Page 308 - Saunders Comprehensive Review For NCLEX-RN

hepatotoxicity.
B. Opioid analgesics
1. Description
a. These medications suppress pain
impulses but can also suppress
respiration and coughing by acting on
the respiratory and cough center,
located in the medulla of the
brainstem.
b. Review the client’s history and note
that clients with impaired renal or liver
function may only be able to tolerate
low doses of opioid analgesics; also
assess for allergy.
c. Intravenous route administration
produces a faster effect than other
routes, but the effect lasts shorter to
relieve pain.
d. Opioids, which produce euphoria and
sedation, can cause physical
dependence.
e. Administer the medication 30 to 60
minutes before painful activities.

f. Monitor the respiratory rate; if it

is slower than 12 breaths per minute in
an adult, withhold the medication and
notify the PHCP.
g. Monitor the pulse; if bradycardia
develops, withhold the medication and
notify the PHCP.
h. Monitor the BP for hypotension and
assess before administering pain
medications to decrease the risk of
adverse effects.
i. Auscultate the lungs for normal breath
sounds.
j. Encourage activities such as turning,
deep breathing, and incentive
spirometry to help prevent atelectasis
and pneumonia.
k. Monitor the client’s level of
consciousness.
l. Initiate safety precautions.
m. Monitor intake and output and assess
the client for urine retention; also
constipation is common with opioid
use.

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