PAIN Ch 10,12,44 Flashcards
The health care provider orders oral (PO) codeine as an adjunctive therapy to pain control medication. What order would be appropriate for the nurse to administer?
A) Codeine 5 mg PO every 6 hour
B) Codeine 10 mg PO every 4 hour
C) Codeine 15 mg PO every 2 hour
D) Codeine 20 mg PO every 4 hour
D) Codeine 20 mg PO every 4 hour
The correct dosage for codeine administered for pain by mouth is 15 to 60 mg q 4 to 6 hour.
The nurse is caring for a patient who is receiving an opioid analgesic. What are the nurse’s priority assessments?
A) Pain intensity and blood glucose level
B) Level of consciousness and respiratory rate
C) Respiratory rate and electrolytes
D) Urine output and pain intensity
B) Level of consciousness and respiratory rate
The nurse should assess respiratory rate and level of consciousness because respiratory depression and sedation are adverse effects of opioid analgesics
The nurse is caring for a patient experiencing postoperative pain. The physician orders 2.5 mg of morphine IV every two hours. Morphine is supplied in 10 mg/mL vials. How many mL will the nurse administer?
A) 0.25 mL
B) 0.5 mL
C) 1 mL
D) 2 mL
A) 0.25 mL
0 mg = 1 mL and a dose of 2.5 mg is ordered. 10 mg/1 mL: 2.5 mg/x Cross-multiply to yield 2.5 mg = 10x. Divide each side by 10 to learn the nurse should administer 0.25 mL
What drug might the nurse administer for both analgesic and antitussive effects?
A) Codeine
B) Aspirin
C) Ibuprofen
D) Acetaminophen
A) Codeine
Codeine is a narcotic drug used for its analgesic and antitussive effects
As the nurse settles the patient into his room after returning from the post-anesthesia care unit (PACU), the patient says he is in severe pain. The nurse checks the medical record and sees the patient has an order for morphine 4 to 8 mg every 1 to 2 hour IV as needed for pain. The nurse sees this medication has not been administered yet so the nurse administers 4 mg. After administering the drug, the PACU nurse calls to say a dose of morphine was given and not documented. What drug will the nurse be prepared to administer if the patient’s respiratory rate is depressed?
A) Naloxone hydrochloride tartrate (Narcan)
B) Butorphanol
C) Buprenorphine (Buprenex)
D) Nalbuphine hydrochloride (Nubain)
A) Naloxone hydrochloride tartrate (Narcan)
Naloxone is the drug of choice for treatment of opioid overdose. Butorphanol (INN) is amorphinan- type synthetic opioid analgesic that would not reverse the effects of an opioid
The nurse is providing patient teaching about a prescribed opioid analgesic. What is an important teaching point related to a possible adverse effect of this drug?
A) Ataxia
B) Blurred vision
C) Hypotension
D) Dysrhythmias
C) Hypotension
Orthostatic hypotension is commonly seen in association with some narcotics.
The nurse receives an order for morphine sulfate 8 mg IV every 1 hour as needed for pain. For which patient would the nurse need to question this order?
A) A 78-year-old with osteoarthritis
B) A 45-year-old, 1-day postoperative mastectomy
C) A 28-year-old with a fractured tibia
D) A 17-year-old, 1-day postoperative appendectomy
A) A 78-year-old with osteoarthritis
Older patients are more likely to experience the adverse effects associated with narcotics, including central nervous system, gastrointestinal, and cardiovascular effects.
The nurse is administering morphine to a trauma patient for acute pain. Before administering the morphine, what common adverse effect should the nurse inform the patient about?
A) Paresthesia in lower extremities
B) Occipital headache
C) Increased intracranial pressure
D) Drowsiness
D) Drowsiness
Common adverse effects include dizziness, drowsiness, and visual changes
The nurse is administering morphine to a trauma patient for acute pain. Before administering the morphine, what common adverse effect should the nurse inform the patient about?
A) Paresthesia in lower extremities
B) Occipital headache
C) Increased intracranial pressure
D) Drowsiness
D) Drowsiness
Common adverse effects include dizziness, drowsiness, and visual changes
The nurse administers a narcotic analgesic to the postoperative patient. What is the best way for the nurse to evaluate response to the medication?
A) Observe the patient without her awareness.
B) Use a pain assessment tool before and 30 minutes after administration.
C)Assess vital signs.
D) Measure oxygen sat
B) Use a pain assessment tool before and 30 minutes after administration.
A standard pain assessment tool should be used both pre- and post-analgesia
The nurse administers a narcotic analgesic to the postoperative patient. What is the best way for the nurse to evaluate response to the medication?
A) Observe the patient without her awareness.
B) Use a pain assessment tool before and 30 minutes after administration.
C)Assess vital signs.
D) Measure oxygen sat
B) Use a pain assessment tool before and 30 minutes after administration.
A standard pain assessment tool should be used both pre- and post-analgesia
A patient, 6 days postoperative, is being weaned off an opioid analgesic. The patient reports he is getting no relief from the pain with the new non-opioid medication he is receiving. What might the nurse suspect is causing this patient’s pain?
a. The patient needs a higher dose of the opioid analgesic.
b. The patient has become addicted to the opioid medication.
c.The patient has developed withdrawal syndrome.
d.The patient has developed a cross-hypersensitive reaction.
c.The patient has developed withdrawal syndrome.
