Examkin

Soru

Zorluk: OrtaChemical and Other Dependencies / Substance Use Disorders

An occupational health nurse is evaluating an employee who appears visibly unwell after returning from a lunch break. The employee confidentially admits to attempting to stop using prescribed hydrocodone without medical assistance, stating, 'My last dose was over 24 hours ago.' Which assessment findings corroborate that this individual is experiencing acute opioid withdrawal? Select all that apply.

  1. Rhinorrhea and excessive tearingCevap
  2. B
    Pupillary constriction to 2 mm bilaterally
  3. C
    Profound lethargy and hypersomnolence
  4. Diffuse muscle aches and visible piloerectionCevap
  5. Increased bowel motility and reports of abdominal crampingCevap

Cevap

The correct findings are rhinorrhea and excessive tearing, diffuse muscle aches and visible piloerection, and increased bowel motility with abdominal cramping.
Opioid withdrawal produces a rebound excitability of the sympathetic nervous system because the central nervous system depressant effect of the drug is abruptly removed. Classic manifestations of this hyperactive state include rhinorrhea (runny nose), lacrimation (tearing), diaphoresis, piloerection (goosebumps), muscle aches, mydriasis (pupillary dilation), insomnia, agitation, and gastrointestinal distress such as abdominal cramping and diarrhea.

Adım Adım Çözüm

1
Analyze the client's history and timeline.
The client abruptly stopped taking hydrocodone (an opioid) after prolonged use, with the last dose over 24 hours ago.
Identifies that the client is at the correct time interval to experience acute opioid withdrawal syndrome.
2
Differentiate between the physiological effects of opioid intoxication and withdrawal.
Opioid intoxication causes CNS and parasympathetic depression (lethargy, constricted pupils, constipation), while withdrawal causes sympathetic nervous system rebound (restlessness, dilated pupils, diarrhea, piloerection, rhinorrhea).
Clarifies the underlying physiological mechanism driving the clinical manifestations.
3
Evaluate each option against the expected signs of sympathetic rebound.
Rhinorrhea, tearing, piloerection, muscle aches, and abdominal cramping accurately reflect the hyperactive withdrawal state. Pupillary constriction and lethargy reflect the depressed intoxication state.
Determines which options correctly answer the stem.

Anahtar Kavram

Opioid Withdrawal Syndrome Manifestations
Bu soruyu puanla

Konular

Chemical and Other Dependencies / Substance Use Disorders

Bu konudan daha fazla soru