Author Question: A young adult postoperative patient is receiving morphine 2 to 4 mg IV every 2 hours PRN pain. ... (Read 27 times)

tiffannnnyyyyyy · **on:** Jul 23, 2018

A young adult postoperative patient is receiving morphine 2 to 4 mg IV every 2 hours PRN pain.

The last dose was 3 mg given 2 hours ago. The patient is asleep, and the nurse notes a heart rate of 86 beats per minute and a respiratory rate of 8 breaths per minute. Which PRN medication will the nurse give this patient?
a. Diphenhydramine (Benadryl) to counter morphine side effects
b. Morphine 4 mg for increased pain, as indicated by tachycardia
c. Naloxone (Narcan) to block the effects of the morphine
d. Nothing at this time, because the patient is resting comfortably

Question 2

In a discussion of drug-drug interactions, which would be the best example of a beneficial inhibitory interaction?

a. Naloxone (Narcan) blocking morphine sulfate's actions
b. Antacids blocking the action of tetracycline (Sumycin)
c. Alcohol blocking the actions of opioids
d. Cholestyramine blocking the actions of antihypertensive drugs

bookworm410 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: C
A respiratory rate of 8 breaths per minute indicates respiratory depression, which is a significant adverse effect indicating morphine toxicity. Naloxone blocks the actions of morphine at cell receptor sites and is given to quickly reverse the effects. This patient does not have signs of an allergic response, which would include shortness of breath, a rapid respiratory rate, and wheezing. The tachycardia might be a sign of worsening pain, but the toxic effects must be treated first. Patients who are sleeping are not always pain free.

Answer to Question 2

ANS: A
Naloxone is used when a narcotic overdose has occurred. As a narcotic antagonist, it provides a beneficial inhibitory interaction. An antacid blocking tetracycline's antibiotic effects would not be beneficial, but rather detrimental to the desired effects of the tetracycline. Alcohol would not block the effects of opiates, but would contribute to CNS depression. Cholestyramine and certain other adsorbent drugs, which are administered orally but do not undergo absorption, can adsorb other drugs onto themselves, thereby preventing absorption of the other drugs into the blood.