What side effects should a nurse monitor for in patients with an opioid epidural catheter?

What side effects should a nurse monitor for in patients with an opioid epidural catheter?

• A. Urinary retention, nausea, itching.
• B. Diarrhea, constipation, dry mouth.
• C. Headache, dizziness, tachycardia.
• D. Hypotension, weight gain, coughing.

Answer: (A)

Opioids given through an epidural catheter commonly produce urinary retention, nausea, and itching. The epidural opioid can decrease bladder contractility and alter sensation, so the patient may have trouble voiding and may need bladder assessment or intermittent catheterization if indicated. Nausea results from the opioid’s central nervous system effects, so watch for vomiting or queasiness and treat with antiemetics as ordered. Itching occurs with central opioid receptor stimulation and is a frequent, uncomfortable side effect of neuraxial opioids, so monitor intensity and manage comfort, sometimes with dose adjustments or antipruritics. While other symptoms can occur in neuraxial anesthesia or with systemic opioids, these three are the most characteristic and important to monitor for patients with an opioid epidural catheter. Remember to also assess respiratory status, as respiratory depression is a serious risk with neuraxial opioids.

Opioids given through an epidural catheter commonly produce urinary retention, nausea, and itching. The epidural opioid can decrease bladder contractility and alter sensation, so the patient may have trouble voiding and may need bladder assessment or intermittent catheterization if indicated. Nausea results from the opioid’s central nervous system effects, so watch for vomiting or queasiness and treat with antiemetics as ordered. Itching occurs with central opioid receptor stimulation and is a frequent, uncomfortable side effect of neuraxial opioids, so monitor intensity and manage comfort, sometimes with dose adjustments or antipruritics. While other symptoms can occur in neuraxial anesthesia or with systemic opioids, these three are the most characteristic and important to monitor for patients with an opioid epidural catheter. Remember to also assess respiratory status, as respiratory depression is a serious risk with neuraxial opioids.