assessment reveals that his respiratory rate is 18 breaths per minute. Which nursing diagnosis would most likely apply?
- A. Acute Pain
- B. Impaired Spontaneous Ventilation
- C. Deficient Knowledge
- D. Ineffective Coping
Correct Answer: A
Rationale: The client is exhibiting nonverbal indicators of acute pain, which can result after naloxone reverses the opioid's effects. The client's respiratory rate is 18 breaths per minute, so impaired spontaneous ventilation is not appropriate.