Nokea
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.
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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.
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 client is prescribed naloxone. The nurse would expect to administer the drug by which route?
- A. IM injection
- B. IV push
- C. Intrathecal injection
- D. IV piggyback
- E. Subcutaneous injection
Correct Answer: B,D
Rationale: Naloxone (Narcan) is administered by IV infusion requiring the use of a secondary line, an IV piggyback, or an IV push.
A client is admitted to a local health care facility for alcohol dependence. The nurse knows that the physician is most likely to prescribe which of the following drugs for the client?
- A. Cisapride
- B. Naproxen
- C. Lincosamide
- D. Naltrexone
Correct Answer: D
Rationale: The nurse should administer naltrexone to the client who has alcohol dependence. It is also used to block the effects of suspected opioids if they are being used by the person undergoing treatment for alcohol dependence. Cisapride, naproxen, and lincosamide are not used to treat alcohol dependence.
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.