A nurse is assessing a client who has received oxycodone. The nurse notes that the client's respiratory rate is 8/min. The nurse should identify that which of the following is the pathophysiology for the client's respiratory rate?

Oxycodone inhibits prostaglandin synthesis.

Oxycodone promotes vasodilation of cranial arteries.

Oxycodone blocks the sodium channel suspending nerve conduction.

Oxycodone causes central nervous system depression.

Answer and Explanation

The Correct Answer is D

D) Oxycodone causes central nervous system depression: Oxycodone is an opioid analgesic that acts centrally on the central nervous system (CNS) to relieve pain. One of the most significant side effects of opioids like oxycodone is respiratory depression, which occurs due to the suppression of the CNS, particularly in the brainstem respiratory centers. The brainstem regulates respiratory rate and rhythm, and when opioids depress these centers, it can lead to decreased respiratory drive, resulting in a decrease in respiratory rate. A respiratory rate of 8/min is significantly below the normal range, indicating respiratory depression caused by oxycodone.

A) Oxycodone inhibits prostaglandin synthesis: Oxycodone does not directly inhibit prostaglandin synthesis. Prostaglandins are lipid compounds with various physiological effects, including inflammation and pain modulation. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, inhibit prostaglandin synthesis by blocking cyclooxygenase enzymes. However, oxycodone primarily acts on opioid receptors in the CNS to relieve pain, rather than through prostaglandin inhibition.

B) Oxycodone promotes vasodilation of cranial arteries: While opioids can cause peripheral vasodilation, particularly in large doses, the primary mechanism of action of oxycodone is not through the promotion of vasodilation of cranial arteries. Vasodilation may occur as a side effect of opioid use, but it is not the primary cause of respiratory depression associated with oxycodone.

C) Oxycodone blocks the sodium channel suspending nerve conduction: This statement describes the mechanism of action of local anesthetics, such as lidocaine, which block sodium channels to inhibit nerve conduction. However, oxycodone is not a sodium channel blocker. Its analgesic effects result from binding to opioid receptors in the CNS, particularly mu-opioid receptors, rather than blocking sodium channels. Therefore, this option is not the pathophysiology for the respiratory rate of 8/min observed in the client receiving oxycodone.

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Correct Answer is A

Explanation

A) Naloxone: This is the correct medication to anticipate administering for opioid toxicity. Naloxone is an opioid antagonist that competitively blocks opioid receptors, reversing the effects of opioid overdose, including respiratory depression, sedation, and hypotension. Administering naloxone can quickly reverse the toxic effects of opioids and restore adequate ventilation and consciousness in the client.

B) Atropine: Atropine is not indicated for opioid toxicity. It is an anticholinergic medication used to treat bradycardia and to decrease respiratory secretions, but it does not reverse the effects of opioids.

C) Midazolam: Midazolam is a benzodiazepine medication used for sedation, anxiety reduction, and induction of anesthesia. While it may be used as an adjunct in the management of acute agitation or seizures, it is not the primary medication for reversing opioid toxicity.

D) Dexamethasone: Dexamethasone is a corticosteroid medication with anti-inflammatory and immunosuppressive effects. It is not indicated for the treatment of opioid toxicity.

A. Extravasation B. Hypotension C. Headache D. Chest pain

Correct Answer is B

Explanation

A) Extravasation: Extravasation, or the leaking of IV medication into surrounding tissues, is a potential complication of IV therapy. However, it does not indicate a need to increase the rate of dopamine infusion. Instead, the priority is to stop the infusion, assess the site for damage, and provide appropriate interventions to minimize tissue injury.

B) Hypotension: Hypotension, or low blood pressure, is a common indication for administering dopamine in septic shock to improve cardiac output and increase blood pressure. If the client's blood pressure remains low despite the’current rate of dopamine infusion, it may be necessary to increase the infusion rate to achieve the desired therapeutic effect and improve perfusion to vital organs. Therefore, hypotension is the correct finding that indicates the need to increase the rate of infusion.

C) Headache: While headache can occur as a side effect of dopamine infusion, it is not typically an indication to increase the infusion rate. Headache may warrant further assessment and management, but it does not directly correlate with the need for a higher dose of dopamine.

D) Chest pain: Chest pain may occur as a side effect of dopamine infusion or could be indicative of other cardiac or pulmonary issues. However, like headache, it is not a specific indicator for increasing the rate of dopamine infusion. Further assessment and appropriate interventions are needed to address chest pain, but it does not directly relate to the need for a higher infusion rate of dopamine.

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A nurse is assessing a client who has received oxycodone. The nurse notes that the client's respiratory rate is 8/min. The nurse should identify that which of the following is the pathophysiology for the client's respiratory rate?

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Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who is experiencing opioid toxicity. Which of the following medications should the nurse anticipate administering?

Correct Answer is A

Explanation

A nurse is assessing a client who has septic shock and is receiving dopamine by continuous IV infusion. Which of the following findings indicates that the nurse should increase the rate of infusion?

Correct Answer is B

Explanation

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