The 17-month-old toddler, diagnosed with terminal cancer, is ...

[Bob-Dole]

The 17-month-old toddler, diagnosed with terminal cancer, is experiencing constant pain. Which prescription does the nurse anticipate from the healthcare provider for this toddler?
 
  1. Patient-controlled analgesia (PCA) with the parents controlling the button that administers the dosage
  2. Intravenously administered opioids on a scheduled basis
  3. Intravenously administered opioids on a prn basis
  4. Orally administered opioids on a prn basis

Question 2

During shift report, the night nurse reports that a terminally ill child has developed tolerance to the prescribed morphine. Which concept should the nurse use when planning care for this child?
 
  1. The child is physically dependent on morphine.
  2. The child is addicted to morphine.
  3. The child is showing physical signs of withdrawal.
  4. The child will need more medication to achieve the same effect.

[nickk12214]

Answer to Question 1

2
Explanation:
1. PCA should always be controlled by the individual receiving the medication. It is inappropriate to have the parents control the medication administration.
2. This provides continuous blood levels of the opioid.
3. By waiting until symptoms are present, the child's blood level will drop, making it more difficult to control the pain.
4. Parenteral administration controls pain more effectively than oral medication as oral absorption may be modified by stomach activities. In addition, providing analgesics on a scheduled basis is preferred over prn.

Answer to Question 2

4
Explanation:
1. While the child may be physically dependent, this is not the meaning of tolerance.
2. Addiction refers to a compulsive use of a substance despite harm. This is not the definition of tolerance.
3. Withdrawal occurs when the opioid is stopped suddenly. This is not the meaning of tolerance.
4. Tolerance occurs when the body has become accustomed to the presence of the drug in the system. When this happens, the child will need more of a drug or a stronger drug to get the same effect.