Which problem or manifestation in a 125-pound, 40-year-old woman, 1-day postoperative for a total abdominal hysterectomy, leads the nurse to suspect possible substance abuse?
A. She has vomited nine times during the first 24 hours after surgery.
B. Morphine 15 mg (subcutaneous) has failed to relieve her pain.
C. She has been unable to void after removal of the Foley.
D. Her wound drainage is greater than expected.
B
Many of the liver enzymes that detoxify abused substances also degrade morphine and other opioids. When people abuse drugs, even alcohol, the level of these degradative enzymes increas-es, and opioid medications are degraded more rapidly, increasing the client's tolerance of these medications even though they may never have had an opioid previously. More drug is required to provide adequate pain relief.
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The nurse administers an opioid analgesic to an older male postoperative patient in the surgical unit. Which is the most important intervention for the nurse to implement before leaving the pa-tient's room?
a. Place side rails up x 4. b. Position the patient comfortably. c. Offer toileting and a sip of water. d. Instruct him to ask for help before getting up.
Which indicates the aspect similar between the different methods of quality management? Each method:
1. Uses all staff in the organization. 2. Does not blame. 3. Provides clinical information 4. Focuses on cost containment.
The nurse manager is concerned about the increased number of medication adverse effects being observed in older patients. What should the manager do to reduce these effects? Select all that apply.
1. Conduct a monthly quality improvement study. 2. Monitor each nurse's ability to detect preparation errors. 3. Discuss the importance of not missing medication doses. 4. Review pharmacy documentation regarding drug—drug interactions. 5. Ensure that the physicians' orders are legible.
When examining the client's external ear, a nurse palpates painless nodules on the pinna. The nurse should inquire about history of which of the following?
A. An old injury to the external ear B. Gout, sun or chemical exposure, arthritis C. Superficial infections of the outer ear D. Considered to be a normal variant of aging