opioid/narcotic type

Question 1

what are opioids not meant to do?

Answer 1

they are not nsaids
Opioids will not reduce a fever
are not anti-inflammatory
not good for gout or rheumatoid arthritis.

Question 2

Morphine

Answer 2

hold if respirations are below 10 will causes respiratory depression

Question 3

Hydromorphone

aka?

Answer 3

reduce respirations
decrease blood pressure=hypotension
orthostatic hypotention

dilaudid

Question 4

Codeine

Answer 4

used as cough suppressant

Question 5

Meperidine

aka

Answer 5

Demerol

DO NOT GIVE TO PATIENTS WITH INCREASED INTRACRNAIL PRESSURE OR SICKLE CELL ANEMIA

Question 6

OXYCODONE

Answer 6

Percocet

HAS ASPIRIN IN IT DO NOT GIVE IF PATIENT IS ALLERGIC

Question 7

Nclex note?

Answer 7

all narcotics:

• reduce pain
• cause physical dependence
• lower respirations
• should not be used with alcohol
• lowers blood pressure
• causes constipation

Question 8

Memory trick’s for opioids?

Answer 8

Low and slow:
BP
RR
HR
Brain

Question 9

when do we stop and give the antidote narcan?

Answer 9

1.) LOW RR- respiratory depression
Hold dose for RR below 12. Remember that we always tech deep breathing exercises to prevent pneumonia and atelectasis. but remember that if the patient does not practice this we still give medication and do not hold it.

Question 10

when do we stop and give the antidote narcan?

Answer 10

1.) LOW RR- respiratory depression
Hold dose for RR below 12. Remember that we always tech deep breathing exercises to prevent pneumonia and atelectasis. but remember that if the patient does not practice this we still give medication and do not hold it.

2.) Low BP-Hypotension
orthostatic hypotension, you need to teach the patient to go slow so slow position changes.

3. Low brain- CNS depression
   key terms:
   unarousable
   easily falls asleep when talking

Question 11

if the client becomes dizzy or lightheaded then what do you do?

Answer 11

place then in a sitting position immediately.

they cannot get up unassisted. so teach them to use the call light to get out of bed.

Question 12

if the patient overdoses on heroin and opioid what do we give?

Answer 12

naloxone IS GONE QUICKLY SO WE NEED TO GIVE MULTIPLE DOSES

Question 13

NALONE key points:

Answer 13

• 1-2 hour half life
• so we always have to reassess every 60 minutes
• monitor for a persistent low and slow
• RR below 12
• unarousable
• falling asleep when talking to you
• prepare for a 2nd dose of naloxone
• notify hcp

Question 14

would you call rapid response?

Answer 14

not unless the airway and breathing are critically low like RR below 12 and O2 below 90%

Question 15

how to administer IV opioid’s like morphine or hydromorphone (dilaudid)?

Answer 15

• administer OVER 2 TO 3 MINUTES IV PUSH.

- reassess every 15 to 30 minutes.

Question 16

greatest risk for death?

Answer 16

advanced age
copd, asthma=respiratory disease
post-surgery 24 hours

Question 17

if given an option for patients both with respiratory disease who do you pick?

Answer 17

1. ) oldest patient 1st

2. ) most recent surgery= 24 hours

Question 18

normal side effects that you do not need to report?

Answer 18

1. ) burning sensation is normal during IV push just dilute it and give it slower next time.
2. ) pruritus- just give antihistamine
3. ) nausea and vomiting when 1st starting= as nausea develops tolerance improves. so give antiemetic like ondansetron. but po opioid’s give with food. do not give on an empty stomach since it increases the nausea.

Question 19

long term side effects of opiods?

Answer 19

low and slow GI = constipation
Key terms:
PRN STOOL SOFTNERS
TEACH PREVENTIVE MEASRES LIKE FIBER, FLUIDS, AND AMBULATION.

Question 20

Does constipation get worse with long term administration ?

Answer 20

yes. but just because it does not mean that you would hold the opioid you continue giving it to the patient.

Question 21

oxycodone aka percocet

what is it used for and how does it work?

Answer 21

typically used for extended release and it has a slower onset.

used for severe chronic pain like cancer pain

it is given twice a day with other painkillers.

Question 22

when it oxycodone given?

Answer 22

“as scheduled” or “around the clock”

• EVEN IF NOT REPORTING PAIN
• GIVEN TOGETHER WITH OTHER PAIN MEDS

Question 23

PCA pumps? key point?

Answer 23

only the client is allowed to push it not their family, nurse, or HCP.

Question 24

When would you alert the HCP to increase the dose?

Answer 24

only when twice the dose of the medication is given.
if the patient still reports pain. what is the first action?
assess their pain level 1st.

Question 25

fentanyl key points:

Answer 25

it is usually used as a patch for chronic PERSISTENT pain.
NOT INTERMITENT 
NOT ACUTE
NOT POST-OP PAIN 
 ONLY CHRONIC PAIN 

IT DOES NOT PROVIDE IMMEDIATE PAIN RELIEF DUE TO IT TAKING 17 hours to get the full effect.

• APPROPRIATE TO USE IF PATIENT IS ALLERGIC TO CODEINE
• side effect? constipation so use stool softeners daily

Question 26

how to know if patient has developed tolerance?

Answer 26

need increase doses for pain relief

Question 27

how to place a fentanyl patch?

Answer 27

remove the old patch before the new one

clean the area
place the patch over dry skin