Nokea
When administering an opioid antagonist, the nurse would expect reversal of which of the following opioid effects?
- A. Respiratory depression
- B. Constipation
- C. Analgesia
- D. Hypotension
- E. Bradycardia
Correct Answer: A,B,C,D,E
Rationale: Opioid antagonists are not selective for reversal of specific adverse reactions occurring with the use of an opioid but will reverse all adverse reactions caused by opioids.
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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 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 monitoring a client receiving naloxone (Narcan) should be cognizant for the development of which of the following adverse reactions?
- A. Nausea
- B. Constipation
- C. Tachycardia
- D. Hypotension
- E. Tremors
Correct Answer: A,C,E
Rationale: Generalized reactions that can occur with the use of opioid antagonists such as naloxone include nausea, vomiting, sweating, tachycardia, increased blood pressure, and tremors.
A client with chronic back pain is admitted to a local health care facility for respiratory depression secondary to an inadvertent overdose of his opioid analgesic. The client is to receive naloxone. Which of the following would the nurse include before administering naloxone?
- A. Monitor the client's blood pressure every 5 minutes.
- B. Review the client's allergy history and treatment modalities.
- C. Monitor vital signs every 5 to 15 minutes if the client is responsive.
- D. Monitor respiratory rate and rhythm of the client.
Correct Answer: B
Rationale: Before administering the antagonist, the nurse should review the client's initial health history, allergy history, and treatment modalities. The nurse should also obtain the client's blood pressure, pulse, and respiratory rate and review the record for the drug suspected of causing the symptoms of respiratory depression. All these interventions are part of the preadministration assessment.
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.