What is the goal of opioid use in terminally ill patients?
c. Titrate the prescribed morphine dose up until the patient indicates adequate pain relief. d. Administer a nonsteroidal antiinflammatory drug (NSAID) to improve patient pain control. The goal of opioid use in terminally ill patients is effective pain relief regardless of adverse effects such as respiratory depression.
What should be included in patient education about opioid addiction?
a. Assess for signs that the patient is becoming addicted to the opioid. b. Monitor for therapeutic and adverse effects of opioid administration. c. Emphasize that the risk of some opioid side effects increases over time. d. Teach the patient about how analgesics improve postoperative activity levels. e.
What is the CDC guideline for prescribing opioids for chronic pain?
To improve patient care and safety, the CDC Guideline recommends nonopioid medications and nonpharmacologic treatments as the preferred therapies for chronic pain outside of active cancer, palliative, or end-of-life care. CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016
What is the best treatment for nausea caused by opiates?
Nausea is frequently experienced with the initiation of opioid therapy, and antiemetics usually are prescribed to treat this expected side effect. The best choice would be to administer the antiemetic medication so the patient can eat.
Which of the following choices is the drug of choice to treat a patient who has taken an overdose of an opioid quizlet?
Naloxone should be administered to anyone who presents with signs of opioid overdose or when opioid overdose is suspected. Naloxone is approved by the Food and Drug Administration (FDA) and has been used for decades by EMS personnel to reverse opioid overdose and resuscitate individuals who have overdosed on opioids.
Which patient on opioid therapy is most susceptible to the side effect of constipation?
Constipation. Constipation is the most common opioid-induced side effect reported by older adults. Up to 80% of opioid-treated patients report this outcome, which occurs as a consequence of opioid's negative effects on gastrointestinal motility, secretions, and blood flow.
Which route is generally preferred for opioids?
Oral administration - Giving an opioid analgesic orally is the most common route of administration, and is the preferred route of administration whenever possible.
Which one of the following opioids is most likely to be prescribed first line for the management of severe pain?
Morphine is the first-line treatment when a strong opioid is indicated for a patient with acute pain. Morphine may cause nausea and vomiting, especially when first initiated, which some patients may be unable to tolerate.
How are opioid side effects treated?
Strategies to minimize adverse effects of opioids include dose reduction, symptomatic management, opioid rotation, and changing the route of administration. Nausea occurs in approximately 25 percent of patients; prophylactic measures may not be required.
Who do opioids cause constipation?
Pain medications, called “opioids” (such as morphine, hydromorphone, oxycodone and Tylenol #3,) may cause constipation. Opioids slow down the movement of stool through your bowel (intestines). This gives your bowel more time to take the water out of your stool, making it hard, dry and difficult to pass.
How do you choose a route of drug administration?
A medication administration route is often classified by the location at which the drug is applied, such as oral or intravenous. The choice of routes in which the medications are applied depends not only on the convenience but also on the drug's properties and pharmacokinetics.
Which route of drug administration is most likely to lead to the first effect?
Oral route of drug administration is most likely to lead to the first-pass effect.
How do you administer opioids?
Many opioids are taken in pill form, but they can also be taken as lozenges or lollipops. Some are administered through a vein, by injection or through an IV, and others can be delivered through a patch placed on the skin or with a suppository.
What is the name of the medication used in the event of an opioid overdose?
Naloxone hydrochloride (naloxone) is a drug that can temporarily stop the effects of opioid drugs. Naloxone can help restore breathing during an opioid overdose.
What are opiate drugs?
Opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and pain relievers available legally by prescription, such as oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, morphine, and many others.
Which conditions would occur due to the administration of an opioid antagonist in a client who is physically dependent on opioids?
In an individual physically dependent on opioids, the administration of the usual dose of an opioid antagonist may precipitate an acute withdrawal syndrome. The severity of this syndrome will depend on the degree of physical dependence and the dose of the antagonist administered.
What is the best treatment for chronic pain?
Recognize that nonopioid medications and nonpharmacologic treatments are the preferred methods for treating chronic pain
How to help patients with pain control?
Talk with your patients and find out where they want to be with respect to pain control or what they want to accomplish. Help them focus on goals related to daily activities and overall function, not just complete elimination of pain. For example, you might say, "You mentioned that you wanted to be able to play with your child. Let's do what we can to get there."
What to consider after a diagnosis?
After your evaluation and diagnosis of the patient, discuss potential options. First, consider nonopioid medications and nonpharmacologic treatment options with the patient. Determine whether the expected benefits of treatment outweigh the associated risks given the patient's comprehensive history. Appropriate use, dose, and duration of treatment should also be considered.
What are the preferred methods for treating chronic pain?
Recognize that nonopioid medications and nonpharmacologic treatments are the preferred methods for treating chronic pain. Describe communication techniques that facilitate a patient-centered approach to manage chronic pain. Describe risks and benefits of first-line treatments to chronic pain.
What are non-pharmacologic treatments?
