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Zorluk: ZorPharmacological Therapies

A client is recovering on the surgical unit following an abdominal procedure and receives a prescribed dose of intravenous morphine for severe pain. Shortly after, the practical nurse (PN) finds the client minimally responsive with a respiratory rate of 7 breaths/min. The PN immediately summons the registered nurse (RN), who administers intravenous naloxone. Fifteen minutes later, the client is fully awake and breathing at 16 breaths/min. Which action should the PN prioritize next?

  1. A
    Assess the client's current pain severity and prepare to administer a prescribed non-opioid analgesic.
  2. B
    Draw up an additional dose of intravenous naloxone to administer if the client's respiratory rate decreases again.
  3. Monitor the client's respiratory rate and level of consciousness closely over the next several hours.Cevap
  4. D
    Apply soft wrist restraints to prevent the client from dislodging the intravenous access if they become agitated.

Cevap

Monitor the client's respiratory rate and level of consciousness closely over the next several hours.
Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression. However, its duration of action is significantly shorter (approximately 30 to 81 minutes) than that of morphine. As the naloxone is metabolized and cleared from the body, the residual morphine can cause a re-emergence of respiratory depression. Therefore, the most critical action is to closely monitor the client's respiratory rate, oxygenation, and level of consciousness for several hours to quickly identify and manage any recurring depression.

Adım Adım Çözüm

1
Analyze the pharmacological properties of the administered medications.
Naloxone is an opioid antagonist that reverses the effects of morphine, but it has a significantly shorter half-life (30 to 81 minutes) compared to most opioids.
Understanding drug pharmacokinetics is essential to anticipate the client's physiological response over time.
2
Identify the primary clinical risk for the client.
The client is at high risk for recurring respiratory depression as the naloxone wears off before the morphine is fully metabolized.
Patient safety requires anticipating and preventing life-threatening complications.
3
Determine the priority action within the PN's legal scope of practice.
Continuous and close monitoring of the client's respiratory status and level of consciousness is the most critical and appropriate intervention.
This ensures immediate detection of recurring respiratory depression while remaining within the boundaries of practical nursing practice.

Anahtar Kavram

Pharmacokinetics of opioid antagonists and post-reversal respiratory monitoring
Tahmini Süre:2m 0s
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Pharmacological Therapies

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