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A nurse is caring for a client who has been prescribed an opioid. Which of the following would the nurse include in the ongoing assessment?
- A. Review the client's health history.
- B. Review the client's allergy history.
- C. Inquire about the pain experienced by the client.
- D. Review the client's past and current drug therapies.
Correct Answer: C
Rationale: As part of the ongoing assessment, the nurse should inquire about the pain experienced by the client and believe the client and family in their reports of pain. The nurse must exercise good judgment because not all changes in pain type, location, or intensity require notifying the primary health care provider.
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A client is prescribed oxymorphone. The client is also receiving promethazine. The nurse would carefully monitor which of the following?
- A. Temperature
- B. Blood pressure
- C. Pulse
- D. Respiratory rate
- E. Blood glucose
Correct Answer: B,C,D
Rationale: The nurse should take care to closely monitor a client's blood pressure, pulse, and respiratory rate when oxymorphone is administered with promethazine.
A postoperative client has a nursing diagnosis of Ineffective Breathing Pattern and is fearful that movement may result in more pain. Which of the following would be most appropriate for the nurse to do?
- A. Get the client out of bed.
- B. Have the client do deep breathing.
- C. Encourage the client to lie still in bed.
- D. Get the client to cough every 2 hours.
- E. Administer more pain medication.
Correct Answer: A,B,D
Rationale: The client taking an opioid may be fearful that exercise will cause more pain. To help overcome this fear, the nurse should get the client out of bed and encourage therapeutic activities, such as deep breathing, coughing, and leg exercises, (when ordered). Having the client lie still in bed and giving more pain medication would be inappropriate.
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 would expect that epidural administration of opioid analgesics is reserved for which of the following?
- A. Labor pain
- B. Support of anesthesia
- C. Postoperative pain
- D. Moderate acute pain
- E. Intractable chronic pain
Correct Answer: A,C,E
Rationale: Epidural administration of opioid analgesics is reserved for postoperative pain, labor pain, and intractable chronic pain.