A patient is brought to the emergency department by his spouse. ...

[a0266361136]

A patient is brought to the emergency department by his spouse. The patient has a history of bone cancer and has been experiencing severe pain, which has not been relieved by doubling of his dose of opiates.
 
  The wife tells the nurse that her husband became confused and that his eyes looked funny. Upon assessment, the nurse notes miosis and a respiratory rate of 6/minute. The nurse should immediately prepare for administration of which medication?
  a. Naloxone (Narcan)
  b. Flumazenil (Romazicon)
  c. Methamphetamine hydrochloride (Desoxyn)
  d. Acetylcysteine (Mucomyst)

Question 2

A nurse is caring for a patient with cancer, who manages her mild pain with acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs.
 
  Her husband asks to speak with the nurse privately and explains that since his wife was diagnosed with cancer 2 years ago, she has been drinking about half a bottle of wine per day, along with a mixed drink before bed. The nurse should obtain from the prescriber an order for which of the following laboratory tests?
  a. Liver function tests
  b. Platelet count
  c. Ammonia level
  d. Hemoglobin and hematocrit level

[LegendaryAnswers]

Answer to Question 1

ANS: A
The patient is experiencing respiratory depression and should be given Narcan to reverse the respiratory effects of the opiate overdose.
Flumazenil is not indicated for opiate overdose.
Methamphetamine hydrochloride, a central nervous system stimulant, would not be indicated for this patient initially, although it would stimulate respirations.
Acetylcysteine is the antidote for acetaminophen poisoning, not opiate overdose.

Answer to Question 2

ANS: A
A patient with chronic alcohol abuse and frequent use of acetaminophen should have liver function tests to assess for any damage to the liver.
A platelet count is not indicated in this situation, because the concern is the hepatoxic effects of both acetaminophen and alcohol.
An ammonia level would be indicated for hepatic encephalopathy and is not required in this situation.
Hemoglobin and hematocrit levels are not indicated in this situation.