Author Question: A patient who has a long-term addiction to opioids takes an overdose of barbiturates. The nurse ... (Read 149 times)

meagbuch · **on:** Jul 23, 2018

A patient who has a long-term addiction to opioids takes an overdose of barbiturates. The nurse preparing to care for this patient will anticipate:

a. a severe abstinence syndrome when the effects of the barbiturates are reversed.
b. minimal respiratory depression, because the patient has developed a tolerance to opioids.
c. observing pinpoint pupils, respiratory de-pression, and possibly coma in this patient.
d. using naloxone Narcan to reverse the effects of the barbiturates, because cross-tolerance is likely.

Question 2

A nursing student asks the nurse why epinephrine, and not other adrenergic agonists, is used to treat anaphylactic shock. What will the nurse tell the student?

a. Epinephrine is the only adrenergic agon-ist that may be given parenterally.
b. Epinephrine has the ability to activate multiple types of adrenergic receptors.
c. Other adrenergic agonists have more se-vere adverse effects and are not safe in the doses needed to treat anaphylaxis.
d. Other adrenergic agonists have little or no effects on beta2-adrenergic receptors.

shewald78 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

C
Patients tolerant to opioids do not have cross-tolerance to barbiturates, so this patient will show signs of overdose such as pinpoint pupils, respiratory depression, and coma. Because there is no cross-tolerance, a patient addicted to opioids will not have an abstinence syndrome when the ef-fects of the barbiturates are reversed. Respiratory depression will be severe. Naloxone cannot be used to reverse the effects of the barbiturates.

Answer to Question 2

B
Epinephrine is used to treat anaphylactic shock because of its ability to activate multiple adre-nergic receptor types. Activation of beta1 receptors helps to increase cardiac output and improve blood pressure as well as suppress glottal edema. Activation of beta2 receptors helps to counteract bronchoconstriction . Activation of alpha1 receptors also causes vasoconstriction, which improves blood pressure. Isoproterenol may also be given parenterally but does not activate multiple receptor types. Other adrenergic agonists, such as albuterol, are more specific to beta2 receptors and have fewer side effects.