Which patient may require a higher than expected dose of an ...

[jparksx]

Which patient may require a higher than expected dose of an opioid analgesic?
 
  a. A patient with cancer
  b. A patient with a concussion
  c. A patient with hypotension
  d. A patient 3 days after surgery

Question 2

One hour after receiving intravenous morphine sulfate, a patient reports generalized itching.
 
  The nurse assesses the patient and notes clear breath sounds, no rash, respirations of 14 breaths per minute, a heart rate of 68 beats per minute, and a blood pressure of 110/70 mm Hg. Which action will the nurse take?
  a. Administer naloxone to reverse opiate overdose.
  b. Have resuscitation equipment available at the bedside.
  c. Prepare an epinephrine injection in case of an anaphylactic reaction.
  d. Reassure the patient that this is a common side effect of this drug.

[IAPPLET]

Answer to Question 1

ANS: A
Opioids are titrated for oncology patients until pain relief is achieved or the side effects become intolerable, and extremely high doses may be required. Patient with closed head injuries should receive reduced doses of opioids if at all to reduce the risk of increased intracranial pressure. Patients with hypotension should receive reduced doses to prevent further decrease in blood pressure. Patients who are 3 days post-operation should not be experiencing severe pain.

Answer to Question 2

ANS: D
Pruritis is a common opioid side effect and can be managed with diphenhydramine. Patients developing anaphylaxis will have urticaria and hypotension, and these patients will need epinephrine and resuscitation. Respiratory depression is a sign of morphine overdose, which will require naloxone.

[jparksx]

Thank you!

[IAPPLET]

Always glad to help...