Which nursing intervention has priority when initiating a continuous epidural infusion with an opioid analgesic?

Apply a pulse oximeter to the client per protocol.

Insert an indwelling urinary catheter per protocol.

Administer an antiemetic per PRN prescription.

Administer a stool softener per PRN protocol.

Answer and Explanation

The Correct Answer is A

A) Apply a pulse oximeter to the client per protocol: The priority intervention is to monitor the client’s respiratory status closely when initiating a continuous epidural infusion with an opioid analgesic. Opioids can cause respiratory depression, and using a pulse oximeter helps in detecting any drop in oxygen saturation, allowing for timely intervention if respiratory issues arise.

B) Insert an indwelling urinary catheter per protocol: While an indwelling urinary catheter might be used in some cases for convenience and monitoring, it is not the immediate priority in the context of starting an epidural opioid infusion. The primary concern is monitoring for respiratory depression and ensuring the client’s safety with the opioid medication.

C) Administer an antiemetic per PRN prescription: Administering an antiemetic may be necessary if the client experiences nausea, which is a potential side effect of opioids. However, the more immediate concern when starting an opioid infusion is ensuring the client’s respiratory function is stable.

D) Administer a stool softener per PRN protocol: Stool softeners might be required to manage opioid-induced constipation, but this is not the most urgent concern when starting the medication. The immediate priority is monitoring respiratory status to prevent potential complications associated with opioid use.

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Correct Answer is B

Explanation

A) Migraine headaches: While migraine headaches are significant for overall health management, they are less directly related to the risks associated with NSAID use compared to other conditions. Migraines do not typically influence the safety profile of NSAIDs.

B) Chronic alcoholism: Chronic alcoholism is a major concern because it significantly increases the risk of gastrointestinal complications with NSAID use. NSAIDs can cause gastric irritation, bleeding, and ulcers, and alcohol can exacerbate these risks, leading to severe gastrointestinal issues or liver damage.

C) Osteoarthritis: Osteoarthritis is a common indication for NSAID use and, therefore, does not pose an additional risk specific to the medication. NSAIDs are often prescribed to manage pain and inflammation associated with osteoarthritis.

D) Type 2 diabetes mellitus: Although diabetes mellitus requires careful management, it does not directly increase the risk of NSAID-related complications. However, clients with diabetes need to be monitored for overall health and medication effects, but chronic alcoholism poses a more immediate risk for NSAID use.

A. High density lipoprotein (HDL) B. Low density lipoprotein (LDL). C. Creatine phosphokinase (CK). D. Prothrombin time (PT).

Correct Answer is B

Explanation

A. High density lipoprotein (HDL):
HDL levels are important for cardiovascular health as higher levels are associated with a lower risk of coronary artery disease. However, atorvastatin primarily targets LDL levels. While increasing HDL is beneficial, it is not the primary measure of atorvastatin's effectiveness.

B. Low density lipoprotein (LDL):
Atorvastatin is a statin medication used to lower LDL cholesterol levels, which is a major risk factor for coronary artery disease. A decrease in LDL levels indicates that the medication is having its desired effect, reducing the risk of cardiovascular events.

C. Creatine phosphokinase (CK):
CK levels are monitored to assess muscle damage or side effects related to statin use, such as rhabdomyolysis. While important for safety monitoring, changes in CK levels do not directly reflect the effectiveness of atorvastatin in managing cholesterol levels.

D. Prothrombin time (PT):
PT is used to evaluate blood clotting ability and is not directly related to the effectiveness of atorvastatin. It is more relevant for monitoring anticoagulant therapy rather than statin therapy for cholesterol management.

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Which nursing intervention has priority when initiating a continuous epidural infusion with an opioid analgesic?

Nursing Test Bank

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