Caution should be used in cases of physical dependence on a narcotic because a withdrawal syndrome may be precipitated, the narcotic antagonistic properties can block the analgesic effect, and so intensify the pain. It is important to differentiate between addiction and dependence because addiction generally does not occur in patients receiving narcotics for medical reasons. There is no indication of a hypersensitivity reaction. Giving a higher dose of the opioid would eliminate the progress made to date on weaning the patient from the narcotic, so attempts should be made to avoid this intervention.
A patient, 6 days postoperative, is being weaned off an opioid analgesic. The patient reports he is getting no relief from the pain with the new non-opioid medication he is receiving. What might the nurse suspect is causing this patient’s pain?
a. The patient needs a higher dose of the opioid analgesic.
b. The patient has become addicted to the opioid medication.
c.The patient has developed withdrawal syndrome.
d.The patient has developed a cross-hypersensitive reaction.
c.The patient has developed withdrawal syndrome.
Caution should be used in cases of physical dependence on a narcotic because a withdrawal syndrome may be precipitated, the narcotic antagonistic properties can block the analgesic effect, and so intensify the pain. It is important to differentiate between addiction and dependence because addiction generally does not occur in patients receiving narcotics for medical reasons. There is no indication of a hypersensitivity reaction. Giving a higher dose of the opioid would eliminate the progress made to date on weaning the patient from the narcotic, so attempts should be made to avoid this intervention.
The home care nurse administers oral morphine to the patient with cancer pain. When will the nurse expect this medication to reach peak activity?
A) 10 minutes
B) 30 minutes
C) 45 minutes
D) 60 minutes
D) 60 minutes
With oral administration, peak activity occurs in about 60 minutes. The duration of action is 5 to 7 hours.
The home care nurse administers oral morphine to the patient with cancer pain. When will the nurse expect this medication to reach peak activity?
A) 10 minutes
B) 30 minutes
C) 45 minutes
D) 60 minutes
D) 60 minutes
With oral administration, peak activity occurs in about 60 minutes. The duration of action is 5 to 7 hours.
Before administering an opiate medication, what will the nurse assess?
A) The patient’s weight
B) The patient’s heart rate
C) The patient’s respiratory rate
D) The patient’s drug tolerance
C) The patient’s respiratory rate
Check the rate, depth, and rhythm of respirations before each dose. If the patient’s heart rate is slower than 12 beats per minute, delay or omit the dose and report to the physician.
Before administering an opiate medication, what will the nurse assess?
A) The patient’s weight
B) The patient’s heart rate
C) The patient’s respiratory rate
D) The patient’s drug tolerance
C) The patient’s respiratory rate
Check the rate, depth, and rhythm of respirations before each dose. If the patient’s heart rate is slower than 12 beats per minute, delay or omit the dose and report to the physician.
Narcotic agonists-antagonists have what function? (Select all that apply.)
A) Relief of moderate-to-severe pain
B) Adjunctive therapies to nonsteroidal anti-inflammatory drugs (NSAIDs)
C) Relief of pain during labor and delivery
D) Relief of orthopedic pain
E) Adjuncts to general anesthesia
A) Relief of moderate-to-severe pain
C) Relief of pain during labor and delivery
E) Adjuncts to general anesthesia
These drugs have three functions: (1) relief of moderate-to-severe pain, (2) adjuncts to general anesthesia, and (3) relief of pain during labor and delivery. Adjunctive therapies to NSAIDs or specificity for orthopedic pain are not functions of this classification of medication.
Narcotic agonists-antagonists have what function? (Select all that apply.)
A) Relief of moderate-to-severe pain
B) Adjunctive therapies to nonsteroidal anti-inflammatory drugs (NSAIDs)
C) Relief of pain during labor and delivery
D) Relief of orthopedic pain
E) Adjuncts to general anesthesia
A) Relief of moderate-to-severe pain
C) Relief of pain during labor and delivery
E) Adjuncts to general anesthesia
These drugs have three functions: (1) relief of moderate-to-severe pain, (2) adjuncts to general anesthesia, and (3) relief of pain during labor and delivery. Adjunctive therapies to NSAIDs or specificity for orthopedic pain are not functions of this classification of medication.
When evaluating the effects of narcotic agonist-antagonists on a patient, what adverse effects would the nurse monitor for?
A) Hypertension
A) Hypertension
Monitor for adverse effects (e.g., central nervous system changes, gastrointestinal (GI) depression, respiratory depression, arrhythmias, hypertension).
What is the nurse’s priority assessment when administering narcotics to older adults? (Select all that apply.)
a.Central nervous system (CNS) effects
b.Gastrointestinal effects
c. Cardiovascular effects
d. Urinary effects
e.Developmental effects
a.Central nervous system (CNS) effects
b.Gastrointestinal effects
c. Cardiovascular effects
Older patients are more likely to experience the adverse effects associated with these drugs, including central nervous system, gastrointestinal (GI), and cardiovascular effects.
