A nurse is planning care for a client who is receiving morphine via continuous epidural infusion.
The nurse should monitor the client for which of the following adverse effects?

Gastric bleeding.

Pruritus.

Cough.

Tachypnea.

Answer and Explanation

The Correct Answer is B

Pruritus is a common adverse effect of morphine administered via continuous epidural infusion. It is caused by the release of histamine from mast cells in the skin. Pruritus can be treated with antihistamines or opioid antagonists. Choice A is wrong because gastric bleeding is not a common adverse effect of morphine administered via continuous epidural infusion.

Gastric bleeding can occur due to peptic ulcer disease, nonsteroidal anti inflammatory drugs (NSAIDs), or anticoagulants.

Choice C is wrong because cough is not a common adverse effect of morphine administered via continuous epidural infusion.

Cough can be caused by respiratory infections, asthma, or chronic obstructive pulmonary disease (COPD).

Choice D is wrong because tachypnea is not a common adverse effect of morphine administered via continuous epidural infusion.

Tachypnea can be caused by hypoxia, anxiety, pain, or fever. Morphine can cause respiratory depression, which is characterized by bradypnea, not tachypnea.

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Correct Answer is ["B","D","E"]

Explanation

Older adults are at higher risk of adverse drug reactions due to multiple health problems, polypharmacy, and decreased renal function.

These factors can affect the pharmacokinetics and pharmacodynamics of pain medications and increase the likelihood of drug interactions, overdosage, or toxicity.

Choice A is wrong because the decreased percentage of body fat does not increase the risk of adverse drug reactions in older adults.

In fact, an increased percentage of body fat can alter the distribution and elimination of some drugs.

Choice C is wrong because an increased rate of absorption does not increase the risk of adverse drug reactions in older adults.

In fact, decreased rate of absorption can occur due to reduced gastric motility and blood flow.

A. The client had chemotherapy 12 hr before the medication was administered. B. The medication vial sat at room temperature for 2 hr before it was administered. C. The client’s absolute neutrophil count was 2,500/mm3 before the medication was administered. D. The nurse flushed the client’s IV line with dextrose 5% in water before and after the medication was administered.

Correct Answer is D

Explanation

The correct answer is d

Choice A reason:

Administering filgrastim 12 hours after chemotherapy does not typically require an incident report. Filgrastim is often given at least 24 hours after chemotherapy to avoid the risk of increasing the toxicity of the chemotherapy agents. While the timing is closer than recommended, it does not necessarily constitute an error unless specific instructions for the timing were provided by the prescribing physician.

Choice B reason:

The medication vial sitting at room temperature for 2 hours before administration does not require an incident report. Filgrastim can be left out at room temperature for up to 24 hours before use. This is within the safe handling guidelines for the medication.

Choice C reason:

An absolute neutrophil count (ANC) of 2,500/mm³ is within the normal range, which is typically 1,500-8,000/mm³. Filgrastim is used to increase neutrophil counts in patients with low ANC due to chemotherapy. Since the ANC was not low before administration, this would not necessitate an incident report, although it may prompt a review of the necessity of the medication.

Choice D reason:

Flushing the client's IV line with dextrose 5% in water before and after the medication was administered is not the standard procedure and could potentially lead to medication errors or adverse effects. Filgrastim should be diluted in glucose 5% in water for intravenous infusion, but not used to flush the line. This deviation from the standard protocol is what necessitates an incident report.

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A nurse is planning care for a client who is receiving morphine via continuous epidural infusion. The nurse should monitor the client for which of the following adverse effects?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is discussing adverse reactions to pain medications in older adult clients with a newly licensed nurse. Which of the following findings should the nurse include as risk factors for an adverse drug reaction? (Select all that apply)

Correct Answer is ["B","D","E"]

Explanation

A nurse recently administered filgrastim intravenously to a client who has cancer and is receiving cytotoxic chemotherapy. For which of the following data, discovered after the medication was administered, should the nurse file an incident report?

Correct Answer is D

Explanation

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A nurse is planning care for a client who is receiving morphine via continuous epidural infusion.
The nurse should monitor the client for which of the following adverse effects?