Nokea
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.
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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 nurse is caring for a client with chronic pain who has been prescribed epidural analgesia. The nurse monitors the client for which of the following after insertion of the epidural catheter and throughout the therapy?
- A. Abdominal pain
- B. Respiratory depression
- C. Fever
- D. Nervousness
Correct Answer: B
Rationale: The most serious adverse reaction associated with the epidurally administered opioids is respiratory depression. The nurse should closely monitor the client for respiratory depression after insertion of the epidural catheter and throughout the therapy.
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.
A nurse is working at a substance abuse clinic. The nurse would expect which of the following to be used in the treatment and management of opioid dependence?
- A. Fentanyl (Duragesic)
- B. Methadone (Dolophine)
- C. Propoxyphene (Darvon)
- D. Levomethadyl (Orlaam)
- E. Oxycodone (OxyContin)
Correct Answer: B,D
Rationale: Levomethadyl and methadone are the two opiates used in the treatment and management of opiate dependence.
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.