A patient who was previously being mechanically ventilated in the pressure-regulated volume control (PRVC) mode and is now receiving CPAP at 10 cm H2O along with pressure support ventilation, requires pain management. The physician has ordered IV infusion of fentanyl. Why should the therapist question this order?
A. Fentanyl will induce hypotension.
B. Fentanyl causes insomnia.
C. Fentanyl will induce diarrhea.
D. Fentanyl may cause respiratory depression.
?ANS: D
A. Incorrect response: See explanation D.
B. Incorrect response: See explanation D.
C. Incorrect response: See explanation D.
D. Correct response: Fentanyl is an opioid analgesic. Therefore it used in the management of pain for patients who are critically ill. Administration is commonly via IV infusion. Opioid analgesics have potentially significant adverse effects in critically ill patients. These adverse effects include respiratory depression, raising the risk of apnea and respiratory arrest in spontaneously breathing patients.
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