Nokea
A client is prescribed an opioid analgesic. The initial interview reveals that the client chronically drinks alcohol. The nurse would assess the client for which of the following as a possible interaction between the opioid analgesic and alcohol?
- A. Respiratory depression
- B. Central nervous system depression
- C. Hypotension
- D. Sedation
Correct Answer: B
Rationale: The nurse should monitor the client for central nervous system depression. The nurse need not monitor the client for respiratory depression, hypotension, or sedation because these are the effects of the interaction of opioid analgesics with barbiturates, not alcohol.
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To decrease the risk of injury to a client taking an opioid, which action would be most appropriate?
- A. Keep the lights in the client's room turned down.
- B. Assist the client from the bed to the toilet.
- C. Assist the client with rising Ang from a lying position.
- D. Assist the client with hall-walking activities.
- E. Advise the client to stay in bed all night.
Correct Answer: B,C,D
Rationale: To decrease the risk of injury to a client taking an opioid, the nurse should assist the client with ambulatory activities and with rising from a sitting or lying position. The nurse should also keep the client's room well lit during daytime hours, keep the client's room free of clutter, and advise the client to seek assistance when getting out of bed at night.
A nurse would expect to administer opioid analgesics primarily for the client with which of the following?
- A. Severe acute pain
- B. Mild acute pain
- C. Moderate chronic pain
- D. Mild chronic pain
- E. Opioid dependence
Correct Answer: A,C,E
Rationale: Opioid analgesics are used primarily for the treatment of moderate to severe acute pain and chronic pain and in the treatment and management of opiate dependence.
A nurse is caring for a client with pain caused by terminal illness. The primary care provider has prescribed an opioid for the client. The nurse would be alert for the development of which of the following?
- A. Emphysema
- B. Alopecia
- C. Dehydration
- D. Severe anorexia
Correct Answer: D
Rationale: The nurse should monitor the client for severe anorexia, which is one of the adverse reactions of opioid analgesics on the GI system. Other adverse effects on the GI system include constipation, nausea, and acute abdominal pain. The nurse need not monitor the client for emphysema, alopecia, or severe headache.
Which of the following would alert the nurse to suspect that a client is experiencing intermediate manifestations of abstinence syndrome?
- A. Rhinorrhea
- B. Increased blood pressure
- C. Tachycardia
- D. Mydriasis
- E. Miosis
Correct Answer: C,D
Rationale: Intermediate symptoms of abstinence syndrome include mydriasis, tachycardia, twitching, tremor, restlessness, irritability, anxiety, and anorexia.
A client is prescribed a transdermal opioid. After teaching the client and family how to administer this drug, the nurse determines that the teaching was successful when they state which of the following?
- A. The drug should be reapplied every 24 hours.
- B. We should try to apply the patch to about the same site each time.
- C. The site should only be cleaned with water before each application.
- D. A hairy area, like the forearm, is an appropriate place to apply the patch.
Correct Answer: C
Rationale: Only water is used to clean the site because soap and other substances may irritate the skin. The patch is applied for 72 hours and sites should be rotated. Any site that is used should be free of hair.