Nonpharmacologic treatments can reduce pain and improve function in patients with chronic pain. These treatments can also encourage active patient participation in the care plan, address the effects of pain in the patient's life, and can result in sustained improvements in pain and function with minimal risks.
Is nonopiod medication effective for chronic pain?
Always consider your patient's clinical situation, functioning, and life context. The CDC Guideline presents contextual evidence that both nonopioid medications and nonpharmacologic treatments are effective for chronic pain. Nonopioid medications are not generally associated with development of substance use disorder.
How to help a patient with chronic pain?
Take time to listen to your patient's concerns. Show that you are genuinely interested in helping and collaborating with the patient to find a solution. For example, you might tell your patient, "I understand that you've been experiencing chronic pain, and it's challenging living with it day to day."
Why do patients need to switch analgesics?
The patient is concerned that the new prescription will not provide optimal pain control. The nurse's response is based on knowledge that doses of analgesics are determined using an equianalgesic table with which drug prototype?
What does a nurse do with pain?
The nurse plans Pharmacologic management for a patient with pain. The nurse would administer the pain medication based on what dosage schedule?
Does naltrexone antagonize opiates?
Naltrexone antagonizes opiates at the receptor site.
Does heroin require methadone?
A heroin addict has entered a rehabilitation program that requires that she take methadone. Methadone is effective in this situation because it:
Is methadone shorter than elimination?
The duration of analgesia for methadone is much shorter than the elimination half-life.
Which opioid antagonist reverses the effects of opioid analgesics?
Naloxone is the opioid antagonist that will reverse the effects, both adverse and therapeutic, of opioid analgesics. Acetylcysteine is the antidote for acetaminophen overdose. Methylprednisolone is a glucocorticoid that is used as an antiinflammatory. Flumazenil, a benzodiazepine antidote, can be used to acutely reverse the sedative effects of benzodiazepines.
Why should a nurse withhold morphine?
Respiratory depression is a side effect of opioid analgesia. Therefore, because the patient's respiratory rate is below normal , the nurse should withhold the morphine and notify the healthcare provider
How to get relief from chronic pain?
Relief of chronic pain is best obtained by administering analgesics around the clock.
What are the side effects of narcotic analgesics?
The most serious side effect of narcotic analgesics is respiratory depression. This is the priority for the nurse to monitor. The other assessments should also be made; however, a decrease in respiratory rate is the highest priority for the nurse to address.
What to ask a patient about pain?
Ask the patient about pain status, location, type of pain, how the pain changes with time, what makes it better, or worse, and how much it impairs the ability to function.
Does morphine cause constipation?
It also causes a decrease in gastrointestinal motility leading to constipation. Morphine sulfate can cause constipation, not increased bowel sounds. This effect is helpful in treating diarrhea. Morphine sulfate does not cause insomnia. It is an opioid and causes drowsiness.
Is fentanyl a duragesic?
Transdermal fentanyl [Duragesic] is indicated only for persistent severe pain in patients who already tolerate opioids because it can cause fatal respiratory depression in patients who are opioid naive. For this reason, the patch is not indicated for acute pain such as postoperative pain, intermittent pain, or pain that responds to a less powerful analgesic.
What is the best first choice medication?
Aspirin (acetylsalicylic acid) 650 mg orally. ANS: C. Acetaminophen is the best first-choice medication. The principle of "start low, go slow" is used to guide therapy when treating older adults because the ability to metabolize medications is decreased and the likelihood of medication interactions is increased.
What is the goal of chronic pain?
The goal for the treatment of chronic pain usually is to enhance function and quality of life. The other questions are also appropriate to ask, but information about patient function is more useful in evaluating effectiveness.
How do NSAIDs work?
Nonsteroidal antiinflammatory drugs (NSAIDs) provide analgesic effects by decreasing the production of pain-sensitizing chemicals such as prostaglandins at the site of injury. Transmission of impulses through the spinal cord, brain sensitivity to pain, and the descending nerve pathways are not affected by NSAIDs. 4.
What is breakthrough pain?
Pain that occurs beyond the chronic pain already being treated by appropriate analgesics is termed breakthrough pain. Neuropathic pain is caused by damage to peripheral nerves or the central nervous system. Somatic pain is localized and arises from bone, joint, muscle, skin, or connective tissue.
Can a nurse administer morphine?
Teaching the patient to administer unneeded medication before going to sleep can result in oversedation and respiratory depression. It is illegal for the nurse to administer the morphine for a patient through PCA. 9.
Can a patient sleep after taking pain medication?
A patient who falls asleep after pain medication can be allowed to rest. 1. The health care provider orders a patient-controlled analgesia (PCA) machine to provide pain relief for a patient with acute surgical pain who has never received opioids before.
Can Lorazepam block pain?
The severe breakthrough pain indicates that the initial therapy should be a rapidly acting opioid, such as the immediate-release morphine. Lorazepam and ami triptyline may be appropriate to use as adjuvant therapy, but they are not likely to block severe breakthrough pain. Use of antianxiety agents for pain control is inappropriate because this patient's anxiety is caused by the pain.