A patient is ready for discharge home from a lengthy hospital ...

[tfester]

A patient is ready for discharge home from a lengthy hospital stay after a motor vehicle accident. The patient suffered multiple fractures and required large doses of morphine for several weeks.
 
  The nurse preparing the patient for discharge notes that the patient requests the maximum dose of the oral opioid analgesic at the exact intervals it is prescribed. The nurse is correct to suspect that what has occurred? a. Addiction
  b. Compulsive drug seeking
  c. Cross-tolerance
  d. Drug tolerance

Question 2

A patient who takes teriparatide Forteo administers it subcutaneously with a prefilled pen injector. The patient asks why she must use a new pen every 28 days when there are doses left in the syringe. Which is the correct response by the nurse?
 
  a. Go ahead and use the remaining drug; I know it is so expensive.
  b. The drug may not be stable after 28 days.
  c. You are probably not giving the drug accurately.
  d. You should be giving the drug more fre-quently.

[pallen55]

Answer to Question 1

D
Patients who use a drug regularly develop tolerance to the drug when a dose produces a smaller response than it did initially. This patient has been on large doses of opioids for several weeks and has developed tolerance to this class of drugs. Addiction is characterized by compulsive drug seeking, which has not occurred. A patient using narcotics for severe pain is not a compulsive drug seeker. Cross-tolerance occurs when tolerance to one drug confers tolerance to another drug. The opioid analgesic for home use is in the same drug classification, so this is not cross-tolerance.

Answer to Question 2

B
Teriparatide is supplied in 3-mL injectors. The pen should be stored in the refrigerator and dis-carded after 28 days, even if some drug remains in the syringe. Although the drug is expensive, it is not correct to use what is in the syringe after 28 days. Drug may be left in the syringe even with correct dosing.

[tfester]

Thank you!

[pallen55]

Always glad to help...