The patient comes to the emergency department with a head injury, broken ribs, and internal bleeding. Opioid analgesics are contraindicated. What does the nurse recognize as the primary rationale for this?
1. The use of opioid analgesics will depress the patient's blood pressure.
2. The patient may not be able to communicate his level of pain.
3. Opioids will not effectively relieve pain in the patient's periphery.
4. Opioids can mask changes in the patient's level of consciousness.
Correct Answer: 4
Rationale: Opioids are central nervous system (CNS) depressants and can mask the patient's level of consciousness; this is dangerous when the patient has a head injury. Depression of blood pressure could occur, but this is not as critical as level of consciousness. The patient may not be able to determine his level of pain, but this is not as critical as level of consciousness. Opioids do not effectively relieve pain in the patient's periphery, but this is not as critical as level of consciousness.
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