A patient who has biliary colic reports a pain level of 8 on a 1 ...

[Pea0909berry]

A patient who has biliary colic reports a pain level of 8 on a 1 to 10 pain scale with 10 being the most severe pain. The patient has an order for ibuprofen as needed for pain. Which action by the nurse is correct?
 
  a. Administer the ibuprofen as ordered.
  b. Contact the provider to discuss nonphar-macologic pain measures.
  c. Request an order for meperidine Deme-rol.
  d. Request an order for morphine sulfate.

Question 2

A woman in labor receives meperidine Demerol for pain. The nurse caring for the infant will observe the infant closely for:
 
  a. congenital anomalies.
  b. excessive crying and sneezing.
  c. respiratory depression.
  d. tremors and hyperreflexia.

[fwbard]

Answer to Question 1

C
Opioids can induce spasm of the common bile duct and can cause biliary colic. For patients with existing biliary colic, morphine may intensify the pain. It is important to treat pain, however, and certain opioids, such as meperidine, which cause less smooth muscle spasm, may be given. Ibu-profen is used for mild to moderate pain and is not appropriate for this patient. Nonpharmaco-logic methods are appropriate when used as adjunctive therapy with an opioid.

Answer to Question 2

C
Use of morphine or other opioids during delivery can cause respiratory depression in the neonate, because the drug crosses the placenta. Infants should be monitored for respiratory depression and receive naloxone if needed. Opioids given during delivery do not contribute to birth defects in the newborn. Excessive crying and sneezing and tremors and hyperreflexia are signs of neonatal opioid dependence, which occurs with long-term opioid use by the mother during pregnancy and not with short-term use of these drugs during labor.

[Pea0909berry]

Excellent

[bbburns21]

TYSM