14 a nurse is assessing a client who has hyperkalemia

14) A nurse is assessing a client who has hyperkalemia. Which of the following findings should the
nurse expect?
a. decreased muscle strength
b. decreased gastric motility
c. increased heart rate
d. increased blood pressure
ANS A – Decreased muscle strength
15) A patient is scheduled to have a tunneled catheter placed for administration of chemotherapy for
breast cancer. When preparing the patient for the catheter insertion, what does the nurse explain
about this method of chemotherapy administration?
Chapter 8 : Pain & Chapter 9 Palliative and EOL
 Neuropathic pain : Burning, numbing, shooting, stabbing, electric, shock like, itchy
 Nociceptice pain: Sharp, aching, throbbing, dull, cramping
 Nonopiods are acetaminophen, aspirin, other salicylates, NSAIDS,
 Opioids bind to receptors in the CNS , inhibit transmission of nociceptive input, altered limbic
system activity, activation of descending inhibitory pathways
o Pure agonists bind to mu receptors : Morphine, oxycodone and codeine
o May cause respiratory depression

o Mixed agnoists-antagonists : Pentazocine, butorphanol bing as agonists on kappa, weak
antagonistsor partial agonists on mu
 Less respiratory depression, more dysphoria and agitation, have an analgesic
ceiling, can precipitate withdrawal
o Dual mechanism agents : Tramadol and tapentadol
 Common side effects include constipation, nausea/vomiting, sedation, respiratory depression,
pruritus
 Care or treatment focusing on reducing the severity of symptoms in EOL care
 Goal of EOL is to prevent and relieve suffering, improve quality of life for patients with serious
life limiting illnesses
 Palliative care allows for curative and palliative treatment
 Hospice care is typically 6 months or less, no further curative treatment, ease distress
Information Reviewed Final Class
 With mild to moderate pain use Nonopioid analgesic which are NSAIDS, ibuprofen,
acetaminophen, Tylenol
 When patients are receiving IV pain medication, be sure to do a respiratory assessment (O2 , RR,
lung sounds)
 If a patient is having respiratory depression give Narcan/ Naloxone
 Primary goal of hospice is pain management, symptom relief, and supportive care to patient and
family
 Important factors when introducing hospice care including having the family understand the goal
of care, and making sure the family and patient both agree
 Chain strokes respirations come at the end of life : they are deep rapid irregular and consist of
apnea , these should be documented
 Side effects from narcotics are constipation : You want to increase fiber, fluid intake and stool
softeners