A patient who was admitted for a heroin overdose received ...

[shenderson6]

A patient who was admitted for a heroin overdose received naloxone (Narcan), which improved the breathing pattern. Two hours later, the patient reports muscle aches, abdominal cramps, gooseflesh and says, I feel terrible. Which analysis is correct?
 
  a. The patient is exhibiting a prodromal symptom of seizures.
  b. An idiosyncratic reaction to naloxone is occurring.
  c. Symptoms of opiate withdrawal are present.
  d. The patient is experiencing a relapse.

Question 2

In the emergency department, a patient's vital signs are: blood pressure (BP), 66/40 mm Hg; pulse (P), 140 beats per minute (bpm); and respirations (R), 8 breaths per minute and shallow. The patient overdosed on illegally obtained hydromorphone (Dilaudid)
 
  Select the priority outcome.
 
  a. Within 8 hours, vital signs will stabilize as evidenced by BP greater than 90/60 mm Hg, P less than 100 bpm, and respirations at or above 12 breaths per minute.
  b. The patient will be able to describe a plan for home care and achieve a drug-free state before being released from the emergency department.
  c. The patient will attend daily meetings of Narcotics Anonymous within 1 week of beginning treatment.
  d. The patient will identify two community resources for the treatment of substance abuse by discharge.

[Expo]

Answer to Question 1

ANS: C
The symptoms given in the question are consistent with narcotic withdrawal. Early symptoms of narcotic withdrawal are flulike in nature. Seizures are more commonly observed in alcohol withdrawal syndrome.

Answer to Question 2

ANS: A
Hydromorphone (Dilaudid) is an opiate drug. The correct answer is the only one that relates to the patient's physical condition. It is expected that vital signs will return to normal when the CNS depression is alleviated. The distracters are desired outcomes later in the plan of care.

[shenderson6]

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[Expo]

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