Podcast
Questions and Answers
What is the primary concern when administering morphine to premature infants during and after delivery?
What is the primary concern when administering morphine to premature infants during and after delivery?
What medication is used as an alternative to morphine for clients with a history of biliary colic?
What medication is used as an alternative to morphine for clients with a history of biliary colic?
What is the purpose of administering an antiemetic such as promethazine (Phenergan)?
What is the purpose of administering an antiemetic such as promethazine (Phenergan)?
Why is meperidine contraindicated for clients with renal failure?
Why is meperidine contraindicated for clients with renal failure?
Signup and view all the answers
What should the client do to prevent accumulation of secretions in the airway?
What should the client do to prevent accumulation of secretions in the airway?
Signup and view all the answers
What is the opioid overdose triad?
What is the opioid overdose triad?
Signup and view all the answers
Why is stool softener administration important for clients receiving opioids?
Why is stool softener administration important for clients receiving opioids?
Signup and view all the answers
What should the nurse do to assist clients who experience orthostatic hypotension?
What should the nurse do to assist clients who experience orthostatic hypotension?
Signup and view all the answers
Which of the following clients is at risk of respiratory depression when administered opioid agonist-antagonist medications?
Which of the following clients is at risk of respiratory depression when administered opioid agonist-antagonist medications?
Signup and view all the answers
What is the primary advantage of using opioid agonist-antagonist medications compared to pure opioid agonists?
What is the primary advantage of using opioid agonist-antagonist medications compared to pure opioid agonists?
Signup and view all the answers
Which of the following is a precaution to consider when administering opioid agonist-antagonist medications to clients in labor?
Which of the following is a precaution to consider when administering opioid agonist-antagonist medications to clients in labor?
Signup and view all the answers
What is the expected pharmacological action of opioid agonist-antagonist medications?
What is the expected pharmacological action of opioid agonist-antagonist medications?
Signup and view all the answers
Which of the following clients is at risk of acute urinary retention when administered opioid agonist-antagonist medications?
Which of the following clients is at risk of acute urinary retention when administered opioid agonist-antagonist medications?
Signup and view all the answers
Which of the following is a common adverse effect of opioid agonist-antagonist medications?
Which of the following is a common adverse effect of opioid agonist-antagonist medications?
Signup and view all the answers
What is the effect of acetaminophen on warfarin?
What is the effect of acetaminophen on warfarin?
Signup and view all the answers
What is the mechanism of action of opioid agonists?
What is the mechanism of action of opioid agonists?
Signup and view all the answers
What is a common indication for the use of codeine?
What is a common indication for the use of codeine?
Signup and view all the answers
What is a common route of administration for fentanyl?
What is a common route of administration for fentanyl?
Signup and view all the answers
What is a potential adverse effect of morphine sulphate?
What is a potential adverse effect of morphine sulphate?
Signup and view all the answers
What should be done if a client's respiratory rate is less than 12/min while taking opioids?
What should be done if a client's respiratory rate is less than 12/min while taking opioids?
Signup and view all the answers
What can help manage constipation in clients taking opioids?
What can help manage constipation in clients taking opioids?
Signup and view all the answers
Why should opioids be avoided with CNS depressant medications?
Why should opioids be avoided with CNS depressant medications?
Signup and view all the answers
Study Notes
Opioid Analgesics/Narcotic Analgesics
- Opioids are classified as agonists, agonist-antagonists, and antagonists.
- Examples of opioid agonists: morphine sulfate, Fentanyl, Meperidine, Methadone, Codeine, Oxycodone.
Mechanism of Action
- Opioid agonists produce analgesia by binding to specific proteins-coupled receptors in the brain and spinal cord regions involved in pain transmission and modulation.
Indication/Therapeutic Uses
- Relief of moderate to severe pain (postoperative, myocardial infarction, cancer)
- Sedation
- Reduction of bowel motility
- Codeine: cough suppression
Route of Administration
- Morphine sulfate: Oral, subcutaneous, IM, rectal, IV, epidural, and intrathecal
- Fentanyl: IV, IM, transmucosal, and transdermal
- Meperidine: Oral, subcutaneous, IM, and IV
- Codeine: Oral, subcutaneous, IM, and IV
- Methadone: Oral, subcutaneous, and IM
- Oxycodone: Oral, rectal
- Hydromorphone: Oral, subcutaneous, IM, IV
Adverse Effects
- Respiratory depression
- Monitor client's vital signs
- Stop opioids if respiratory rate is less than 12/min
- Have naloxone (Narcan) and resuscitation equipment available
- Avoid use with CNS depressant medications
- Constipation
- Increase fluid intake and physical activity
- Decreased bowel motility
- Administer stimulant laxative (e.g., Bisacodyl) or stool softener (e.g., docusate sodium)
- Orthostatic hypotension
- Advise clients to sit or lie down if symptoms of lightheadedness or dizziness occur
- Avoid sudden changes in position
- Provide assistance with ambulation as needed
- Urinary retention
- Advise clients to void every 4 hours
- Monitor I&O
- Assess client's bladder for distension every 4-6 hours
- Cough suppression
- Advise clients to cough at regular intervals
- Auscultate client's lungs for crackles
- Instruct clients to increase fluid intake to liquefy secretions
- Sedation
- Advise clients to avoid hazardous activities
- Biliary colic
- Avoid giving morphine to clients with a history of biliary colic
- Use meperidine as an alternative
- Emesis
- Administer antiemetic (e.g., promethazine)
- Opioid overdose triad (coma, respiratory depression, pinpoint pupils)
- Monitor client's vital signs
- Provide mechanical ventilation
- Administer opioid antagonists (e.g., naloxone or nalmefene)
Contraindications/Precautions
- Morphine is contraindicated after biliary tract surgery
- Morphine is contraindicated for premature infants during and after delivery
- Meperidine is contraindicated for clients with renal failure
- Use cautiously with:
- Clients who have asthma, emphysema, and/or head injuries
- Infants
- Older adults
- Clients who are pregnant
- Clients in labor
- Clients who are extremely obese
- Clients with inflammatory bowel disease
- Clients with an enlarged prostate
- Clients with hepatic or renal disease
Opioid Agonist-Antagonist
- Examples: Butorphanol, Nalbuphine hydrochloride, Buprenorphine hydrochloride
- These medications act as antagonists on mu receptors and agonists on kappa receptors
- Compared to pure opioid agonists, agonist-antagonists have:
- A low potential for abuse causing little euphoria
- In fact, high doses can cause dysphoria
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
This quiz covers the administration of stimulant laxatives and stool softeners to counteract decreased bowel motility, and managing side effects such as orthostatic hypotension and urinary retention.
