A client has received an opioid analgesic for pain. The nurse ...

[Garrulous]

A client has received an opioid analgesic for pain. The nurse assesses that the client has a Pasero Scale score of 3 and a respiratory rate of 7 shallow breaths/min. The client's oxygen saturation is 87. What action should the nurse perform first?
 
  a. Apply oxygen at 4 L/min.
  b. Attempt to arouse the client.
  c. Give naloxone (Narcan).
  d. Notify the Rapid Response Team.

Question 2

An older adult has diabetic neuropathy and often reports unbearable foot pain. About which medication would the nurse plan to educate the client?
 
  a. Desipramine (Norpramin)
  b. Duloxetine (Cymbalta)
  c. Morphine sulfate
  d. Nortriptyline (Pamelor)

[nanny]

Answer to Question 1

ANS: B
The Pasero Opioid-Induced Sedation Scale is used to assess for unwanted opioid-associated sedation. A Pasero Scale score of 3 is unacceptable but is managed by trying to arouse the client in order to take deep breaths and staying with the client until he or she is more alert. Administering oxygen will not help if the client's respiratory rate is 7 breaths/min. Giving naloxone and calling for a Rapid Response Team would be appropriate for a higher Pasero Scale score.

Answer to Question 2

ANS: B
Antidepressants and anticonvulsants often are used for neuropathic pain relief. Morphine would not be used for this client. However, older adults do not tolerate tricyclic antidepressants very well, which eliminates desipramine and nortriptyline. Duloxetine would be the best choice for this older client.

[Garrulous]

Thanks for the timely response, appreciate it

[LVPMS]

Excellent