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NCLEX · Pharmacological Therapies

A client is prescribed an opioid for post-operative pain. Which assessment is the highest priority before and after administration?

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Correct answer

Respiratory rate and sedation level — opioids cause respiratory depression, the most dangerous adverse effect; assess RR (hold if below 12/min) and level of sedation before and after administration

  1. A Temperature
  2. B Blood pressure
  3. C Bowel sounds
  4. D Respiratory rate and sedation level — opioids cause respiratory depression, the most dangerous adverse effect; assess RR (hold if below 12/min) and level of sedation before and after administration

Why this is the answer

OPIOID SAFETY — RESPIRATORY DEPRESSION: The most dangerous opioid adverse effect is respiratory depression — opioids suppress the brainstem respiratory drive.

Priority assessments: Respiratory rate (hold and notify if < 12/min in adults); Sedation level (use a sedation scale — increasing sedation precedes respiratory depression); oxygen saturation.

Assess before: Establish baseline RR and sedation.

Assess after: Peak effect timing — IV opioids 15-30 min, oral 60 min.

Progression: Sedation increases BEFORE respiratory rate drops — a sedated patient who is hard to arouse is a warning sign even if RR is still normal.

Antidote: Naloxone (Narcan) reverses opioid respiratory depression — should be available.

Additional monitoring: Constipation (give stool softeners prophylactically); orthostatic hypotension; nausea; urinary retention; LPN role: assess respiratory status before/after, monitor sedation, hold and notify for RR < 12, have naloxone accessible.

Source: NCLEX-PN Physiological — Pharmacology, Opioid Respiratory Depression

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About this topic: Pharmacological Therapies

Pharmacological therapies questions cover medication administration, dosage calculation, the rights of medication administration, common drug classes and their side effects, and when to hold a medication and report. This is one of 18 PN: Physiological Integrity questions on pharmacological therapies, each with a full explanation on a single study page.

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