Nokea
A group of nursing students are reviewing information about epidural pain management with opioid analgesics. The students demonstrate understanding of the information when they identify which of the following as an advantage over other routes of administration?
- A. Longer time to tolerance development
- B. Lower total dose of opioid
- C. Fewer adverse reactions
- D. Greater client comfort
- E. Decreased demand on nursing staff
Correct Answer: B,C,D
Rationale: Epidural administration offers several advantages over other routes of administration for opioid analgesics, including lower total dosages of the drug used, fewer adverse reactions, and greater client comfort.
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A nurse is assessing a client who is to receive an opioid analgesic. The nurse would contact the primary health care provider immediately if which of the following occur?
- A. Respiratory rate of less than 10 breaths/min
- B. Decrease in pulse
- C. Increase in pulse
- D. Increase in blood pressure
- E. Blood pressure of 90/65 mm Hg
Correct Answer: A,B,C,E
Rationale: The nurse should contact the primary health care provider immediately if any of the following occur while a client is receiving an opioid analgesic: significant decrease in respiratory rate or a respiratory rate less than 10 breaths/min; significant increase or decrease in the pulse rate or a change in the pulse quality; or significant decrease in blood pressure or a systolic blood pressure below 100 mm Hg.
A nurse should be aware of contraindications to the use of opioids to help decrease the likelihood of adverse reactions. The nurse understands that opioids would be contraindicated in which client?
- A. A client with acute bronchial asthma
- B. A client with an acute myocardial infarction
- C. A client with a head injury
- D. A client with grand mal seizures
- E. A client with mild renal impairment
Correct Answer: A,C,D
Rationale: The use of opioids is contraindicated in clients with acute bronchial asthma, emphysema, upper airway obstruction, head injury, increased intracranial pressure, convulsive disorders, severe renal or hepatic dysfunction, and acute ulcerative colitis.
A nurse is assessing a client receiving an opioid as treatment for diarrhea. The nurse would notify the primary health care provider immediately if which of the following occur?
- A. Constipation
- B. Blood noted in the stool
- C. Worsening of diarrhea
- D. Report of severe abdominal pain
- E. Diarrhea unrelieved
Correct Answer: B,C,D,E
Rationale: A nurse monitoring a client taking an opioid for diarrhea should notify the physician immediately if diarrhea is not relieved or becomes worse, if the client has severe abdominal pain, or if blood in the stool is noted.
A nurse is caring for a client who is prescribed an opioid analgesic by her primary health care provider. Which assessment finding would lead the nurse to suspect that the client is experiencing an adverse reaction?
- A. Decreased intracranial pressure
- B. Increased breathing rate
- C. Tachycardia
- D. Urinary frequency
Correct Answer: C
Rationale: The nurse should monitor the client for tachycardia, increased intracranial pressure, depressed breathing rate, and urinary retention as possible adverse reactions.
After teaching a group of nursing students about opioids, the instructor determines that additional teaching is needed when the students identify which of the following as a natural opioid?
- A. Meperidine
- B. Morphine
- C. Codeine
- D. Opium
Correct Answer: A
Rationale: Meperidine is a synthetic opioid. Natural opioids include morphine sulfate, codeine, opium alkaloids, and tincture of opium.