A middle-aged patient tells the nurse, My mother died 4 months ...

[humphriesbr@me.com]

A middle-aged patient tells the nurse, My mother died 4 months ago, and I just can't seem to get over it. I'm not sure it is normal to still think about her every day. Which nursing diagnosis is most appropriate?
 
  a. Hopelessness related to inability to resolve grief
  b. Complicated grieving related to unresolved issues
  c. Anxiety related to lack of knowledge about normal grieving
  d. Chronic sorrow related to ongoing distress about loss of mother

Question 2

The nurse cares for a terminally ill patient who is experiencing pain that is continuous and severe. How should the nurse schedule the administration of opioid pain medications?
 
  a. Give around-the-clock routine administration of analgesics.
  b. Provide PRN doses of medication whenever the patient requests.
  c. Offer enough pain medication to keep the patient sedated and unaware of stimuli.
  d. Suggest analgesic doses that provide pain control without decreasing respiratory rate.

[bigsis44]

Answer to Question 1

ANS: C
The patient should be reassured that grieving activities such as frequent thoughts about the deceased are considered normal for months or years after a death. The other nursing diagnoses imply that the patient's grief is unusual or pathologic, which is not the case.

Answer to Question 2

ANS: A
The principles of beneficence and nonmaleficence indicate that the goal of pain management in a terminally ill patient is adequate pain relief even if the effect of pain medications could hasten death. Administration of analgesics on a PRN basis will not provide the consistent level of analgesia the patient needs. Patients usually do not require so much pain medication that they are oversedated and unaware of stimuli. Adequate pain relief may require a dosage that will result in a decrease in respiratory rate.

[humphriesbr@me.com]

TYSM

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Excellent