Patient Data
Which other medications would the nurse expect the surgeon to prescribe along with morphine? Select all that apply.
Propofol
Methadone
Docusate sodium
Ibuprofen
Naloxone
Senna
Correct Answer : C,D,E,F
A. Propofol: Propofol is a powerful sedative used mainly for anesthesia or sedation during mechanical ventilation. It is not appropriate or expected for routine postoperative pain management with morphine on a surgical floor.
B. Methadone: Methadone is another opioid used for chronic pain management or opioid dependency, not typically prescribed alongside morphine for acute postoperative pain because combining opioids increases the risk of respiratory depression.
C. Docusate sodium: Docusate sodium is a stool softener often prescribed with opioids like morphine to prevent constipation, a common opioid side effect. Promoting bowel movements is an important preventative measure in postoperative patients.
D. Ibuprofen: Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), may be prescribed to provide additional pain relief through a different mechanism and reduce inflammation. This combination allows lower opioid doses, improving pain management while minimizing opioid side effects.
E. Naloxone: Naloxone is an opioid antagonist kept available as a safety measure in case of opioid-induced respiratory depression. Having naloxone ordered and readily accessible is a critical precaution during opioid therapy.
F. Senna: Senna is a stimulant laxative that can be prescribed along with docusate to prevent or treat opioid-induced constipation by actively stimulating bowel movements, making it a commonly expected medication alongside opioids.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Elective surgery is scheduled in two hours: Clopidogrel is an antiplatelet agent that significantly increases the risk of bleeding. It should be held prior to surgery to minimize intraoperative and postoperative bleeding risks. Surgeons often require clopidogrel to be discontinued several days in advance, making it critical to withhold the drug if surgery is imminent.
B. An abdominal sonogram is scheduled: An abdominal ultrasound is a noninvasive imaging test that does not carry bleeding risks. There is no need to hold clopidogrel prior to sonogram procedures because it does not impact the safety or accuracy of the imaging study.
C. Breakfast has not been eaten: Clopidogrel can be taken with or without food. Skipping a meal does not contraindicate administering the medication, although taking it with food can sometimes help reduce gastrointestinal discomfort.
D. The client's platelet level is high: Clopidogrel works by inhibiting platelet aggregation, not by lowering platelet count. A high platelet count alone is not a reason to withhold the medication unless there is a specific bleeding risk or another contraindication identified by the healthcare provider.
Correct Answer is ["B","E","F"]
Explanation
A. Print an electrocardiogram strip: While cardiac monitoring is important, printing an ECG strip does not immediately address the critical issue of respiratory depression and unresponsiveness. Priority actions must focus on airway and breathing first.
B. Call for rapid response: The client is critically unstable with severe respiratory depression and unresponsiveness, meeting criteria for a rapid response or even a code blue if the situation deteriorates further. Immediate expert team support is crucial.
C. Perform chest compressions: Chest compressions are only indicated if the client is pulseless. In this case, the client has a heart rate of 92 beats/minute, meaning compressions are not appropriate at this moment.
D. Apply oxygen via nasal cannula: A nasal cannula would not deliver high enough oxygen concentrations for someone with a respiratory rate of 5 breaths/minute and oxygen saturation of 54%. Higher oxygen delivery methods and ventilatory support are urgently needed.
E. Give naloxone 2 mg intravenous push: Naloxone is indicated immediately to reverse opioid-induced respiratory depression. Giving the prescribed naloxone IV push can rapidly counteract the morphine overdose and improve the client’s respiratory effort.
F. Provide rescue breaths with a manual ventilation bag: Because the client’s respirations are critically low, rescue breathing with a manual resuscitation bag is necessary to maintain oxygenation and ventilation until naloxone takes effect or more advanced airway management is available.
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