A hospitalized client has a history of depression for which ...

[Mr. Wonderful]

A hospitalized client has a history of depression for which sertraline (Zoloft) is prescribed. The client also has a morphine allergy and a history of alcoholism. After surgery, several opioid analgesics are prescribed. Which one would the nurse choose?
 
  a. Hydrocodone and acetaminophen (Lorcet)
  b. Hydromorphone (Dilaudid)
  c. Meperidine (Demerol)
  d. Tramadol (Ultram)

Question 2

A hospitalized client uses a transdermal fentanyl (Duragesic) patch for chronic pain. What action by the nurse is most important for client safety?
 
  a. Assess and record the client's pain every 4 hours.
  b. Ensure the client is eating a high-fiber diet.
  c. Monitor the client's bowel function every shift.
  d. Remove the old patch when applying the new one.

[scottmt]

Answer to Question 1

ANS: B
Hydromorphone is a good alternative to morphine for moderate to severe pain. The nurse should not choose Lorcet because it contains acetaminophen (Tylenol) and the client has a history of alcoholism. Tramadol should not be used due to the potential for interactions with the client's sertraline. Meperidine is rarely used and is often restricted.

Answer to Question 2

ANS: D
The old fentanyl patch should be removed when applying a new patch so that accidental overdose does not occur. The other actions are appropriate, but not as important for safety.

[Mr. Wonderful]

Thank you

[scottmt]

Happy to help you