Nokea
After administering an opioid antagonist, which of the following would be most appropriate for the nurse to do when the client's pain recurs?
- A. Change opioid antagonists.
- B. Review the circumstances that led to the use of the opioid antagonist.
- C. Assess the client's pain level.
- D. Begin to treat the pain again.
- E. Decrease the rate of opioid antagonist administration.
Correct Answer: B,C,D
Rationale: The nurse should assess the client's pain level, review the circumstances that required the use of the antagonist, and begin to treat the pain again. Changing antagonists and decreasing the rate of antagonist administration are inappropriate.
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Which of the following are evaluations the nurse should make when caring for a client receiving naloxone?
- A. Pain relief is resumed.
- B. Adverse reactions are identified and managed.
- C. Therapeutic response is achieved.
- D. Client demonstrates an understanding of the drug regimen.
- E. Client's respiratory rate is normal.
Correct Answer: A,B,C,D,E
Rationale: Pain relief is resumed, adverse reactions are identified and managed, therapeutic response is achieved, client demonstrates an understanding of the drug regimen, and client's respiratory rate is normal are evaluations of successful therapy with an opioid antagonist.
After teaching a group of nursing students about opioid antagonists, the instructor determines that the teaching was successful when the students identify which of the following as true about these drugs?
- A. An opioid antagonist has greater affinity for opioid receptors than do opioid agonists.
- B. An opioid antagonist has lesser affinity for opioid receptors than do opioid agonists.
- C. An opioid antagonist prevents a response to the opioid by binding to opioid agonists in the bloodstream.
- D. An opioid antagonist prevents a response to the opioid by binding to opioid receptors.
- E. An opioid antagonist potentiates the effect of an opioid.
Correct Answer: A,D
Rationale: An opioid antagonist has a greater affinity for a cell receptor than an opioid agonist, and by binding to the cell receptor, it prevents a response to the opioid agonist.
The nurse is evaluating a client who has received naloxone for respiratory depression. Assessment of which of the following would indicate effectiveness of the drug therapy?
- A. Client is now receiving mechanical ventilation.
- B. Client's level of pain has decreased.
- C. Respiratory rate and depth are within acceptable parameters.
- D. Fluid intake and output are balanced.
Correct Answer: C
Rationale: The client receives naloxone to reverse respiratory depression. Therefore, a respiratory rate and depth within acceptable parameters indicate that the drug was effective. The need for mechanical ventilation indicates that the client is still experiencing respiratory difficulty.
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 receiving an opioid antagonist. The nurse would closely monitor the client for which of the following?
- A. Cramps
- B. Sweating
- C. Low blood pressure
- D. Skin inflammation
Correct Answer: B
Rationale: The nurse should monitor for sweating when caring for the client since it is one of the adverse reactions of opioid antagonists. Other adverse reactions include nausea, vomiting, tachycardia, increased blood pressure, and tremors. The nurse need not monitor for cramps, low blood pressure, or skin inflammation since these conditions are not known to be caused by opioid antagonists.