The MedSurg nurse assesses a patient after arriving on the unit from the PACU. The patient states that she is in pain, rating the pain at a 7 out of 10. The nurse administers 4mg morphine IV as prescribed. After administering the drug, the PACU nurse calls to say a dose of morphine was given and not documented. What actions should the nurse perform? (Select all that apply) (Select All that Apply.)
Monitor the patient's respiratory rate
Ensure naloxone is readily available
Report the error to the facility through the proper paperwork
Inform the patient's health care provider
Document the dose of morphine given by the MedSurg nurse
Correct Answer : A,C,D,E
A. Monitor the patient's respiratory rate: It's essential to monitor the patient for any adverse effects of morphine administration, particularly respiratory depression.
B. Ensure naloxone is readily available: While naloxone is an antidote for opioid overdose, administering it would depend on the patient's response and any signs of opioid toxicity, which may not be evident at this time.
C. Report the error to the facility through the proper paperwork: Reporting the medication error is crucial for documentation, investigation, and implementation of corrective actions.
D. Inform the patient's health care provider: The healthcare provider should be notified of the medication error to ensure appropriate follow-up and monitoring of the patient.
E. Document the dose of morphine given by the MedSurg nurse: Documenting the medication administration accurately is essential for the patient's medical record and continuity of care.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Improved ability to perform activities of daily living: Antiparkinson medications are aimed at improving motor symptoms such as tremors, rigidity, and bradykinesia, leading to improved function in activities of daily living.
B. Decreased appetite: Decreased appetite is not a therapeutic response to antiparkinson medications. In fact, some medications may cause weight gain due to increased appetite.
C. Newly developed dyskinesias: Dyskinesias are involuntary movements that can occur as a side effect of long-term treatment with antiparkinson medications, particularly levodopa. They are not a therapeutic response and may require adjustments to medication.
D. Gradual development of cogwheel rigidity: Cogwheel rigidity is a symptom of Parkinson's disease and would not be expected to develop gradually with treatment. Antiparkinson
medications aim to reduce rigidity, not cause it.
Correct Answer is A
Explanation
A. Partial agonists like nalbuphine have a lower dependency potential than full agonists. This means they are less likely to lead to physical dependence or tolerance when used for pain
management.
B. Partial agonists do not necessarily have a higher potency than agonists. Potency refers to the dose of a drug required to produce a specific effect, which can vary among different drugs regardless of their classification as agonists or partial agonists.
C. Partial agonists like nalbuphine are not typically used for their anti-inflammatory effects.
They are primarily used for pain management.
D. Partial agonists like nalbuphine are not typically used to reverse the effects of opiates. They may be used in certain situations to manage opioid-induced side effects or in cases of opioid overdose, but their primary indication is for pain management.
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