Which of the following treatments would be most appropriate for the patient with postoperative adynamic ileus?

Correct Answer: C

Rationale: In the case of a patient with postoperative adynamic ileus, the most appropriate treatment option among the given choices is C) Tramadol PO, twice daily. Tramadol is a centrally acting analgesic that can help manage pain without significantly affecting gastrointestinal motility, making it suitable for a patient with adynamic ileus which is characterized by decreased bowel motility. Option A) Naproxen orally once daily is a nonsteroidal anti-inflammatory drug (NSAID) that can potentially worsen gastrointestinal motility issues and should be avoided in this case. Option B) Morphine intramuscularly as needed and option D) Fentanyl intramuscularly as needed are both opioids that can further slow down bowel motility, exacerbating the condition of adynamic ileus. Educationally, this question highlights the importance of considering the effects of different medications on specific conditions like adynamic ileus. It reinforces the need for healthcare providers to select medications that will not worsen the existing gastrointestinal motility issues in postoperative patients. Understanding the pharmacological properties of drugs and their effects on different body systems is crucial for safe and effective patient care.

Correct Answer: D

Rationale: Naloxone is commonly used in detoxification programs to discourage the intravenous abuse of opioids like buprenorphine. By adding naloxone to the buprenorphine/naloxone combination, it can help deter individuals from misusing the medication by injection. This combination is often used to prevent the euphoric effects of opioids if injected, making naloxone a suitable choice for this purpose.

Correct Answer: A

Rationale: Fentanyl is a potent opioid analgesic that is often used for severe pain, including cancer-related pain. In this case, the patient's pain was initially relieved by ibuprofen but later required a stronger analgesic due to increasing pain intensity. Fentanyl's conversion to morphine in the body makes it a likely choice for managing the patient's continuous but moderate bone pain.

Correct Answer: C

Rationale: The symptoms described in the patient, such as nystagmus, difficulty concentrating, and a pounding heart, suggest overstimulation of the central nervous system. A Glutamate receptor antagonist would help counteract this overstimulation by blocking the excitatory effects of glutamate, providing immediate relief to the patient.

Correct Answer: D

Rationale: Naltrexone, an opiate receptor antagonist, was likely administered to the patient to facilitate avoidance from ethanol dependence, as research suggests that compulsive alcohol drinking is influenced by opiate receptor activity. Naltrexone helps reduce the rewarding effects of alcohol, making it easier for the patient to abstain from drinking.