Chapter 10: Analgesics Test, Fentanyl – Pharmacology for Nurses: Practical Applications
The key terms in this Pharmacology course include Analgesics, Patient, Pain, Opioid, Muscles, Pharmacology, Nurse, Prescribed, Fentanyl, Adverse, Internal, Fentanyl Transdermal Delivery System, Analgesic Drugs, Morphine, Equianalgesic Table, Chronic Pain, Pharmacology for Nurses: Practical Applications.
The nurse teaches a patient prescribed the fentanyl (Duragesic) transdermal delivery system to change the patch at what interval?
Every 24 hours
When pain recurs
Every 72 hours
Once a week
The fentanyl transdermal delivery system is designed to slowly release analgesic over a 72-hour time frame.
A patient needs to switch analgesic drugs secondary to an adverse reaction to the current treatment regimen. The patient is concerned that the new prescription will not provide optimal pain control. The nurse’s response is based on knowledge that doses of analgesics are determined using an equianalgesic table with which drug prototype?
Fentanyl
Codeine
Morphine
Meperidine
An equianalgesic table is a conversion chart for commonly used opioids. It identifies oral and parenteral dosages that provide comparable analgesia. The equianalgesic table identifies dosages of various narcotics that are equal to 10 mg of morphine. It is important to use when changing to a new opioid or different route. Morphine is the drug prototype for all opioid drugs.
A patient is prescribed an opioid analgesic for chronic pain. Which information would the nurse discuss with the patient to minimize the GI adverse effects?
Increase fluid intake and fiber in the diet.
Take the medication on an empty stomach.
Avoid eating foods high in lactobacilli.
Take diphenoxylate–atropine (Lomotil) with each dose.
Opioid analgesics decrease GI intestinal motility (peristalsis), leading to constipation. Increasing fluid and fiber in the diet or use of stool softener or mild laxative can prevent constipation.
What assessment is highest priority when monitoring a patient on an opioid analgesic?
Respiratory rate
Mental status
Blood pressure
The most serious adverse effect of opioid analgesics is respiratory depression and is the assessment priority.
A patient prescribed massage therapy for musculoskeletal pain asks the nurse, “How is rubbing my muscles going to make the pain go away?” What is the nurse’s best response?
“Massaging muscles activates large sensory nerve fibers that send signals to the spinal cord to close the gate, thus blocking painful stimuli from reaching the brain.”
“Massaging muscles decreases the inflammatory response that initiates the painful stimuli.”
“Massaging muscles activates small sensory nerve fibers that send signals to the spinal cord to open the gate and allow endorphins to reach the muscles and relieve the pain.”
“Massaging muscles helps relax the contracted fibers and decrease painful stimuli.”
The gate theory of pain control identifies large sensory nerve fibers that, when stimulated, send signals to the spinal cord to close the gate, blocking pain stimuli from reaching the brain. Therefore, the patient is not having the sensation of pain even if the stimulus is still present.
When assessing a patient for adverse effects related to morphine sulfate (MS Contin), which clinical findings are the nurse most likely to find? (Select all that apply.)
Weight gain
Constipation
Diarrhea
Excessive bruising
Inability to void
How would a patient receiving narcotic analgesics for chronic pain can minimize the GI side effects?
taking Lomotil with each dose
increasing fluid and fiber in the diet
taking the medication on an empty stomach
eating foods high in lactobacilli
Narcotic analgesics decrease intestinal motility, leading to constipation. Increasing fluid and fiber in the diet can prevent constipation.