Question

Case Study, Chapter 26, Narcotics, Narcotic Antagonists, and Antimigraine Agents

A new graduate RN has been assigned to a medical–surgical unit. The new graduate RN is in the week of nursing orientation and is administering medications. The RN has to administer an antimigraine medication to an adult patient, a narcotic to an older adult in acute pain, and a narcotic antagonist to a third patient. (Learning Objectives 1, 2, 3, and 5)

1. What is the gate control theory of pain, and how does this block pain for a patient?
2. What are the key lifespan considerations for an older adult when administering narcotics?
3. What are the key nursing implementation considerations for a patient receiving a narcotic antagonist?
4. What are the key lifespan considerations for an adult when administering antimigraine medication?

Answer 1

A. Gate control theory of pain:

The gate control theory of pain asserts that non-painful input closes the gates to painful Input which prevent pain sensation from travelling to the central nervous system. Therefore stimulation by non-noxious input is able to suppress pain.

b. Lifespan considerations for adult administering narcotics:

Elderly patients should be specifically asked whether they require pain medication. Many older patients can recall a time when nurses were able to spend more time with patients; they may tend to believe that the nurse will meet their needs.

C. Key nursing implementation considerations for a patient receiving a narcotic antagonist:

Give in smallest effective dose, observe for development of dependence, encourage respiratory exercises, use carefully to avoid respiratory depression, monitor VS, monitor I&O and bowel patterns, use for cardiac patients reduces pre-load and after load pressures, decreasing cardiac work load.

D. lifespan considerations for an adult administering antimigraine medication:

The nurse should carefully assess the patient before one of the antimigraine drugs is used to ensure that the headache being treated is of the type that can benefit from these drugs.

The nurse should check if the patient is pregnant because

The ergots and the triptans are contraindicated during pregnancy because of the potential for adverse effects in the mother and fetus.

Women of childbearing age should be advised to use contraception while they are taking these drugs.

Women who are nursing should be encouraged to find another method of feeding the baby because of the potential for adverse drug effects on the baby.