A patient has been taking narcotic analgesics for chronic pain for several months. The nurse caring for this patient notes that the prescribed dose is higher than the recommended dose
The patient has normal vital signs, is awake and alert, and reports mild pain. What does the nurse recognize about this patient? a. This patient exhibits a negative placebo effect with a reduced response to the drug.
b. This patient has developed a reaction known as tachyphylaxis because of re-peated exposure to the drug.
c. This patient has developed pharmacody-namic tolerance, which has increased the minimal effective concentration (MEC) needed for analgesic effect.
d. This patient produces higher than normal hepatic enzymes as a result of prolonged exposure to the drug.
C
Pharmacodynamic tolerance results when a patient takes a drug over a period of time. Adaptive processes occur in response to chronic receptor occupation. The result is that the body requires increased drug, or an increased MEC, to achieve the same effect. This patient is getting adequate pain relief, so there is no negative placebo effect. Tachyphylaxis is a form of tolerance that can be defined as a reduction in drug responsiveness brought on by repeated dosing over a short time; this occurs over several months. Barbiturates induce synthesis of hepatic enzymes that cause increased metabolism of the drug, but it does not increase the MEC.
You might also like to view...
Which of the following laboratory results is found in a patient with hyperglycemia?
a. Insulin level of 25 ?/mL b. Absence of ketones in the urine c. Presence of ketones in the blood d. Serum osmolality of 270 mOsm/kg H2O
Emergency medical services arrive to the emergency department with a client who has a cervical spinal cord injury. Which priority assessment does the emergency department nurse perform at this time?
a. Level of consciousness and orientation b. Heart rate and rhythm c. Muscle strength and reflexes d. Respiratory pattern and airway
While caring for a patient with a spinal cord injury (SCI), the nurse elevates the head of the bed, removes compression stockings,
and continues to assess vital signs every 2 to 3 minutes while searching for the cause in order to prevent loss of consciousness or death. By practicing these interventions, the nurse is avoiding the most dangerous complication of autonomic dysreflexia, which is what condition? 1. hypoxia 2. bradycardia 3. elevated blood pressure 4. tachycardia
Each element in the population has an equal chance of being selected in a quota-sampling plan
A) True B) False