Unit 5 Pharm Chapter 26 Flashcards
Beta-receptors react with endorphins in the periphery to modulate pain transmission.
A) FALSE
B) TRUE
A) FALSE
Rationale:Beta-receptors react with enkephalins in the periphery to modulate pain transmission.
What does a nurse keep readily available should a client who is receiving morphine experience significant respiratory depression?
A) Naloxone
B) Ergotamine
C) Nalbuphine
D) Buprenorphine
A) Naloxone
Rationale:Naloxone is a narcotic antagonist that is used to reverse the effects of narcotics such as morphine. Buprenorphine is a narcotic agonist–antagonist that is used for moderate to severe pain relief. Ergotamine would be used to prevent and treat migraine attacks. Nalbuphine is used to provide pain relief during labor and delivery and as an adjunct to general anesthesia, as well as to treat moderate to severe pain in adults.
What action by the nurse best addresses a common adverse effect related to narcotic administration?
A) Encourage the client’s fluid intake.
B) Encourage the client to eat several meals daily.
C) Teach the client to take antiemetics as prescribed.
D) Teach the client to perform deep breathing and coughing exercise
A) Encourage the client’s fluid intake.
Rationale:Constipation is nearly ubiquitous in clients taking narcotics. Increasing fluid intake reduces the frequency and severity of constipation and may prevent it in some clients. There is not normally any need to eat frequent meals. Constipation is a more likely adverse effect than nausea. Deep breathing and coughing exercises do not directly address the respiratory depression than accompanies narcotic use.
What client may benefit from the addition of codeine to his or her pain control regimen?
A) A client who is experiencing pruritus (itching)
B) A client whose pain is causing insomnia
C) A client with decreased renal function
D) A client who has a dry, persistent cough
D) A client who has a dry, persistent cough
Rationale:Codeine is sometimes used as an antitussive
A nurse reviews various methods for assessing pain. The nurse determines which method is the most reliable?
A) Asking a client to describe his or her pain
B) Assessing the client’s vital signs
C) Using a pain rating scale
D) Percussing or palpating the area where pain is identified
C) Using a pain rating scale
Rationale:A pain rating scale is the most reliable method because it provides measurable evidence of pain severity. A client’s description of pain is useful but does not provide objective or quantifiable data over time. Although percussing or palpating provides information, it would increase the client’s pain and be inappropriate. Vital sign changes occur for numerous reasons and are not the best indicator of pain in clients who can speak.
When assessing a client reporting of a classic migraine headache, what would the nurse expect to assess? Select all that apply.
A) Aura
B) Sharp steady eye pain
C) Sensitivity to light
D) Nausea
E) One-sided pulsating pain
F) Tearing
A) Aura
C) Sensitivity to light
D) Nausea
E) One-sided pulsating pain
Rationale:Classic migraines are associated with an aura usually about a half-hour before the onset of pain. Unilateral pulsating pain is associated with a classic migraine headache. Sensitivity to light is associated with a classic migraine headache. Nausea is associated with a classic migraine headache. Sharp steady eye pain is associated with cluster headaches. Tearing is associated with cluster headaches.
A hospital client has been prescribed morphine for the treatment of postsurgical pain. The client tells the nurse, “I’m determined to push through my pain if I can, because there’s no way I want to end up addicted to narcotics.” What should the nurse teach the client?
A) Any addiction that the client develops can be treated prior to discharge from the hospital.
B) The client’s need for pain control should be a higher priority than the fear of addiction.
C) Narcotics used in healthcare settings are nonaddictive and are unrelated to drugs used recreationally.
D) It is extremely unlikely that the client would become addicted to narcotics used for this purpose.
D) It is extremely unlikely that the client would become addicted to narcotics used for this purpose.
Rationale:A client’s risk of becoming addicted to narcotics that are used for medical purposes is exceedingly low. However, the drugs themselves are capable of causing addiction and many have a potential for abuse. It is paternalistic to state that a client must prioritize pain control over a fear of addiction.
Morphine, when administered orally, has duration of action of 5 to 7 hours.
A) TRUE
B) FALSE
A) TRUE
Rationale:Oral, rectal, and subcutaneous administration of morphine has a 5- to 7-hour duration of action, while IM and IV administration has a 5- to 6-hour duration of action
The sigma receptors are primarily pain-blocking receptors.
A) FALSE
B) TRUE
A) FALSE
Rationale:The mu receptors are primarily pain blocking receptors.
A client’s past experience with pain has little impact on his or her perception of pain.
A) FALSE
B) TRUE
A) FALSE
Rationale:Past experience with pain has a large impact on how pain is perceived.
AT 10:30, the nurse administers morphine 5 mg IV as prescribed for a client in pain. The nurse should expect to assess for the drug’s maximum effect at what time?
A) 1050’
B) 1100
C) 1130
D) 1200
A)1050
Rationale:When given intravenously, morphine levels peak in 20 minutes.
A client has been prescribed morphine 4 to 6 mg IV q4h PRN. The client reports pain rated at 8/10, and the nurse confirms that the client has most often required 6-mg doses. The nurse chooses to administer 6 mg. The drug is available in ampoules containing 10 mg/mL. How many milliliters should the nurse withdraw?
________mL
0.6 ml
Rationale:6 mg ÷ 10 mg/mL = 0.6 mL.
Larger doses of narcotic antagonists are needed to reverse the effects of morphine than for pentazocine.
A) FALSE
B) TRUE
A) FALSE
Rationale:Larger doses of narcotic antagonists are needed to reverse the effects of pentazocine than morphine.
The nurse has entered the room of a client who is being treated with regular doses of morphine. The client is unresponsive to voice but responsive to touch, with a respiratory rate of 6 breaths/min. In addition to informing the care team, what is a priority action?
A) Administration of acetylcysteine as prescribed
B) Cardiac monitoring
C) Administration of naloxone as prescribed
D) Auscultating the client’s lungs
C) Administration of naloxone as prescribed
Rationale:Naloxone reverses the effects of opioids and should be administered to this client. Acetylcysteine is an antidote to acetaminophen overdose. Careful monitoring of the client’s status is necessary, but administration of naloxone is a priority.
A client has received a narcotic agonist for pain relief. The nurse should monitor the client for what?
A) Diarrhea
B) Hypertension
C) Pupil constriction
D) Tachypnea
C) Pupil constriction
Rationale:Narcotics are associated with pupil constriction, constipation, orthostatic hypotension, and respiratory depression with apnea.
