Question

A nurse is providing teaching to an older adult client who has cancer and a new prescription for an opioid analgesic for pain management. Which of the following information should the nurse include in the teaching?

A. It is an expected effect to sleep through the day when taking this medication.
B. Your constipation will be lessened as you develop a tolerance to the medication.
C. You should void every 4 hours to decrease the risk of urinary retention.
D. If you experience ringing in your ears, your dose will need to be reduced.

Answer 1

The nurse should inform the client that opioid analgesics can cause constipation and urinary retention, but not necessarily that sleepiness or reduced constipation will occur with tolerance. Clients should prevent constipation and attempt to void every 4 hours to decrease the risk of urinary retention.

Step-by-step explanation:

When teaching an older adult client with cancer about the use of opioid analgesics for pain management, it is essential to provide accurate information regarding the side effects and correct use of these medications. Opioid analgesics are potent pain relievers that can have several side effects, including constipation, nausea, and urinary retention.

It is not expected to sleep through the day as a normal effect of taking these medications; such excessive drowsiness can be a sign of an overdose. While constipation is a common side effect of opioid use, it may not necessarily lessen with the development of tolerance to the pain-relieving effects. Instead, clients should be encouraged to engage in preventive measures such as increased fluid intake, a fiber-rich diet, and possibly the use of stool softeners as recommended by their healthcare provider.

It is important to maintain regular urinary habits to prevent urinary retention. Advising the client to attempt to void every 4 hours can help manage this risk. Lastly, while ringing in the ears is not a common side effect directly attributed to opioids, it may indicate other issues, and any new symptoms should be reported to the healthcare provider for further evaluation.

Answer 2

The nurse should include "You should void every 4 hours to decrease the risk of urinary retention (Option C)" in the teaching. The nurse should teach the client that constipation is a common side effect of opioids and doesn't lessen with tolerance, to void every 4 hours to reduce the risk of urinary retention, and to monitor for serious side effects indicating possible overdose

Step-by-step explanation:

When teaching an older adult client about using an opioid analgesic for pain management, several important points should be included.

It's crucial to address the common side effects of opioids, such as constipation, which is unlikely to lessen with tolerance and may require proactive management with diet changes or laxatives.

Opioids can lead to physical dependence, where withdrawal symptoms occur if the medication is stopped.

Encouraging the client to void every 4 hours can help decrease the risk of urinary retention, another potential side effect.

It's important to monitor for symptoms that may indicate an adverse reaction or overdose, such as extreme drowsiness or difficulty breathing, rather than symptoms like ringing in the ears, which are not typical of opioid use.

Hence, the correct answer is Option C.