A patient sustained a fractured femur while driving under the influence of drugs. Family members indicate that the patient has "dabbled in drugs" for years

When the patient obtains little relief from the prescribed dose of narcotic analgesic, the nurse suspects the ineffective pain relief is related to: a. drug tolerance to the narcotic prescribed.
b. the predictable onset of withdrawal symptoms.
c. insufficient analgesic dosage to manage the pain.
d. the strong likelihood of a history of substance abuse.


A
Tolerance to opiates develops when used repeatedly (i.e., a larger amount of the drug is needed to produce the desired effect). If the patient uses heroin or another opiate individually or in conjunction with other drugs, tolerance may be present. In addition, cross-tolerance develops among CNS depressants, meaning that as tolerance to one drug develops, tolerance develops to all other drugs in the group as well. Although withdrawal and insufficient analgesic medication dosage may result in pain, this patient's assessment data and history are strong indicators of possible drug tolerance. A history of substance abuse would be a "red flag" regarding the possibility of withdrawal symptoms when the patient is no longer receiving any analgesic medications.

Nursing

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