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Questions and Answers
A client receiving opioids post-operatively exhibits respiratory depression. Which medication would the nurse anticipate administering to reverse this effect?
A client receiving opioids post-operatively exhibits respiratory depression. Which medication would the nurse anticipate administering to reverse this effect?
- Alvimopan
- Naltrexone
- Methylnaltrexone
- Naloxone (correct)
A client with a history of opioid use disorder is starting naltrexone therapy. What is the primary goal of this medication in this client's treatment plan?
A client with a history of opioid use disorder is starting naltrexone therapy. What is the primary goal of this medication in this client's treatment plan?
- To reverse respiratory depression from opioid overdose.
- To accelerate recovery after GI surgery.
- To relieve opioid-related constipation.
- To prevent euphoric effects of opioids. (correct)
A nurse is caring for a post-operative client who has undergone bowel resection and anastomosis. Which opioid antagonist would be most appropriate to prescribe to this client?
A nurse is caring for a post-operative client who has undergone bowel resection and anastomosis. Which opioid antagonist would be most appropriate to prescribe to this client?
- Nalmefene
- Naloxegol
- Naltrexone
- Alvimopan (correct)
A client is admitted to the emergency department with suspected opioid overdose. After administering naloxone, the nurse observes the client developing hypertension, vomiting, and tremors. What is the most likely cause of these new manifestations?
A client is admitted to the emergency department with suspected opioid overdose. After administering naloxone, the nurse observes the client developing hypertension, vomiting, and tremors. What is the most likely cause of these new manifestations?
A nurse is preparing to administer naloxone to a client who has overdosed on an opioid. What is the priority nursing action?
A nurse is preparing to administer naloxone to a client who has overdosed on an opioid. What is the priority nursing action?
Which of the following outcomes indicates that naloxone has been effective for a client experiencing an opioid overdose?
Which of the following outcomes indicates that naloxone has been effective for a client experiencing an opioid overdose?
Which of the following opioid antagonists primarily target the gastrointestinal system to relieve opioid-induced constipation?
Which of the following opioid antagonists primarily target the gastrointestinal system to relieve opioid-induced constipation?
A client with a history of cardiac disease is receiving naloxone for opioid overdose. What adverse effect requires the most immediate nursing intervention?
A client with a history of cardiac disease is receiving naloxone for opioid overdose. What adverse effect requires the most immediate nursing intervention?
Why is it crucial to monitor vital signs frequently (every 5-15 minutes) during and after intravenous naloxone administration?
Why is it crucial to monitor vital signs frequently (every 5-15 minutes) during and after intravenous naloxone administration?
A client who has received naloxone for opioid overdose begins to complain of increased pain. What is the MOST appropriate initial nursing intervention?
A client who has received naloxone for opioid overdose begins to complain of increased pain. What is the MOST appropriate initial nursing intervention?
A client with a known history of opioid dependence is given naloxone. Which of the following assessment findings would indicate the client is experiencing opioid withdrawal?
A client with a known history of opioid dependence is given naloxone. Which of the following assessment findings would indicate the client is experiencing opioid withdrawal?
Why is naloxone administered cautiously to clients with a head injury and increased intracranial pressure?
Why is naloxone administered cautiously to clients with a head injury and increased intracranial pressure?
A nurse is preparing to administer naloxone to a client with respiratory depression. Which route of administration allows for the MOST rapid onset of action?
A nurse is preparing to administer naloxone to a client with respiratory depression. Which route of administration allows for the MOST rapid onset of action?
A client receives naloxone for opioid-induced respiratory depression. After the initial dose, the client's respiratory rate improves, but then begins to decline again 75 minutes later. What is the MOST likely explanation for this?
A client receives naloxone for opioid-induced respiratory depression. After the initial dose, the client's respiratory rate improves, but then begins to decline again 75 minutes later. What is the MOST likely explanation for this?
A client is being discharged after receiving naloxone for an opioid overdose. Which instruction is MOST important for the nurse to provide?
A client is being discharged after receiving naloxone for an opioid overdose. Which instruction is MOST important for the nurse to provide?
