Nokea
A primary health care provider orders opioid antagonist treatment for a client with respiratory depression. The nurse should be aware of which of the following conditions that can occur during an abrupt reversal of opioid respiratory treatment?
- A. Dizziness
- B. Headache
- C. Vomiting
- D. Lightheadedness
Correct Answer: C
Rationale: The nurse should know that an abrupt reversal of opioid respiratory depression with an opioid antagonist results in vomiting. The nurse must maintain a patent airway and should turn and suction the client as needed in such cases. Headache, dizziness, and lightheadedness are not known to occur during an abrupt reversal of opioid respiratory treatment.
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If time allows, the nurse should review which of the following with the client prior to administering an opioid antagonist?
- A. Initial health history
- B. Allergy history
- C. Bowel history
- D. Family medical history
- E. Current treatment modalities
Correct Answer: A,B,E
Rationale: If time allows, the nurse should review the client's initial health history, allergy history, and current treatment modalities prior to administering an opioid antagonist.
A nursing student is assigned to lead a class discussion on opioid antagonists. Which of the following would the student include as the mechanism by which opioid antagonists reverse the effects of opioid agonists?
- A. Competitive inhibition of the opioid receptor
- B. Direct binding to the opioid agonist
- C. Displacement of the opioid agonist from the opioid receptor
- D. Irreversible inhibition of the opioid receptor
- E. Mutation of the opioid receptor
Correct Answer: A,C
Rationale: Opioid agonists reverse the opioid effects by competing for the opiate receptor site and displacing the opioid drug.
A client is given a postoperative opioid drug for pain relief. The nurse observes that the drug has slowed the client's breathing pattern. Which of the following reasons would the nurse most likely identify as the cause of the lowered breathing pattern?
- A. Anxiety
- B. Somnolence
- C. Nausea
- D. Anorexia
Correct Answer: B
Rationale: The nurse should identify somnolence as a cause of slowing of the client's breathing pattern. Sometimes the somnolence and pain relief produced by the opioid drug can slow the client's breathing pattern. Anxiety, nausea, and anorexia are not known to be responsible for slowing down a client's breathing pattern when the client is administered an opioid drug.
An opioid-naïve client experiences acute pain after surgery and is prescribed opioid therapy. The nurse would be especially alert for the development of which of the following?
- A. Pruritus
- B. Severe headache
- C. Respiratory depression
- D. Urticaria
Correct Answer: C
Rationale: The nurse should monitor for symptoms of respiratory depression developing in the client as one of the severe adverse reactions of opioid treatment. Pruritus, urticaria, and headache are caused by opioids, but these conditions are not the most severe and common adverse reactions observed in opioid-naïve clients.
A nurse would expect to administer naloxone cautiously to which client?
- A. A client who is pregnant
- B. A client with cardiovascular disease
- C. A client with an alcohol dependency
- D. A client with an opioid dependency
- E. A client with chronic obstructive pulmonary disease
Correct Answer: A,B,D
Rationale: Opioid antagonists like naloxone (Narcan) should be used cautiously in those who are pregnant or lactating, in infants of opioid-dependent mothers, and in clients with an opioid dependency or cardiovascular disease.