When administering codeine, the nurse should be aware that:
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Solution
Codeine is very constipating
Codeine is very constipating, so the client’s diet should include foods that fight constipation, such as water, fruits, and vegetables.
Which of the following statements about morphine is correct?
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Solution
Morphine quickly enters all body tissues.
Morphine quickly enters all body tissues. Morphine is not contraindicated for head-injured clients, and withdrawal symptoms can be relieved by methadone. Morphine is equally effective by all routes when the proper dose is prescribed.
The half-life of morphine is:
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Solution
2 to 4 hours
The half-life of morphine is 2 to 4 hours. Other choices are incorrect because they are either longer or shorter than the true half-life of morphine.
In addition to analgesia, narcotic effects include:
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Solution
Euphoria, miosis, nausea and vomiting
These are the effects that often occur with administration of narcotics. Constipation (not diarrhea) and decreased respirations (not increased) are noted during administration of narcotics. Decreased blood pressure results from narcotic administration. Narcotics do not cause the effects in choice D at all.
All narcotics, regardless of their origin, reduce pain by:
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Solution
Stimulating opiate receptors
It is the stimulation of cerebral opiate receptors that reduces pain. Excitatory transmitters are not released during administration of morphine. Endorphin release is not associated with narcotic pain relief. The mu receptors mediate analgesia and are not blocked during narcotic administration.
The client asks the nurse to explain the action of infiltration anesthesia. The nurse’s response is based on the knowledge that infiltration anesthesia:
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Solution
Blocks a specific group of nerves in tissues close to the operative area.
Infiltration anesthesia blocks a specific group of nerves close to the operative area by diffusion of a drug into the tissues. It is used to anesthetize small areas. Topical anesthetics are applied to mucous membranes. Nerve blocks provide anesthesia to a large surface area. Spinal anesthesia affects large, regional areas.
Nurse Gretchen is discussing the use of cocaine as a local anesthetic with a nursing student. Which statement by the student indicates understanding of this agent?
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Solution
“Vasoconstrictors should not be used as adjunct agents with this drug.”
Cocaine should not be combined with epinephrine or other vasoconstrictors, because it causes vasoconstriction itself, and the combination could precipitate severe hypertension. Cocaine has a rapid onset of effects, which last about 1 hour. It is used only topically for anesthesia. Although subject to widespread abuse with profound psychological dependence, it does not cause substantial physical dependence.
The nurse receives the client in the postanesthesia care unit (PACU) following a procedure requiring general anesthesia. The most important assessment made by the nurse relates to the client’s:
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Solution
Respiratory status.
General anesthesia causes relaxation of all muscles, including respiratory muscles, requiring mechanical ventilation. The client’s respiratory status must be monitored closely following general anesthesia.
During induction of anesthesia, the nurse notes the client becomes hyperactive and physically resists the treatment. The nurse concludes what interventions are needed?
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Solution
An intravenous drug will be given to calm the client.
Stage 2 is the stage of excitement and hyperactivity. Medications may be given IV to calm the client.
The nurse observes a co-worker preparing to administer a solution of lidocaine and epinephrine to a client with multiple premature ventricular contractions. The appropriate action by the nurse is to:
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Solution
Prevent the administration, and give a plain lidocaine solution.
Solutions of lidocaine containing preservatives or epinephrine are intended for local anesthesia only, and must never be given IV for dysrhythmias.