A nurse is monitoring a client who received naloxone to counteract the effects of an opioid overdose.
Which of the following findings should indicate to the nurse that the medication is effective?

Increased temperature.

Decreased blood pressure.

Increased respiratory rate.

Report of decreased pain.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Increased temperature is not a direct indication of naloxone’s effectiveness. Naloxone works by reversing the effects of opioids, which do not typically include fever.

Choice B rationale:

While naloxone can cause an abrupt withdrawal in opioid-dependent individuals, leading to symptoms such as hypertension, it does not typically decrease blood pressure in opioid overdose cases.

Choice C rationale:

Naloxone works by reversing the life-threatening depression of the central nervous system and respiratory system caused by an opioid overdose. Therefore, an increased respiratory rate after administration would indicate that the medication is effective.

Choice D rationale:

Naloxone reverses the effects of opioids, including pain relief. Therefore, a report of decreased pain would not indicate that the medication is effective.

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Correct Answer is D

Explanation

Choice A rationale:

Fluoxetine is an antidepressant. While some antidepressants are used for chronic pain management, fluoxetine is not typically used for this purpose.

Choice B rationale:

Methylphenidate is a stimulant used to treat attention deficit hyperactivity disorder (ADHD) and is not used for pain management.

Choice C rationale:

Lorazepam is a benzodiazepine used for treating anxiety, seizures, and insomnia. It is not typically used for managing neuralgia pain.

Choice D rationale:

Carbamazepine is an anticonvulsant that is commonly used to manage trigeminal neuralgia. It helps to reduce nerve impulses that cause pain.

A. The nurse asks the client to demonstrate dose delivery. B. The nurse administers a PCA dose for the client. C. The nurse reassures the client that the PCA device will not cause an overdose. D. The nurse monitors the client for oversedation.

Correct Answer is B

Explanation

Choice A rationale:

Asking the client to demonstrate dose delivery can be part of patient education and helps ensure that the client understands how to use the PCA device. This action does not require intervention.

Choice B rationale:

The nurse administering a PCA dose for the client requires intervention. PCA stands for “Patient-Controlled Analgesia,” meaning that only the patient should administer doses to themselves. This prevents overdosing and ensures that pain medication is administered according to the patient’s needs.

Choice C rationale:

Reassuring the client that the PCA device will not cause an overdose is appropriate because PCA devices are designed with safety measures to prevent overdosing.

Choice D rationale:

Monitoring for oversedation is an important part of care for a client using a PCA device. This action does not require intervention.

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A nurse is monitoring a client who received naloxone to counteract the effects of an opioid overdose.Which of the following findings should indicate to the nurse that the medication is effective?

Nursing Test Bank

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A nurse is monitoring a client who received naloxone to counteract the effects of an opioid overdose.
Which of the following findings should indicate to the nurse that the medication is effective?