A postoperative patient has a history of opioid abuse. Which ...

[big1devin]

A postoperative patient has a history of opioid abuse. Which analgesic medication will the nurse expect the provider to order for this patient?
 
  a. Buprenorphine (Buprenex)
  b. Butorphanol tartrate (Stadol)
  c. Naloxone (Narcan)
  d. Pentazocine (Talwin)

Question 2

The nurse assesses an older patient 60 minutes after administering 4 mg of intravenous morphine sulfate (MS) for postoperative pain. The patient's analgesia order is for 2 to 5 mg of MS IV every 2 hours.
 
  The nurse notes that the patient is lying very still. The patient's heart rate is 96 beats per minute, respiratory rate is 14 breaths per minute, and blood pressure is 140/90 mm Hg. When asked to rate the level of pain, the patient replies just a 5. The nurse will perform which action?
  a. Give 3 mg of MS at the next dose.
  b. Give 5 mg of MS at the next dose.
  c. Request an order for an oral opioid to give now.
  d. Request an order for acetaminophen to give now.

[whitcassie]

Answer to Question 1

ANS: A
Buprenorphine is an opioid agonist-antagonist analgesic and was developed to help decrease opioid abuse. Butophanol and pentazocine are also in this class, but reports say that they cause dependence. Naloxone is an opioid antagonist and is given to reverse the effects of opioids if toxicity occurs.

Answer to Question 2

ANS: B
Older patients often minimize pain when asked, so the nurse should evaluate nonverbal cues to pain such as elevated heart rate and blood pressure and the fact that the patient is lying very still. The nurse should increase the dose the next time the pain medication is given.