Answer to Question 1
D
D. Because opioids are delivered close to their site of action (CNS), they have greater bioavailability and thus require much smaller doses to achieve adequate pain relief.
A. Although the use of epidural opioids for pain control has many advantages for the client, it requires astute nursing observation and care.
B. The catheter poses a threat to client safety because of its anatomical location, its potential for migration through the dura, and its proximity to spinal nerves and vessels. An epidural catheter migration into the subarachnoid space can produce medication levels too high for intrathecal use.
C. Fentanyl and sufentanil are hydrolipid, causing them to have a quicker onset and shorter duration of action (2 hours). Morphine and hydromorphone are hydrophilic, resulting in a longer onset and duration of action (up to 24 hours with a single bolus dose)
Answer to Question 2
C
Mucous shreds are normal when urine flows through an intestinal segment. Obtain a urine specimen for culture and sensitivity to test for possible infection when ordered by the physician if urine output is less than 30 mL/hr, or if the urine has a foul odor. Teach patients the significance and importance of drinking 1.5 to 2 quarts of fluid daily to prevent urinary tract infection. Avoid soap; it leaves residue on the skin, which interferes with pouch adhesion.
A nurse prepares a client for anesthesia and surgery.
The nurse cares for the postop client in the postanesthesia care unit (PACU).
Sample client goals from the Wellness Massage Pyramid.
Control of glycogen synthase activity
Testing client’s ability to identify sharp sensations
Results of disrupted control of skeletal muscles