A nurse cares for an alert patient with cancer who has been on ...

[bio_gurl]

A nurse cares for an alert patient with cancer who has been on large doses of opioids for several months.
 
  When the patient is hospitalized and placed on patient-controlled analgesia with morphine, the nurse is concerned about the risk of respiratory depression. The primary nursing action should be which of the following interventions?
  a. Administer naloxone (Narcan) prophylactically.
  b. Obtain an arterial blood gas measurement at least once per shift.
  c. Measure respiratory pattern and oxygen saturation initially and periodically throughout treatment.
  d. Assess level of consciousness and compare to previous day.

Question 2

A nurse is differentiating between breakthrough pain and end-of-dose pain with a group of nursing students. The nurse asks the group, How is breakthrough pain different from end-of-dose pain?
 
  A student would be correct to respond that breakthrough pain differs from end-of-dose pain in what manner?
  a. It occurs immediately before the next dose is scheduled.
  b. It can occur spontaneously at any time during the dosing interval.
  c. It can occur when analgesic levels are at their lowest.
  d. It occurs immediately after a dose is given.

[amit]

Answer to Question 1

ANS: C
One of the best indications that respiratory depression has occurred would be measurement of the baseline respiratory pattern and oxygen saturation and periodic monitoring throughout the duration of treatment.
Narcan is never administered prophylactically.
Arterial blood gases are not indicated as an initial measure of respiratory depression.
Assessment of level of consciousness is not indicated, because the information states the patient is alert.

Answer to Question 2

ANS: B
Breakthrough pain occurs spontaneously or may be precipitated by other movements.
Breakthrough pain is not related to dosing intervals; it can occur anytime and spontaneously.
End-of-dose pain occurs because analgesic levels are lowest at that time, not breakthrough pain.
Breakthrough pain is not related to dosing intervals.

[bio_gurl]

Thank you!

[amit]

Always glad to help...