Chapter 15: Opioid Analgesics Introductory Clinical Pharmacology 12th Edition by Susan M Ford

Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. The nurse is assessing a client who is prescribed an opioid analgesic. The nurse will monitor the client for which reaction if the client reveals the chronic use of alcohol? a. Respiratory depression b. Central nervous system depression c. Hypotension d. Sedation Answer: B Rationale: The nurse should monitor the client for central nervous system depression. The nurse does not need to monitor the client for respiratory depression, hypotension, or sedation because these are the effects of the interaction of opioid analgesics with barbiturates, not effects of alcohol. Question Format: Multiple Choice Chapter: 15 Learning Objective: 5 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 193, Interactions 2. 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 events occur? Select all that apply. 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 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. Question Format: Multiple Select Chapter: 15 Learning Objective: 3 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 199, Monitoring and Managing Client Needs 3. A client is receiving an opioid analgesic. Assessment reveals that the respiratory rate has dropped. Which steps would the nurse expect to implement? Select all that apply. a. Oxygen administration b. Coaching of the client to breathe c. Discontinuation of the opioid analgesic d. Naloxone administration e. Albuterol administration Answer: B, D Rationale: Coaching the client to breathe and administering naloxone (in severe cases) are appropriate measures used to treat a drop-in respiratory rate in a client receiving an opioid analgesic. Oxygen would have little effect if the client's rate has dropped. The opioid would not be discontinued. Albuterol would be used if the client were experiencing bronchospasms. Question Format: Multiple Select Chapter: 15 Learning Objective: 5 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 196, Fears of Respiratory Depression 4. A client with severe chronic pain is to receive an opioid analgesic agent. The nurse will monitor the client for signs of tolerance which can develop at different rates related to which factors? Select all that apply. a. Body weight b. Gender c. Dosage d. Route of administration e. Age 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. Question Format: Multiple Select Chapter: 15 Learning Objective: 3 Cognitive Level: Understand Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 198, Tolerance Versus Dependence 5. A nurse is preparing to administer pain medications to various clients. The nurse anticipates administering an opioid analgesic to clients with which assessment finding? Select all that apply. a. Severe acute pain b. Mild acute pain c. Moderate chronic pain d. Mild chronic pain e. Opiate dependence