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 A
Explanation
Choice A reason:
Diabetes insipidus: Desmopressin acetate (DDAVP) is primarily used to treat central diabetes insipidus, a condition where the body lacks sufficient antidiuretic hormone (ADH) due to issues with the pituitary gland or hypothalamus. This hormone helps regulate water balance in the body, and desmopressin acts as a synthetic replacement to reduce frequent urination and excessive thirst.
Choice B Reason:
Acute adrenocortical insufficiency: This condition, also known as Addison’s disease, involves insufficient production of cortisol and aldosterone by the adrenal glands. Desmopressin is not used to treat this condition as it does not address the hormonal deficiencies involved.
Choice C Reason:
Hypopituitarism: This condition involves the underproduction of one or more hormones by the pituitary gland. While desmopressin can be used to manage specific symptoms related to ADH deficiency, it is not a comprehensive treatment for hypopituitarism, which requires hormone replacement therapy for multiple hormones.
Choice D Reason:
Syndrome of inappropriate antidiuretic hormone (SIADH): SIADH is characterized by excessive release of ADH, leading to water retention and hyponatremia. Desmopressin is not used to treat SIADH; in fact, it would exacerbate the condition by increasing ADH levels.
Correct Answer is C
Explanation
Choice A reason:
Performing an ultrasound to determine if there is urinary retention is not the immediate priority action. While an ultrasound can help assess urinary retention, the presence of edema, redness, and the foreskin being behind the glans penis suggests a condition known as paraphimosis. Paraphimosis is a medical emergency that requires prompt attention to prevent complications such as tissue damage. Therefore, alerting the ER physician is the priority action.
Choice B reason:
Asking the parents specifically how long the infant has not voided is important for gathering information, but it is not the immediate priority action. The clinical signs of edema, redness, and the foreskin being behind the glans penis indicate a potential emergency that requires immediate medical intervention. While obtaining a detailed history is important, the nurse should first alert the ER physician to ensure timely management.
Choice C reason:
Alerting the ER physician to the patient’s condition is the correct priority action. The presence of edema, redness, and the foreskin being behind the glans penis suggests paraphimosis, which is a urological emergency. Prompt intervention is necessary to reduce the foreskin and restore normal blood flow to prevent tissue damage3. The ER physician can provide the necessary treatment and management for this condition.
Choice D reason:
Continuing to monitor the patient in the ER setting is not appropriate without first addressing the potential emergency. The signs of edema, redness, and the foreskin being behind the glans penis indicate a condition that requires immediate medical attention. Monitoring alone is insufficient; the nurse must alert the ER physician to ensure prompt intervention.
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