A nurse is reviewing the medication administration record for a client who has cancer and is receiving morphine via a PCA pump. Which of the following prescriptions should the nurse clarify with the provider?
Ondansetron
Nalbuphine
Insulin glargine
Acetaminophen
The Correct Answer is B
B) Nalbuphine: Nalbuphine is an opioid analgesic that acts on the central nervous system to relieve pain. When administered concurrently with morphine, there is a risk of additive respiratory depression and other opioid-related side effects, such as sedation and hypotension. Therefore, the nurse should clarify the prescription for nalbuphine with the provider to ensure that the combination of opioid medications is appropriate for the client's pain management. Additionally, nalbuphine has mixed agonist-antagonist properties and can precipitate withdrawal symptoms in clients who are physically dependent on full opioid agonists like morphine. Due to these potential interactions and safety concerns, it is essential for the nurse to obtain clarification from the provider before administering nalbuphine to the client receiving morphine via a PCA pump.
A) Ondansetron: Ondansetron is an antiemetic medication commonly prescribed to manage nausea and vomiting, which can be side effects of opioid analgesics like morphine. There are no significant contraindications or interactions between ondansetron and morphine, making it a suitable choice for adjunctive therapy in clients receiving PCA morphine for cancer pain.
C) Insulin glargine: Insulin glargine is a long-acting insulin analog used to control blood glucose levels in clients with diabetes mellitus. While clients with cancer may have comorbidities such as diabetes, the prescription for insulin glargine is unlikely to require clarification in the context of concurrent morphine use. However, the nurse should verify the client's current blood glucose levels and adjust the insulin dosage as needed based on the client's glycemic control.
D) Acetaminophen: Acetaminophen is a non-opioid analgesic commonly used to manage mild to moderate pain. When used in combination with opioids like morphine, acetaminophen can provide additive pain relief and may reduce the total opioid dosage required. There are no significant contraindications or interactions between acetaminophen and morphine, making it a suitable choice for adjunctive pain management in clients receiving PCA morphine for cancer pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) Document the administration of the medication: Documentation of medication administration is an essential step in the medication administration process, ensuring accurate recording of the time, dose, route, and client's response to the medication. However, before administering a controlled substance, the nurse should first identify the client using two identifiers to prevent medication errors.
B) Identify the client using two identifiers: This is the correct initial action. Verifying the client's identity using two identifiers, such as name and date of birth, is a crucial safety measure to ensure that the medication is administered to the correct individual. By confirming the client's identity, the nurse helps prevent medication errors and promotes patient safety.
C) Remove the medication from the medication dispensing cabinet: While obtaining the medication from the medication dispensing cabinet is necessary for administration, it should occur after confirming the client's identity. Identifying the client using two identifiers is the priority to ensure accurate medication administration.
D) Compare the amount of medication available to the inventory record: Verifying the amount of medication available against the inventory record is an important step in medication management to maintain adequate stock levels and prevent medication shortages. However, it is not the first action the nurse should take before administering a controlled substance. Confirming the client's identity is the priority to ensure safe medication administration.
Correct Answer is B
Explanation
A) Increased energy: While increased energy could be a positive outcome of treatment, it is not a specific indicator of the client's response to spironolactone therapy for’cirrhosis.
B) Decreased ascites: This is the correct answer. Spironolactone, a potassium-sparing diuretic, is commonly used to treat ascites in clients with cirrhosis by promoting diuresis and reducing fluid retention in the abdomen. Therefore, a decrease in ascites indicates a positive response to spironolactone therapy.
C) Increased appetite: Increased appetite is not typically a direct response to spironolactone therapy for cirrhosis. It may be influenced by various factors and is not specific to the client's response to the medication.
D) Decrea’ed jaundice: While spironolactone may indirectly help improve liver function, decrease fluid retention, and alleviate symptoms of cirrhosis, it is not primarily used to address jaundice. Other interventions and treatments may be necessary to manage jaundice in clients with liver cirrhosis.
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