The nurse cares for a terminally ill patient who has 20-second ...

[KWilfred]

The nurse cares for a terminally ill patient who has 20-second periods of apnea followed by periods of deep and rapid breathing. Which action by the nurse would be most appropriate?
 
  a. Suction the patient.
  b. Administer oxygen via face mask.
  c. Place the patient in high Fowler's position.
  d. Document the respirations as Cheyne-Stokes.

Question 2

A patient with chronic pain who has been receiving morphine sulfate 20 mg IV over 24 hours is to be discharged home on oral sustained-release morphine (MS Contin), which will be administered twice a day.
 
  What dosage of MS Contin will be needed for each dose to obtain an equianalgesic dose for the patient? (Morphine sulfate 10 mg IV is equianalgesic to morphine sulfate 30 mg orally.)
  What will be an ideal response?

[ririgirl15]

Answer to Question 1

ANS: D
Cheyne-Stokes respirations are characterized by periods of apnea alternating with deep and rapid breaths. Cheyne-Stokes respirations are expected in the last days of life. There is also no need for supplemental oxygen by face mask or suctioning the patient. Raising the head of the bed slightly and/or turning the patient on the side may promote comfort. There is no need to place the patient in high Fowler's position.

Answer to Question 2

ANS:
MS Contin 30 mg/dose
Morphine sulfate 20 mg IV over 24 hours will be equianalgesic to MS Contin 60 mg in 24 hours. Since the total dose needs to be divided into two doses, each dose should be 30 mg.