Which side effects should a nurse monitor for in patients receiving opioid analgesics?

Which side effects should a nurse monitor for in patients receiving opioid analgesics?

• A. Constipation, pruritus, respiratory depression.
• B. Diarrhea, hypertension, tachycardia.
• C. Nausea, vomiting, headaches.
• D. Sedation, blurred vision, rash.

Answer: (A)

Opioid analgesics have a characteristic set of adverse effects that nurses monitor closely, with constipation, pruritus, and respiratory depression at the forefront. Constipation occurs because opioids bind to receptors in the gut and slow peristalsis, which can lead to stool retention if not proactively managed with a bowel regimen, hydration, and fiber as appropriate. Pruritus results from histamine release triggered by opioids, often presenting as itching without a rash; it can be relieved by adjusting the dose or adding antihistamines if needed. Respiratory depression is the most dangerous effect, arising from reduced brainstem drive to breathe; it requires vigilant monitoring of respiratory rate, depth, and oxygen saturation, with readiness to intervene if breathing becomes inadequate. Other listed effects are less characteristic or less immediately life-threatening in typical opioid use. Diarrhea and tachycardia/hypertension are not the usual pattern, since opioids commonly slow gut motility and can cause other cardiovascular and CNS effects that differ from those listed. Nausea, vomiting, sedation, and, less commonly, rash can occur, but the trio of constipation, pruritus, and respiratory depression best captures the key issues to watch for.

Opioid analgesics have a characteristic set of adverse effects that nurses monitor closely, with constipation, pruritus, and respiratory depression at the forefront. Constipation occurs because opioids bind to receptors in the gut and slow peristalsis, which can lead to stool retention if not proactively managed with a bowel regimen, hydration, and fiber as appropriate. Pruritus results from histamine release triggered by opioids, often presenting as itching without a rash; it can be relieved by adjusting the dose or adding antihistamines if needed. Respiratory depression is the most dangerous effect, arising from reduced brainstem drive to breathe; it requires vigilant monitoring of respiratory rate, depth, and oxygen saturation, with readiness to intervene if breathing becomes inadequate.

Other listed effects are less characteristic or less immediately life-threatening in typical opioid use. Diarrhea and tachycardia/hypertension are not the usual pattern, since opioids commonly slow gut motility and can cause other cardiovascular and CNS effects that differ from those listed. Nausea, vomiting, sedation, and, less commonly, rash can occur, but the trio of constipation, pruritus, and respiratory depression best captures the key issues to watch for.