A client has been receiving the same dose of IV opiate for 2 days to manage post-surgical pain. The client reports the drug is no longer controlling the pain. What does the nurse suspect?
Tolerance to the opiate medication is developing
There is likely a history of addiction
The client is opiate naive
Physical dependence
The Correct Answer is A
Choice A rationale:
Tolerance to the opiate medication is developing. This is the most likely explanation for why the client's pain is no longer being controlled by the same dose of medication. Tolerance is a physiological adaptation that occurs with repeated exposure to opioids, leading to a decrease in their effectiveness over time. This means that the client's body is becoming less responsive to the medication, and a higher dose is needed to achieve the same level of pain relief.
Choice B rationale:
There is likely a history of addiction. While it is possible that the client has a history of addiction, this is not the most likely explanation for why the medication is no longer controlling the pain. Addiction is a complex condition that is characterized by compulsive drug seeking and use, despite negative consequences. It is not simply a matter of tolerance developing.
Choice C rationale:
The client is opiate naive. This means that the client has not previously been exposed to opioids. While opiate-naive clients may be more sensitive to the effects of opioids, they are also more likely to experience side effects, such as nausea and vomiting. The fact that the client has been receiving the same dose of medication for 2 days without experiencing side effects suggests that they are not opiate naive.
Choice D rationale:
Physical dependence. Physical dependence is a state of adaptation that occurs with repeated exposure to opioids, leading to withdrawal symptoms if the medication is abruptly stopped. However, physical dependence does not necessarily mean that the medication is no longer effective in controlling pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Rationale for Choice A:
Arranging for a bedside commode can be helpful for patients who have difficulty ambulating to the bathroom. However, it is not the most effective intervention for preventing falls in an ambulatory and independent patient. In fact, it could potentially increase the risk of falls if the patient attempts to use the commode without assistance or if they become disoriented in the dark.
Research has shown that bedside commodes are associated with an increased risk of falls in hospitalized patients. This is because patients may try to get out of bed to use the commode without assistance, or they may become disoriented in the dark and fall.
Additionally, bedside commodes can be a tripping hazard, especially for patients with impaired mobility.
Rationale for Choice B:
Ensuring the bathroom light is kept on during the night can help to reduce the risk of falls by making it easier for the patient to see. However, it is not the most effective intervention for preventing falls.
Patients may still fall even if the bathroom light is on, especially if they are weak, unsteady, or have impaired vision. Additionally, keeping the bathroom light on all night can disrupt the patient's sleep, which can also increase the risk of falls.
Rationale for Choice C:
Using side rails to keep the patient in bed is not an effective intervention for preventing falls. In fact, it can actually increase the risk of falls by making it more difficult for the patient to get out of bed safely.
Patients may try to climb over the side rails, which can lead to falls.
Additionally, side rails can restrict the patient's movement and make them feel trapped, which can lead to agitation and an increased risk of falls.
Rationale for Choice D:
Implementing a toileting schedule is the most effective intervention for preventing falls in an ambulatory and independent patient. This is because it helps to reduce the patient's need to get out of bed at night to use the bathroom.
When a patient has a scheduled time to toilet, they are less likely to try to get out of bed on their own and risk a fall. Additionally, a toileting schedule can help to prevent incontinence, which can also lead to falls.
Correct Answer is A
Explanation
Choice A rationale:
Prednisone is a corticosteroid that suppresses the body's natural production of cortisol. Cortisol is a hormone that is essential for life, and it plays a role in many important bodily functions, including:
Regulating blood sugar levels Maintaining blood pressure Reducing inflammation Responding to stress
When a person takes prednisone for a long period of time, their body begins to rely on the medication to provide cortisol. If the medication is stopped suddenly, the body cannot produce enough cortisol on its own, which can lead to a life-threatening condition called adrenal insufficiency.
Adrenal insufficiency can cause a variety of symptoms, including: Extreme fatigue
Weakness Dizziness Nausea Vomiting Abdominal pain Confusion
Loss of consciousness
To prevent adrenal insufficiency, it is important to taper off prednisone slowly over a period of time. This allows the body to gradually adjust to producing cortisol on its own.
Here are some additional details about why prednisone should never be discontinued abruptly: The risk of adrenal insufficiency is highest when prednisone has been taken for more than 3 weeks. The longer a person has been taking prednisone, the slower the taper should be.
It is important to follow the tapering instructions provided by the healthcare provider.
If a person experiences any symptoms of adrenal insufficiency, they should seek medical attention immediately.
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