NUR 145 Ch. 2- Drugs Used for Pain
Management Questions and Correct
Answers
Chapter 20 ✅
Opiate agonists ✅for severe acute pain
Salicylates ✅for mild acute pain
The nurse is educating a postoperative patient about the use of a patient-controlled
analgesia (PCA) pump. Which statement by the patient indicates a need for further
teaching?
A. "I'm afraid I'll give myself too much medicine and
become addicted to it."
B. "I can only receive the medication every 10 minutes."
C. "I'll let the nurse know if my pain doesn't improve."
D. "I'll be sure to push the button to give myself pain
medicine before I get up into a chair." ✅Answer: A
Rationale: PCA delivery is a safe, effective means of pain management that gives
control to the patient who is experiencing the pain and eliminates the wait for individual
analgesic doses. If the patient fears addiction and is not relieving the pain, then more
teaching and reinforcement need to take place.
Actions of Opiate Agonists ✅-Act on same sites in the brain as morphine to stimulate
analgesic effects
-Block the pain sensation
Uses of Opiate Agonists ✅-Relieve acute or chronic moderate/severe pain
-Can be used preoperatively or to supplement anesthesia
*Prolonged use can produce drug tolerance or addiction (may develop after 3 to 6
weeks of use).
Prolong use of opiate agonists ✅can produce drug tolerance or addiction (may
develop after 3-6 weeks of use)
Drug Class: Opiate Agonists: ✅Ex: Morphine and morphine-like derivatives;
meperidine-like derivatives; methadone-like derivatives; other opiate agonists
Drug class: meperidine-like derivatives ✅fentanyl (Duragesic)
, meperidine (Demerol)
fentanyl (Duragesic) ✅Transdermal opioid analgesia
Uses of fentanyl (Duragesic) ✅relief of chronic pain
Duration of fentanyl (Duragesic) ✅72 hrs
- takes 12-24 hrs for initial patch to reach steady blood level, so other analgesics must
be used during this time
meperidine (Demerol) ✅- less frequently prescribed because of adverse effects
associated with normeperidine
- not recommended for use more than 1-2 days
Which patients are predisposed to normeperidine if used large doses of meperidine
long-term? ✅patients with renal impairment, and those with highly acidic urine
Symptoms of toxic levels of normeperidine ✅excitation, tremors and seizures
Common adverse effect of Opiate agonists ✅Lightheadedness, dizziness, sedation,
sweating, confusion, disorientation; orthostatic hypotension, nausea, vomiting,
constipation
Serious adverse effects of Opiate agonists ✅Respiratory depression; urinary retention;
excessive use or abuse, increased effect with CNS depressants
Drug interactions of Opiate agonists ✅tranquilizers, tricyclic antidepressants,
antihistamines, alcohol.
Premedication assessments & planning for Opiate agonists: ✅- Neurological
assessment
- Vitals: hold if respiration are below 12/min
- Appropriate pain assessment
Which common adverse effect may be seen with use of opiate agonists?
A. Appetite stimulation
B. Orthostatic hypotension
C. Mood elevation
D. Increased respirations ✅Answer: B
Rationale: Blood pressure is likely to be affected with the use of opiate agonists.
Sedation, confusion, nausea and vomiting, and constipation may also occur.
Respirations can be decreased by opioids, and an antagonistic drug such as naloxone
(Narcan) should be available.
Management Questions and Correct
Answers
Chapter 20 ✅
Opiate agonists ✅for severe acute pain
Salicylates ✅for mild acute pain
The nurse is educating a postoperative patient about the use of a patient-controlled
analgesia (PCA) pump. Which statement by the patient indicates a need for further
teaching?
A. "I'm afraid I'll give myself too much medicine and
become addicted to it."
B. "I can only receive the medication every 10 minutes."
C. "I'll let the nurse know if my pain doesn't improve."
D. "I'll be sure to push the button to give myself pain
medicine before I get up into a chair." ✅Answer: A
Rationale: PCA delivery is a safe, effective means of pain management that gives
control to the patient who is experiencing the pain and eliminates the wait for individual
analgesic doses. If the patient fears addiction and is not relieving the pain, then more
teaching and reinforcement need to take place.
Actions of Opiate Agonists ✅-Act on same sites in the brain as morphine to stimulate
analgesic effects
-Block the pain sensation
Uses of Opiate Agonists ✅-Relieve acute or chronic moderate/severe pain
-Can be used preoperatively or to supplement anesthesia
*Prolonged use can produce drug tolerance or addiction (may develop after 3 to 6
weeks of use).
Prolong use of opiate agonists ✅can produce drug tolerance or addiction (may
develop after 3-6 weeks of use)
Drug Class: Opiate Agonists: ✅Ex: Morphine and morphine-like derivatives;
meperidine-like derivatives; methadone-like derivatives; other opiate agonists
Drug class: meperidine-like derivatives ✅fentanyl (Duragesic)
, meperidine (Demerol)
fentanyl (Duragesic) ✅Transdermal opioid analgesia
Uses of fentanyl (Duragesic) ✅relief of chronic pain
Duration of fentanyl (Duragesic) ✅72 hrs
- takes 12-24 hrs for initial patch to reach steady blood level, so other analgesics must
be used during this time
meperidine (Demerol) ✅- less frequently prescribed because of adverse effects
associated with normeperidine
- not recommended for use more than 1-2 days
Which patients are predisposed to normeperidine if used large doses of meperidine
long-term? ✅patients with renal impairment, and those with highly acidic urine
Symptoms of toxic levels of normeperidine ✅excitation, tremors and seizures
Common adverse effect of Opiate agonists ✅Lightheadedness, dizziness, sedation,
sweating, confusion, disorientation; orthostatic hypotension, nausea, vomiting,
constipation
Serious adverse effects of Opiate agonists ✅Respiratory depression; urinary retention;
excessive use or abuse, increased effect with CNS depressants
Drug interactions of Opiate agonists ✅tranquilizers, tricyclic antidepressants,
antihistamines, alcohol.
Premedication assessments & planning for Opiate agonists: ✅- Neurological
assessment
- Vitals: hold if respiration are below 12/min
- Appropriate pain assessment
Which common adverse effect may be seen with use of opiate agonists?
A. Appetite stimulation
B. Orthostatic hypotension
C. Mood elevation
D. Increased respirations ✅Answer: B
Rationale: Blood pressure is likely to be affected with the use of opiate agonists.
Sedation, confusion, nausea and vomiting, and constipation may also occur.
Respirations can be decreased by opioids, and an antagonistic drug such as naloxone
(Narcan) should be available.
