An equianalgesic chart provides a list of doses of analgesic agents, both oral and parenteral (IV, subcutaneous, and intramuscular), that are approximately equal to each other in ability to provide pain relief. A client was receiving 1 mg of oxymorphone, how much oxymorphone should the provider prescribe at discharge to ensure continued pain relief and prevent withdrawal?
100
75
1
10
The Correct Answer is C
Rationale:
A. Prescribing 100 mg of oxymorphone for a patient who was previously receiving 1 mg would be an extremely dangerous overdose, potentially causing severe respiratory depression, sedation, coma, or death. This dose does not align with equianalgesic principles, which rely on maintaining continuity of analgesic effect.
B. Similarly, prescribing 75 mg represents a dramatic increase over the previous effective dose. Equianalgesic dosing is intended to ensure comparable pain control, and a 75-fold increase is unsafe and medically inappropriate.
C. The patient was receiving 1 mg of oxymorphone prior to discharge. To maintain pain control and prevent withdrawal, the same dose should be continued unless clinical factors, such as breakthrough pain, side effects, or changes in pain severity, warrant an adjustment. Maintaining the current dose ensures stable analgesia and prevents withdrawal symptoms, which can include agitation, anxiety, sweating, nausea, vomiting, abdominal cramps, and muscle aches. Continuity of opioid therapy is critical in avoiding these potentially distressing symptoms.
D. Prescribing 10 mg represents a tenfold increase, which is extremely unsafe and not supported by equianalgesic dosing guidelines for a patient previously on 1 mg. Such a dose could result in life-threatening respiratory depression or opioid toxicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Opioids like fentanyl are not typically associated with increased urination or incontinence. In fact, they may cause urinary retention rather than increased output. Therefore, this is incorrect.
B. Fentanyl is a potent opioid analgesic that can significantly depress the central nervous system, particularly the respiratory center in the brain. High doses increase the risk of respiratory depression, which can lead to hypoventilation, hypoxia, and potentially death if not promptly recognized and managed. This is the most critical adverse effect to monitor, making this the correct answer.
C. Opioids generally do not cause increased heart rate; they are more likely to cause bradycardia due to their depressant effects on the central nervous system. Therefore, this is incorrect.
D. Fentanyl is more commonly associated with hypotension rather than elevated blood pressure due to vasodilation and decreased sympathetic tone. Therefore, this option is incorrect.
Correct Answer is A
Explanation
Rationale:
A. Hypercalcemia increases the risk of kidney stones, nephrocalcinosis, and cardiac dysrhythmias. Administering IV fluids (usually normal saline) promotes hydration and renal calcium excretion, helping to rapidly lower serum calcium levels and prevent acute complications. This is a priority nursing intervention in the acute management of hypercalcemia.
B. Increasing calcium intake would worsen hypercalcemia and exacerbate complications. Patients with hyperparathyroidism are usually advised to limit excessive calcium intake.
C. While surgical removal of overactive parathyroid tissue is the definitive treatment for primary hyperparathyroidism, it is not an immediate nursing intervention to manage hypercalcemia. Surgery is considered after stabilization and further evaluation.
D. Administering calcium would directly increase serum calcium levels, which is contraindicated in a patient already experiencing hypercalcemia.
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