A client with a history of cardiac irritability requires naloxone administration. What specific monitoring consideration is MOST critical for this client?
A client with a history of cardiac irritability requires naloxone administration. What specific monitoring consideration is MOST critical for this client?
Flashcards
Opioid Antagonists
Opioid Antagonists
Medications that block opioid receptors, reversing the effects of opioids; used to treat opioid overdose and respiratory depression.
Naloxone
Naloxone
The prototype opioid antagonist, primarily used to reverse respiratory depression from opioid overdose.
Methylnaltrexone
Methylnaltrexone
Relieves constipation caused by opioid use.
Naltrexone
Naltrexone
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Alvimopan
Alvimopan
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Pharmacologic Action of Opioid Antagonists
Pharmacologic Action of Opioid Antagonists
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Ventricular Arrhythmias
Ventricular Arrhythmias
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Abstinence Syndrome
Abstinence Syndrome
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Monitoring after Naloxone
Monitoring after Naloxone
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Naloxone Dosing
Naloxone Dosing
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Naloxone Duration
Naloxone Duration
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Naloxone Side Effects
Naloxone Side Effects
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Client Education (Naloxone)
Client Education (Naloxone)
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Naloxone Contraindications
Naloxone Contraindications
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Naloxone Precautions
Naloxone Precautions
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Study Notes
- Opioid antagonists reverse opioid effects and treat opioid overdose
- They also reverse neonatal respiratory depression resulting from the mother's opioid use during labor
Medications
- Naloxone is the prototype opioid antagonist
- Methylnaltrexone, nalmefene, naloxegol, and naldemedine relieve opioid-related constipation
- Naltrexone prevents opioid euphoria in addicted clients, similar to disulfiram for alcohol use disorder
- Alvimopan accelerates recovery after upper and lower GI surgeries involving bowel resection and anastomosis
Pharmacologic Action
- Opioid antagonists block opioid receptors, reversing or antagonizing opioid effects
Adverse Drug Reactions
- Ventricular arrhythmias may occur
- Heart and respiratory rates typically increase
- Abstinence syndrome (withdrawal) may occur in opioid-dependent clients, manifesting as hypertension, vomiting, and tremors
Safety Information
- Naloxone reverses respiratory depression from opioid overdose; abstinence syndrome may occur in opioid-dependent individuals
- In cases of CNS depressant overdose outside the hospital, the client's opioid dependence may be unknown
- Have suction equipment available to prevent aspiration from vomiting during withdrawal
- Administer naloxone in small, spaced doses to minimize withdrawal symptoms
Interventions
- Monitor blood pressure and other vital signs (respiratory rate, heart rate/rhythm, oxygen saturation, consciousness) for opioid withdrawal
- Naloxone is ineffective against non-opioid medications
- Use cautiously in clients with cardiac irritability, head injury with increased intracranial pressure, brain tumor, or seizure disorder
Administration
- Naloxone can be administered intramuscularly, intravenously, subcutaneously, sublingually, and intranasally
- Titrate intravenous doses carefully
- Monitor vital signs every 5 to 15 minutes during and after administration
- Naloxone's effects last 60 to 90 minutes, so respiratory depression may recur
- Pain may return as naloxone blocks opioid analgesic effects; acute withdrawal may occur in opioid-dependent clients
- Administer naloxone every 2 to 3 minutes until the desired effect is achieved; repeat the dose as opioid effects may outlast naloxone
- Observe for nausea, vomiting, tachycardia, and diaphoresis, which may accompany opioid reversal and withdrawal
Client Instructions
- Inform awake clients about the need for the opioid antagonist
- Warn of potential adverse reactions and the return of pain
Contraindications and Precautions
- Naloxone should not be given to opioid-dependent individuals or those with respiratory depression from non-opioids
- Ineffective against non-opioid medications
- Use cautiously in clients with cardiac irritability, head injury with increased intracranial pressure, brain tumor, or seizure disorder
Interactions
- Opioid antagonists decrease the effects of opioids
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