Chapter 10: Analgesics Test, Surgery, Pharmacology for Nurses: Practical Applications
The key terms in this Pharmacology course include Analgesics Test, pain medication, morphine sulfate, Lethargic, Naloxone (Narcan), Patient, Opioid, Block, Pharmacology, Nurse, opioid Vicodin (acetaminophen/hydrocodone), adverse effects, Constipation, Urinary retention, Diarrhea, Abdominal Surgery, Pancreatic Cancer, Opioid Analgesic
A 78-year-old patient is in the recovery room after having a lengthy surgery on his hip. As he is gradually awakening, he requests pain medication. Within 10 minutes after receiving a dose of morphine sulfate, he is very lethargic and his respirations are shallow, with a rate of 7 breaths/minute. The nurse prepares for which priority action at this time?
Administration of naloxone (Narcan)
Assessment of the patient’s pain level
Close observation of signs of opioid tolerance
Immediate intubation and artificial ventilation
Naloxone, an opioid-reversal agent, is used to reverse the effects of acute opioid overdose and is the drug of choice for reversal of opioid-induced respiratory depression. This situation is describing an opioid overdose, not opioid tolerance. Intubation and artificial ventilation are not appropriate because the patient is still breathing at 7 breaths/min. It would be inappropriate to assess the patient’s level of pain.
The opioid Vicodin (acetaminophen/hydrocodone) is prescribed for a patient who has had surgery. The nurse informs the patient that which common adverse effects can occur with this medication? (Select all that apply.)
Nervousness
Constipation
Urinary retention
Diarrhea
Itching
Lightheadedness
A patient will be discharged with a 1-week supply of an opioid analgesic for pain management after abdominal surgery. The nurse will include which information in the teaching plan?
The importance of taking the drug on an empty stomach
The importance of taking the drug only when the pain becomes severe
How to prevent constipation
How to prevent dehydration due to diarrhea
Gastrointestinal (GI) adverse effects, such as nausea, vomiting, and constipation, are the most common adverse effects associated with opioid analgesics. Physical dependence usually occurs in patients undergoing long-term treatment. Diarrhea is not an effect of opioid analgesics. Taking the dose with food may help minimize GI upset.
A patient was diagnosed with pancreatic cancer last month, and has complained of a dull ache in the abdomen for the past 4 months. This pain has been gradually increasing, and the pain relievers taken at home are no longer effective. What type of pain is the patient experiencing?
Acute pain
Neuropathic pain
Somatic pain
Chronic pain
Chronic pain is associated with cancer and is characterized by slow onset, long duration, and dull, persistent aching. The patient’s symptoms are not characteristics of acute pain, somatic pain, or neuropathic pain.
A patient is suffering from tendonitis of the knee. The nurse is reviewing the patient’s medication administration record and recognizes that which adjuvant medication is most appropriate for this type of pain?
Anticonvulsant
Corticosteroid
Antidepressant
Local anesthesia
Corticosteroids have an anti-inflammatory effect, which may help to reduce pain. The other medications do not have anti-inflammatory properties.