A patient who has been taking an opiate for 2 years is preparing ...

[Jramos095]

A patient who has been taking an opiate for 2 years is preparing to discontinue use of the medication. Which statement made by the patient, indicates no need for further teaching?
 
  a. I will discontinue the drug when I am ready.
  b. I will continue taking a very low dose for 3 to 6 months.
  c. I will taper the drug slowly over 7 to 10 days.
  d. I can switch to another opiate and then discontinue the medication.

Question 2

A nurse is reviewing discharge instructions with a patient. The patient asks the nurse why the oral dose of the opioid is so much higher than the intravenous dose he has been receiving. The nurse's best response would be
 
  a. Only a maintenance dose of the medication is required. Your body already has built up the medication from its intravenous administration.
  b. The oral form of the drug passes through the liver and is then metabolized prior to obtaining the desired effect.
  c. Opiates are subject to being acid labile and destroyed in the gut, so the dose required is higher.
  d. The doses should be the same. The prescriber must think that your pain is not well controlled.

[heinisk01]

Answer to Question 1

ANS: C
To prevent withdrawal symptoms, the patient should taper the drugs over a 7-to-10-day period; no further teaching is required.
Long-term use of opiates requires a tapering of the drug to prevent withdrawal symptoms, and they cannot be stopped randomly; further teaching is required.
The drugs should be tapered over 7 to 10 days, not 3 to 6 months, especially if the patient no longer requires the medication; further teaching is required.
Switching to another opiate will not help taper the medication to promote discontinuation of the drug; further teaching is required.

Answer to Question 2

ANS: B
The oral dose is delivered enterally and is subject to the first-pass effect, therefore a higher oral dosage is required compared with the intravenous dose.
Dosing for morphine sulfate is not determined by previous intravenous usage.
Opiates are not acid labile and are not destroyed in the gut.
The intravenous dose of morphine sulfate is significantly lower than the dose for oral administration.

[Jramos095]

Wow, this really help

[coreycathey]

Thanks for the timely response, appreciate it