The nurse instructs a client who is receiving their first dose of tramadol. Which statement(s) by the client indicates the need for further education? Select all that apply.
"I will focus on drinking more water to prevent constipation."
"I will move quickly when changing from lying to standing."
"If my pain does not improve, I will let someone know."
"After my pain is gone, I can walk to the bathroom by myself."
"I will request my next dose once my pain is severe."
Correct Answer : B,D,E
A. "I will focus on drinking more water to prevent constipation.": This demonstrates understanding, as tramadol, like other opioids, can cause constipation. Adequate hydration, fiber intake, and activity help prevent this common side effect.
B. "I will move quickly when changing from lying to standing.": This statement indicates the need for further education. Tramadol can cause dizziness and orthostatic hypotension, so clients should change positions slowly to prevent falls and injury.
C. "If my pain does not improve, I will let someone know.": This shows appropriate understanding. Reporting insufficient pain control ensures timely evaluation and safe management, including adjustment of pain therapy.
D. "After my pain is gone, I can walk to the bathroom by myself.": This requires further education. Until the client’s dizziness and sedation risk are assessed after the first dose, they should have assistance to prevent falls.
E. "I will request my next dose once my pain is severe.": This statement reflects misunderstanding. Pain management is most effective when medication is taken before pain becomes severe, following prescribed dosing intervals to maintain comfort and avoid breakthrough pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Constipation: Vasopressin does not typically affect gastrointestinal motility or cause constipation. Its primary actions are on water reabsorption and vascular tone, making gastrointestinal side effects uncommon.
B. Bruising: Vasopressin is not associated with hematologic effects such as bruising. Bruising is more related to anticoagulant therapy or platelet dysfunction, which are not influenced by vasopressin.
C. Nausea: While mild nausea may occasionally occur, it is not a common or clinically significant side effect of vasopressin. The drug’s main physiologic impact is on fluid balance and vascular resistance.
D. Bradycardia: Vasopressin can increase systemic vascular resistance and elevate blood pressure, which may trigger a reflex bradycardia via baroreceptor-mediated vagal stimulation. This cardiovascular effect is an important side effect for nurses to monitor.
Correct Answer is D
Explanation
A. A client with a low serum albumin: Low albumin levels affect protein binding of highly protein-bound drugs, increasing the free drug concentration and potential toxicity. While this influences drug distribution and effects, it does not directly impair hepatic metabolism.
B. A client diagnosed with renal failure: Renal failure primarily affects drug excretion rather than metabolism. Drugs cleared by the kidneys may accumulate, but hepatic metabolism may remain largely intact unless concomitant liver disease is present.
C. A client with slowed gastric emptying: Slowed gastric emptying affects the rate and sometimes the extent of drug absorption. While this can delay onset of action, it does not significantly alter hepatic metabolism of the medication.
D. A client with cirrhosis of the liver: Cirrhosis significantly impairs hepatic function, reducing the liver’s ability to metabolize drugs through phase I and phase II reactions. This increases drug half-life, risk of accumulation, and potential toxicity, making these clients the highest risk for decreased drug metabolism.
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