The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about giving him morphine and it causing addiction. Which is appropriate for the nurse to explain about opioid analgesics?
Are given as a last resort because of the threat of addiction.
Are often ordered but not usually needed.
Rarely cause addiction because they are medically indicated.
Are used only if other measures, such as ice packs, are ineffective.
The Correct Answer is C
Choice A reason:
Opioid analgesics are not given as a last resort solely because of the threat of addiction. While the risk of addiction is a concern, opioids are often necessary for managing severe pain, especially in conditions like sickle cell anemia. The American Society of Hematology guidelines emphasize the importance of effective pain management in sickle cell disease, which often includes the use of opioids. The goal is to manage pain effectively while monitoring for signs of misuse or addiction.
Choice B reason:
Opioid analgesics are often ordered and are usually needed for managing severe pain in patients with sickle cell anemia. Pain episodes in sickle cell disease can be extremely severe and debilitating, requiring potent analgesics like morphine for relief. The management of acute vaso-occlusive pain in sickle cell disease often necessitates the use of opioids to provide adequate pain control.
Choice C reason:
Opioid analgesics, when medically indicated and used under proper medical supervision, rarely cause addiction. The risk of addiction is significantly lower when opioids are used appropriately for pain management in a controlled medical setting. The Mayo Clinic highlights that while opioids have addictive properties, their medical use for pain relief, especially in acute settings, is generally safe when monitored by healthcare professionals.
Choice D reason:
Opioid analgesics are not used only if other measures, such as ice packs, are ineffective. While non-pharmacological measures can be part of pain management, opioids are often necessary for managing severe pain episodes in sickle cell disease. The use of opioids is based on the severity of the pain and the clinical judgment of the healthcare provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["2"]
Explanation
Calculation Steps
Step 1: Determine the total urine output in mL.
- Total urine output = 360 mL
Step 2: Determine the child’s weight in kg.
- Weight = 15 kg
Step 3: Determine the time period in hours.
- Time = 12 hours
Step 4: Calculate the urine output in mL/kg/hour.
- Urine output (mL/kg/hour) = Total urine output ÷ (Weight × Time)
Step 5: Perform the multiplication inside the parentheses first.
- Weight × Time = 15 kg × 12 hours = 180 kg·hours
Step 6: Perform the division.
- Urine output (mL/kg/hour) = 360 mL ÷ 180 kg·hours = 2 mL/kg/hour
Result
The child’s urine output is 2 mL/kg/hour.
Correct Answer is A
Explanation
Choice A reason:
Cardiac arrhythmia is a primary clinical manifestation of hyperkalemia. Hyperkalemia, defined as an elevated level of potassium in the blood, can significantly affect the electrical activity of the heart. This can lead to various types of arrhythmias, including bradycardia, ventricular tachycardia, and even cardiac arrest1. The presence of arrhythmias is a critical indicator of hyperkalemia and requires immediate medical attention to prevent life-threatening complications.
Choice B reason:
Seizures are not typically associated with hyperkalemia2. While severe electrolyte imbalances can potentially lead to neurological symptoms, seizures are more commonly linked to conditions such as hyponatremia (low sodium levels) or hypocalcemia (low calcium levels). Therefore, seizures are not a primary sign of hyperkalemia.
Choice C reason:
Dyspnea, or difficulty breathing, can occur in various medical conditions, including heart failure and respiratory disorders. While hyperkalemia can lead to muscle weakness and fatigue, which might indirectly affect breathing, dyspnea is not a primary clinical manifestation of hyperkalemia. The main concern with hyperkalemia is its effect on cardiac function.
Choice D reason:
Oliguria, or reduced urine output, is a symptom of acute renal failure but not specifically indicative of hyperkalemia. While acute renal failure can lead to hyperkalemia due to the kidneys’ inability to excrete potassium, oliguria itself is not a direct sign of hyperkalemia. The focus should be on the cardiac effects of elevated potassium levels
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