NCLEX RN Practice Question # 411

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Time limit: 0 Quiz-summary 0 of 1 questions completed Questions: 1 Information Nclex Practice Questions You have already completed the quiz before. Hence you can not start it again. Quiz is loading... You must sign in or sign up to start the quiz. You have to finish following quiz, to start this quiz: Results 0 of 1 questions answered correctly Your time: Time has elapsed You have reached 0 of 0 points, (0) Categories Not categorized 0% 1 Answered Review Question 1 of 1 1. Question A nurse is preparing to administer a dose of naloxone hydrochloride (Narcan) intravenously to a client with an intravenous opioid overdose. Which supportive medical equipment would the nurse plan to have at the client’s bedside if needed? 1. Nasogastric tube 2. Paracentesis tray 3. Resuscitation equipment 4. Central line insertion tray Correct Answer & Rationale: Option 3 is Correct Rationale: The nurse administering naloxone for suspected opioid overdose should have resuscitation equipment readily available to support naloxone therapy if it is needed. Other adjuncts that may be needed include oxygen, mechanical ventilator, and vasopressors. Test-Taking Strategy: Use the process of elimination. Note the strategic words intravenous opioid overdose. Recalling the effects of these medications will direct you to option 3. Option 3 is also the umbrella response. Review this medication if you had difficulty with this question. Incorrect Answer & Rationale: Option 3 is Correct Rationale: The nurse administering naloxone for suspected opioid overdose should have resuscitation equipment readily available to support naloxone therapy if it is needed. Other adjuncts that may be needed include oxygen, mechanical ventilator, and vasopressors. Test-Taking Strategy: Use the process of elimination. Note the strategic words intravenous opioid overdose. Recalling the effects of these medications will direct you to option 3. Option 3 is also the umbrella response. Review this medication if you had difficulty with this question.

 

OPIOID ANALGESICS

 Description

• Used to relieve moderate to severe pain associated with labor
• Administered by intramuscular or intravenous route
• Regular use of opioids during pregnancy may produce withdrawal symptoms in the newborn (irritability, excessive crying, tremors, hyperactive reflexes, fever, vomiting, diarrhea, yawning, sneezing, and seizures).

Antidotes for opioids

• Naloxone (Narcan) is usually the treatment of choice because it rapidly reverses opioid toxicity; the dose may need to be repeated every few hours until opioid concentrations have decreased to nontoxic levels.
• Nalmefene (Revex) is a long-acting opioid antagonist that does not require repeat doses.
• These medications can cause withdrawal in opioid-dependent clients.

Meperidine hydrochloride (Demerol) and hydromorphone hydrochloride (Dilaudid)

• Can cause dizziness, nausea, vomiting, sedation, decreased blood pressure, decreased respirations, diaphoresis, flushed face, urinary retention
• May be prescribed to be administered with an antiemetic such as promethazine (Phenergan) to prevent nausea
• High dosages may result in respiratory depression, skeletal muscle flaccidity, cold clammy skin, cyanosis, and extreme somnolence progressing to seizures, stupor, and coma.
• Used cautiously in clients delivering preterm infants
• Not administered in early labor because it may slow the labor process
• Not administered in advanced labor (within 1 hour of expected delivery); if the medication is not adequately removed from the fetal circulation, respiratory depression can occur. Fentanyl (Sublimaze) and sufentanil (Sufenta): Can cause respiratory depression, dizziness, drowsiness, hypotension, urinary retention, fetal narcosis and distress

 Butorphanol tartrate (Stadol) and nalbuphine(Nubain)

• Can cause confusion, sedation, sweating, nausea, vomiting, hypotension, sinusoidal-like fetal heart rhythm
• Use with caution in a client with preexisting opioid dependency because these medications can precipitate withdrawal symptoms in the client and the newborn.

Interventions

• signs, particularly respiratory status; if respirations are 12 breaths/min or less, withhold the medication and contact the health care provider.
• Monitor the fetal heart rate and characteristics of uterine contractions.
• Monitor for blood pressure changes (hypotension); maintain the client in a recumbent position (elevate the hip with a wedge pillow or other device).
• Record the client’s response and level of pain relief.
• Monitor the bladder for distention and retention.
• Have the antidote naloxone (Narcan) available, especially if delivery is expected to occur during peak drug absorption time.