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 an example?
- A. Naproxen
- B. Nalbuphine
- C. Naloxone
- D. Nevirapine
Correct Answer: C
Rationale: Naloxone is an opioid antagonist. Naproxen is an NSAID. Nalbuphine is an opioid agonist-antagonist. Nevirapine is an antiretroviral agent.
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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 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.
Abrupt reversal of opioid-induced respiratory depression may cause vomiting. Which action by the nurse would be most appropriate if this occurs during reversal of opioid-induced respiratory depression?
- A. Maintaining a patent airway
- B. Stopping the opioid antagonist
- C. Suctioning the client as needed
- D. Administering more of the opioid
- E. Turning the client to the side as needed
Correct Answer: A,C,E
Rationale: If vomiting occurs during the reversal of opioid-induced respiratory depression, the nurse must maintain a patent airway and should turn and suction the client as needed.
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 nurse determines that an opioid antagonist would most likely be needed in which situation?
- A. Postoperative acute respiratory depression
- B. Reversal of phenytoin toxicity
- C. Reversal of opioid-induced hypotension
- D. Suspected acute benzodiazepine overdosage
- E. Suspected acute opioid overdosage
Correct Answer: A,C,E
Rationale: Opioid antagonists are used for the treatment of the following: postoperative acute respiratory depression, reversal of opioid adverse effects (hypotension, bradycardia, etc.), and suspected acute opioid overdosage.