Analgesics and Pain Management Medications > Pharmacology
Exam Review
Opioid Analgesics
Total Questions : 5
Showing 5 questions, Sign in for moreA nurse is caring for a client who is receiving intravenous morphine for postoperative pain.
The nurse should monitor the client for which adverse effects of morphine?
Explanation
Morphine is an opioid analgesic that can cause respiratory depression by decreasing the sensitivity of the respiratory centre in the brainstem to carbon dioxide levels. This can lead to hypoventilation, hypoxia, and even death if not treated promptly.
Choice B is wrong because hyperthermia is not a common adverse effect of morphine.Morphine can cause sweating and flushing, but it does not increase body temperature.
Choice C is wrong because tachycardia is not a common adverse effect of morphine.Morphine can cause bradycardia by stimulating the vagus nerve and reducing sympathetic activity.
Choice D is wrong because hypertension is not a common adverse effect of morphine.Morphine can cause hypotension by dilating peripheral blood vessels and reducing cardiac output.
A nurse is administering nalbuphine to a client who has moderate pain. The client asks the nurse how this drug works.
What should the nurse say?
Explanation
Nalbuphine is a mixed opioid agonist-antagonist that binds to and activates kappa receptors, producing pain relief and sedation and blocking mu receptors, preventing respiratory depression. This makes it a safer option than pure opioid agonists for clients who have moderate pain and are at risk of respiratory complications.
Choice A is wrong because it describes the mechanism of action of pure opioid agonists, such as morphine or fentanyl, which bind to and activate both mu and kappa receptors, producing strong pain relief and sedation, but also respiratory depression and dependence.
Choice B is wrong because it describes the mechanism of action of partial opioid agonists, such as buprenorphine or tramadol, which bind to and partially activate mu receptors, producing moderate pain relief and less respiratory depression than pure opioid agonists, but also less analgesia.
Choice D is wrong because it describes the mechanism of action of opioid antagonists, such as naloxone or naltrexone, which bind to and block both mu and kappa receptors, reversing the effects of other opioids, but also precipitating withdrawal symptoms.
A nurse is preparing to administer codeine to a client who has a cough. The client asks the nurse why codeine is used for cough suppression.
What should the nurse say?
Explanation
Codeine acts on opioid receptors in your brainstem to suppress the activity of your cough centre and decrease your urge to cough. This is how codeine works as an antitussive or cough suppressant.
Choice A is wrong because codeine does not block pain signals from reaching your cough centre.Codeine blocks pain signals from reaching your brain and spinal cord, which is how it works as an analgesic or pain reliever.
Choice B is wrong because codeine does not act on opioid receptors in your lungs.Codeine does not reduce inflammation or mucus production that triggers your cough reflex.
Choice D is wrong because codeine does not act on opioid receptors in your throat.Codeine does not numb the nerve endings that stimulate your cough reflex.
A nurse is reviewing the medication history of a client who is prescribed buprenorphine for chronic pain.
The nurse should identify that which medication can interact with buprenorphine and increase the risk of serotonin syndrome?
Explanation
Fluoxetine can interact with buprenorphine and increase the risk of serotonin syndrome. Serotonin syndrome is a serious drug reaction that occurs when there is too much serotonin in the body. It can cause symptoms such as agitation, confusion, muscle rigidity, fever, seizures and coma.
Choice B is wrong because metformin is not known to have any serotonergic effects or interact with buprenorphine.
Choice C is wrong because omeprazole is not known to have any serotonergic effects or interact with buprenorphine.
Choice D is wrong because lisinopril is not known to have any serotonergic effects or interact with buprenorphine.
A nurse is teaching a client who has chronic pain about the use of transdermal fentanyl.
Which statements by the client indicate understanding of the teaching? Select all that apply.
Explanation
The client should change the patch every 72 hours and apply it to a clean, dry, and hairless area of skin. This ensures that the patch adheres well and delivers the medication at a steady rate.
Choice C is wrong because the client should not cut the patch in half.This can damage the patch and cause fentanyl to leak out or be absorbed too quickly.
Choice D is wrong because the client should avoid exposing the patch to heat sources, such as heating pads, electric blankets, saunas, or hot tubs.Heat can increase the absorption of fentanyl and cause an overdose.
Choice E is wrong because the client should dispose of the used patch by folding it onto itself and placing it in a sealed container or a special disposal pouch.Flushing the patch down the toilet can contaminate the water supply and pose a risk to others.
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