A patient who uses a fentanyl (Duragesic) patch for chronic ...

[JMatthes]

A patient who uses a fentanyl (Duragesic) patch for chronic abdominal pain caused by ovarian cancer asks the nurse to administer the prescribed hydrocodone (Vicodin) tablets, but the patient is asleep when the nurse returns with the medication.
 
  Which action is best for the nurse to take?
  a. Wake the patient and administer the hydrocodone.
  b. Wait until the patient wakes up and reassess the pain.
  c. Suggest the use of nondrug therapies for pain relief instead of additional opioids.
  d. Consult with the health care provider about changing the fentanyl (Duragesic) dose.

Question 2

The nurse is completing the medication reconciliation form for a patient admitted with chronic cancer pain. Which medication is of most concern to the nurse?
 
  a. Amitriptyline (Elavil) 50 mg at bedtime
  b. Ibuprofen (Advil) 800 mg 3 times daily
  c. Oxycodone (OxyContin) 80 mg twice daily
  d. Meperidine (Demerol) 25 mg every 4 hours

[bitingbit]

Answer to Question 1

ANS: A
Because patients with chronic pain frequently use withdrawal and decreased activity as coping mechanisms for pain, sleep is not an indicator that the patient is pain free. The nurse should wake the patient and administer the hydrocodone.

Answer to Question 2

ANS: D
Meperidine is contraindicated for chronic pain because it forms a metabolite that is neurotoxic and can cause seizures when used for prolonged periods. The ibuprofen, amitriptyline, and oxycodone are all appropriate medications for long-term pain management.

[JMatthes]

Thank you

[bitingbit]

No problemo