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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.
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A client is receiving an opioid analgesic following abdominal surgery. The client has been out of bed to the chair and is encouraged to ambulate with assistance. The nurse is also encouraging the client to increase his fluids. He reports that his appetite is good and he has been finishing most of his meals. His bowel sounds are active but he is having difficulty passing stools. A laxative is ordered. Which nursing diagnosis would be most appropriate?
- A. Imbalanced Nutrition: Less Than Body Requirements
- B. Constipation
- C. Risk for Injury
- D. Deficient Knowledge
Correct Answer: B
Rationale: The client is most likely experiencing constipation from the opioid therapy as well as from the lack of ambulation and activity. The client is eating, so imbalanced nutrition is not necessarily a problem.
A nurse is reviewing the differences between opioid agonists and opioid agonist-antagonists. The nurse correctly identifies which of the following as an opioid agonist-antagonist?
- A. Alfentanil (Alfenta)
- B. Buprenorphine (Buprenex)
- C. Meperidine (Demerol)
- D. Nalbuphine (Nubain)
- E. Pentazocine (Talwin)
Correct Answer: B,D,E
Rationale: Opioid agonist-antagonists include buprenorphine, butorphanol, nalbuphine, and pentazocine.
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 to administer a prescribed opioid to a client. Which of the following conditions should the nurse confirm in the client to ensure that opioid therapy is not contraindicated in this client?
- A. Client does not have acute bronchial asthma.
- B. Client does not have acute diabetic retinopathy.
- C. Client does not have acute pre-existing liver disease.
- D. Client does not have decreased intracranial pressure.
Correct Answer: A
Rationale: Opioid therapy is contraindicated in clients with acute bronchial asthma; therefore, the nurse should confirm that the client does not have this condition before administering opioid therapy. Opioid therapy is not known to be contraindicated in clients with diabetic retinopathy and pre-existing liver disease. Opioid therapy is contraindicated in clients with increased, not decreased, intracranial pressure.
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.