The nurse receives a medication order for fentanyl patches (Duragesic) for a new home health client. What should the nurse check before ordering these patches from the pharmacy?
Standard Text: Select all that apply.
1. Is the client allergic to amitriptyline (Elavil)?
2. Was the client's morphine discontinued?
3. Has the client ever taken opioids?
4. Can the client manage changing the patch every morning?
5. Has the client had adverse reactions to morphine?
Correct Answer: 3,5
Rationale 1: Allergy to amitriptyline is not a contraindication to use of fentanyl.
Rationale 2: Fentanyl patches are used for breakthrough pain and so are used with other pain medications.
Rationale 3: Giving fentanyl formulations to clients who are opioid naïve can result in serious or fatal respiratory depression.
Rationale 4: These patches are dosed every 72 hours.
Rationale 5: Fentanyl has the same actions and adverse effects as morphine.
Global Rationale: Giving fentanyl formulations to clients who are opioid naïve can result in serious or fatal respiratory depression. Fentanyl has the same actions and adverse effects as morphine. Allergy to amitriptyline is not a contraindication to use of fentanyl. Fentanyl patches are used for breakthrough pain and so are used with other pain medications. These patches are dosed every 72 hours.
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