Nokea
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.
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Which of the following would a nurse most likely be ordered to give to a client experiencing opioid-induced respiratory depression?
- A. Naloxone
- B. Nalbuphine
- C. Naltrexone
- D. Naproxen
- E. Nitroglycerin
Correct Answer: A
Rationale: Naloxone is an opioid antagonist specifically developed to reverse respiratory depression associated with opioids. Naltrexone may also be used, but its primary use is in the treatment of alcohol dependence. Nalbuphine is an agonist-antagonist used for severe chronic pain. Naproxen is an NSAID. Nitroglycerin is used for angina.
When administering an opioid antagonist to reverse opioid-induced respiratory depression, which of the following would be most important for the nurse to keep in mind?
- A. Monitoring is less frequent if respiratory depression occurs in the immediate postoperative setting.
- B. The nurse should notify the primary health care provider if any adverse drug reactions occur.
- C. After the client has shown a response to the drug, the nurse monitors vital signs every 30 to 60 minutes.
- D. Monitoring of the client's respiratory status includes rate, rhythm, and depth.
- E. The nurse monitors the client's blood pressure, pulse, and respiratory rate at frequent intervals, usually every 3 minutes, until the client responds.
Correct Answer: B,D
Rationale: As part of the ongoing assessment during the administration of the antagonist, continue to monitor the blood pressure, pulse, and respiratory rate at frequent intervals, usually every 5 minutes, until the client responds. This monitoring should be more frequent if respiratory depression occurs in the immediate postoperative setting. After the client has shown a response to the drug, monitor vital signs every 5 to 15 minutes. Notify the anesthesiologist or primary health care provider if any adverse drug reactions occur because additional medical treatment may be needed. Continue to monitor the respiratory rate, rhythm, and depth; pulse; blood pressure; and level of consciousness until the effects of the opioid wear off.
A client with respiratory depression is administered an opioid antagonist by the nurse. What ongoing assessment should the nurse perform when administering the opioid antagonist to the client?
- A. Monitor vital signs every 5 to 15 minutes.
- B. Review allergy history and other treatment modalities.
- C. Teach different breathing patterns to the client.
- D. Monitor the blood pH level of the client.
Correct Answer: A
Rationale: The ongoing assessment performed by the nurse when administering an opioid antagonist to the client involves monitoring the vital signs of the client every 5 to 15 minutes. Monitoring the blood pH level of the client is not part of the ongoing assessment. Reviewing the allergy history and other treatment modalities and teaching different breathing patterns to the client are preadministration assessments that are performed before the administration of the drug; they are not ongoing assessments.
A nurse must be careful when administering opioid antagonists to clients taking which of the following?
- A. Codeine for cough
- B. Zolpidem for sleep
- C. Oxycodone for analgesia
- D. Naproxen for analgesia
- E. Diphenoxylate for diarrhea
Correct Answer: A,C,E
Rationale: Opioid antagonists may prevent the action or intended use of opioids like codeine for cough, oxycodone for analgesia, or diphenoxylate for diarrhea, so administration of opioid antagonists in clients taking these medications must be monitored carefully.
A client is prescribed naloxone for the treatment of postoperative acute respiratory depression after a kidney transplant. The nurse explains the drug to the family, describing its action as which of the following?
- A. Naloxone stops internal bleeding.
- B. Naloxone restores respiratory function.
- C. Naloxone restores reflexes of limbs.
- D. Naloxone helps the client overcome pain.
Correct Answer: B
Rationale: The nurse should explain that naloxone restores respiratory function within 1 to 2 minutes after administration. Naloxone neither stops internal bleeding nor restores limb reflexes. Naloxone also does not overcome pain.