Saunders Comprehensive Review for the NCLEX-RN Examination, 5th Edition Pharmacology

The nurse is caring for a client in labor. The nurse reviews the physician’s prescriptions and notes that the client has a prescription for butorphanol tartrate (Stadol). The nurse understands that this medication is prescribed for: 1. Pain relief 2. Increasing uterine contractions 3. Decreasing uterine contractions 4. Promoting fetal lung maturity ANS: 1 Rationale: The client in labor may be given parenteral analgesia during the first stage of labor, up to 2 to 3 hours before the anticipated delivery. Butorphanol tartrate is a medication that may be prescribed for pain relief. “Increasing uterine contractions,” “decreasing uterine contractions,” and “promoting fetal lung maturity” are not actions of this medication. Test-Taking Strategy: Knowledge of the action of butorphanol tartrate is required to answer this question. Remember that this medication is used for pain relief. Review the action of this medication if you had difficulty with this question and are unfamiliar with this medication. PTS: 1 DIF: Level of Cognitive Ability: Understanding REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders. OBJ: Client Needs: Physiological Integrity TOP: Content Area: Pharmacology MSC: Integrated Process: Nursing Process—Planning 2. The postpartum nurse is caring for a client with an epidural catheter in place for opioid analgesic administration following cesarean birth. If the client develops respiratory depression and requires naloxone (Narcan) as an antidote, the client may complain of which of the following? 1. Increase in her pain level 2. Decrease in her pain level 3. Increase in the amount of itching from the opioid used in the epidural 4. Decrease in the amount of itching from the opioid used in the epidural ANS: 1 Rationale: Remember that opioids are used for epidural analgesia. Naloxone is an opioid antagonist, which reverses the effects of opioids. If it is given, the client may complain of an increase in her pain level. Therefore “decrease in her pain level,” “increase in the amount of itching from the opioid used in the epidural,” and “decrease in the amount of itching from the opioid used in the epidural” are incorrect. Test-Taking Strategy: To answer this question accurately, you must know that opioid analgesics are the medications used with epidural analgesia to relieve pain. Therefore if naloxone is administered as an antidote for an opioid analgesic, the client’s pain will increase. Review the effects of naloxone if this question was difficult. PTS: 1 DIF: Level of Cognitive Ability: Understanding REF: Lehne, R. (2010). Pharmacology for nursing care (7th ed.). St. Louis: Saunders. OBJ: Client Needs: Physiological Integrity TOP: Content Area: Pharmacology MSC: Integrated Process: Nursing Process—Assessment 3. A client experiencing preterm labor at the twenty-ninth week of gestation has been admitted to the hospital. The client has a prescription to receive betam....................