Key Concepts
Introduction
Opioid analgesics produce their effects primarily through mu (μ) receptor agonism in the CNS. Mu-1 receptors mediate supraspinal analgesia, while mu-2 receptors mediate respiratory depression, constipation, and physical dependence. Kappa receptors contribute to spinal analgesia and dysphoria. The nurse must understand equianalgesic dosing for opioid rotation, the multimodal analgesia approach combining opioids with non-opioid agents (acetaminophen, NSAIDs, gabapentinoids) to reduce opioid requirements, and patient-controlled analgesia (PCA) management. Opioid-induced respiratory depression remains the primary safety concern, monitored through the Pasero Opioid-Induced Sedation Scale (POSS) and continuous pulse oximetry or capnography. On the exam, writers often pair stable-sounding options with unstable data—notice the mismatch before you commit. If the stem names a license or role, reread that line; scope errors are classic trap answers even when the clinical topic is familiar. Run a 60-second scan: breathing work and oxygenation, perfusion and end organs, neuro baseline, likely infection sources, and devices that can fail quietly. When two answers feel partly right, pick the one that reduces imminent harm and matches orders for the role you were given. Train yourself to state the **primary...