A patient who has chronic low back pain is prescribed oxycodone (OxyContin) for long-term use.

Which of the following interventions should the nurse implement to prevent complications from this medication? (Select all that apply.)

Monitor the patient’s vital signs regularly.

Encourage fluid intake and high-fiber foods.

Advise the patient to avoid alcohol and other CNS depressants.

Instruct the patient to take acetaminophen (Tylenol) for breakthrough pain.

Teach the patient how to use a patient-controlled analgesia (PCA) pump.

Answer and Explanation

Correct Answer : B,C

The correct answer is choice B and C. Oxycodone (OxyContin) is a potent opioid analgesic that can cause constipation, drowsiness, nausea, pruritus, and vomiting as common side effects.

To prevent constipation, the patient should be encouraged to drink plenty of fluids and eat high-fiber foods. To prevent respiratory depression and sedation, the patient should be advised to avoid alcohol and other CNS depressants while taking oxycodone.

Choice A is wrong because monitoring vital signs regularly is not specific to oxycodone use, but rather a general nursing intervention for any patient with chronic pain.

Choice D is wrong because acetaminophen (Tylenol) can interact with oxycodone and increase the risk of liver damage.

The patient should not take any other pain medications without consulting the prescriber.

Choice E is wrong because a patient-controlled analgesia (PCA) pump is not used for long-term pain management, but rather for acute or postoperative pain. Oxycodone (OxyContin) is formulated as an extended-release tablet that provides sustained pain relief for up to 12 hours.

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Correct Answer is A

Explanation

The correct answer is choice A. The client reports a pain level of 4 on a scale of 0 to 10.This indicates that the PCA pump is effective in reducing the client’s pain, which is the primary symptom of sickle cell crisis.

Choice B is wrong because a respiratory rate of 12 breaths per minute is normal and does not indicate the effectiveness of the PCA pump.

Choice C is wrong because a blood pressure of 140/90 mm Hg is high and may indicate hypertension, which is a complication of sickle cell disease.

Choice D is wrong because a pulse oximetry reading of 95% is normal and does not indicate the effectiveness of the PCA pump.

Normal ranges for vital signs are:

• Respiratory rate: 12-20 breaths per minute

• Blood pressure: <120/80 mm Hg

• Pulse oximetry: >95%

A. Take ibuprofen with food or milk to prevent gastric irritation. B. Drink at least 2 liters of fluid per day to prevent renal impairment. C. Avoid alcohol and other NSAIDs to prevent bleeding complications. D. Report any signs of hypersensitivity such as rash, itching, or wheezing. E. Monitor blood pressure and report any significant increase or decrease.

Correct Answer is ["A","B","C","D"]

Explanation

The correct answer is choice A, B, C, and D.Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that has anti-inflammatory, analgesic, and antipyretic effects.It works by inhibiting the synthesis of prostaglandins, which are involved in inflammation, pain, and fever.However, ibuprofen can also cause adverse effects such as gastric irritation, bleeding complications, renal impairment, and hypersensitivity reactions.

Therefore, the nurse should instruct the client to:

• Take ibuprofen with food or milk to prevent gastric irritation.This will reduce the direct contact of the drug with the stomach lining and decrease the risk of ulcers and bleeding.

• Drink at least 2 liters of fluid per day to prevent renal impairment.This will help maintain adequate hydration and renal perfusion and prevent the accumulation of ibuprofen in the kidneys.

• Avoid alcohol and other NSAIDs to prevent bleeding complications.Alcohol and other NSAIDs can increase the risk of gastric bleeding by interfering with the protective effects of prostaglandins on the stomach mucosa.

• Report any signs of hypersensitivity such as rash, itching, or wheezing.These may indicate an allergic reaction to ibuprofen that can be serious or life-threatening.

Choice E is wrong because ibuprofen does not affect blood pressure significantly.However, some other NSAIDs such as celecoxib may increase the risk of cardiovascular events such as thrombosis, myocardial infarction, and stroke.Therefore, clients with hypertension or cardiovascular disease should use NSAIDs with caution and monitor their blood pressure regularly.

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A patient who has chronic low back pain is prescribed oxycodone (OxyContin) for long-term use. Which of the following interventions should the nurse implement to prevent complications from this medication? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a sickle cell crisis and is receiving morphine via patient-controlled analgesia (PCA) pump. Which assessment finding indicates that the PCA pump is effective?

Correct Answer is A

Explanation

A nurse is educating a client about ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), that has been prescribed for moderate pain and inflammation. Which of the following instructions should the nurse include? (Select all that apply.).

Correct Answer is ["A","B","C","D"]

Explanation

A patient who is addicted to heroin is admitted to the hospital for treatment of an infection. The patient is prescribed methadone (Dolophine) as part of a detoxification program. What is the rationale for using methadone in this patient?

The nurse is caring for a client who has been prescribed acetaminophen, a non-opioid analgesic, for mild pain. Which laboratory test result should the nurse monitor closely in this client?

A nurse is caring for a client who has rheumatoid arthritis and has been prescribed ibuprofen (Advil). Which of the following instructions should the nurse include in the teaching? Select all that apply.

A nurse is teaching a client who has chronic pain about nonpharmacological pain management techniques. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.).

A patient with chronic back pain is prescribed gabapentin as an adjuvant analgesic. The nurse should instruct the patient to report which of the following adverse effects?

The nurse is preparing to administer morphine sulfate, an opioid analgesic, to a client who reports pain at level 8 on a scale of 0 to 10. Which action should the nurse take first?

A nurse is reviewing laboratory results for a client who takes acetaminophen for osteoarthritis pain management.Which of the following findings should alert the nurse to possible hepatotoxicity? (Select all that apply.).

A patient who has chronic low back pain is prescribed oxycodone (OxyContin) for long-term use.

Which of the following interventions should the nurse implement to prevent complications from this medication? (Select all that apply.)