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To decrease the risk of injury to a client taking an opioid, which action would be most appropriate?
- A. Keep the lights in the client's room turned down.
- B. Assist the client from the bed to the toilet.
- C. Assist the client with rising Ang from a lying position.
- D. Assist the client with hall-walking activities.
- E. Advise the client to stay in bed all night.
Correct Answer: B,C,D
Rationale: To decrease the risk of injury to a client taking an opioid, the nurse should assist the client with ambulatory activities and with rising from a sitting or lying position. The nurse should also keep the client's room well lit during daytime hours, keep the client's room free of clutter, and advise the client to seek assistance when getting out of bed at night.
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A group of nursing students are reviewing information about epidural pain management with opioid analgesics. The students demonstrate understanding of the information when they identify which of the following as an advantage over other routes of administration?
- A. Longer time to tolerance development
- B. Lower total dose of opioid
- C. Fewer adverse reactions
- D. Greater client comfort
- E. Decreased demand on nursing staff
Correct Answer: B,C,D
Rationale: Epidural administration offers several advantages over other routes of administration for opioid analgesics, including lower total dosages of the drug used, fewer adverse reactions, and greater client comfort.
A nurse is assessing a client who is to receive an opioid analgesic. The nurse would contact the primary health care provider immediately if which of the following occur?
- A. Respiratory rate of less than 10 breaths/min
- B. Decrease in pulse
- C. Increase in pulse
- D. Increase in blood pressure
- E. Blood pressure of 90/65 mm Hg
Correct Answer: A,B,C,E
Rationale: The nurse should contact the primary health care provider immediately if any of the following occur while a client is receiving an opioid analgesic: significant decrease in respiratory rate or a respiratory rate less than 10 breaths/min; significant increase or decrease in the pulse rate or a change in the pulse quality; or significant decrease in blood pressure or a systolic blood pressure below 100 mm Hg.
A client is prescribed oxymorphone. The client is also receiving promethazine. The nurse would carefully monitor which of the following?
- A. Temperature
- B. Blood pressure
- C. Pulse
- D. Respiratory rate
- E. Blood glucose
Correct Answer: B,C,D
Rationale: The nurse should take care to closely monitor a client's blood pressure, pulse, and respiratory rate when oxymorphone is administered with promethazine.
A nurse is administering an opioid analgesic to a client with severe chronic pain. The nurse understands that the rate of tolerance to an opioid analgesics effects varies from client to client. The nurse identifies which of the following as affecting the rate at which tolerance develops?
- A. Body weight
- B. Gender
- C. Dosage
- D. Route of administration
- E. Age
Correct Answer: C,D
Rationale: The rate at which tolerance to an opioid analgesic develops varies according to dosage, the route of administration, and the individual.
A postoperative client has a nursing diagnosis of Ineffective Breathing Pattern and is fearful that movement may result in more pain. Which of the following would be most appropriate for the nurse to do?
- A. Get the client out of bed.
- B. Have the client do deep breathing.
- C. Encourage the client to lie still in bed.
- D. Get the client to cough every 2 hours.
- E. Administer more pain medication.
Correct Answer: A,B,D
Rationale: The client taking an opioid may be fearful that exercise will cause more pain. To help overcome this fear, the nurse should get the client out of bed and encourage therapeutic activities, such as deep breathing, coughing, and leg exercises, (when ordered). Having the client lie still in bed and giving more pain medication would be inappropriate.