A patient is receiving hydromorphone (Dilaudid) as treatment for ...

[mcmcdaniel]

A patient is receiving hydromorphone (Dilaudid) as treatment for chronic pain. Which patient action would indicate a developing tolerance to the drug?
 
  a. The patient takes fewer doses during the day.
  b. The time frame between doses lengthens.
  c. The patient forgets to take a dose as scheduled.
  d. The patient takes a higher dose to obtain relief.

Question 2

A patient who was taking oxycodone (Percocet) at home for relief of chronic back pain visits the emergency department on the weekend after the prescription for this drug expired and could not be refilled by the local pharmacist.
 
  The patient is complaining of back pain and muscle and joint pain, and also exhibits tremors and irritability. Which condition may the patient have?
  a. Acute back injury
  b. Pain-induced psychosis
  c. Opioid withdrawal
  d. Influenza

[14vl19]

Answer to Question 1

ANS: D
Tolerance to opioids can develop quickly, depending on the dose and frequency of use. Toler-ance is characterized by a shorter duration of pain relief, decrease in peak analgesic effect, and increase in the amount of the drug needed to relieve the pain.

Answer to Question 2

ANS: C
Signs of opioid withdrawal peak at 36 to 72 hours after the last dose and include tactile halluci-nations, irritability, sleeplessness, yawning, tremor, joint and muscle pain, anorexia, nausea, vom-iting, diarrhea, dehydration, abdominal cramps, ketosis, weight loss, distorted vision and photo-phobia. They subside gradually over 2 to 5 weeks.

[mcmcdaniel]

Excellent

[JaynaD87]

Gracias!