A 74-year-old client with a history of osteoarthritis is being ...

[karlynnae]

A 74-year-old client with a history of osteoarthritis is being treated in the hospital for pneumonia and malnutrition. The nurse administered 650 mg of acetaminophen 90 minutes ago and the client is now requesting another dose.
 
  The medication administration record has the following choices; which choice by the nurse is most appropriate?
 
  A) Normal saline 5 ml IV
  B) Acetaminophen 1,000 mg PO
  C) Morphine 5 mg IV
  D) Oxycodone 5 mg PO

Question 2

A 79-year-old woman had a total knee replacement yesterday; she has rung her call light to report pain. What consideration should the nurse prioritize when choosing an appropriate intervention?
 
  A) The fact that the woman has a documented history of persistent pain that precedes her surgery
  B) The need to ensure that the woman does not develop addiction during her course of treatment
  C) The fact that women consistently report a higher prevalence of persistent pain than men
  D) The need to provide prompt, adequate relief of the woman's pain

[Carissamariew]

Answer to Question 1

Ans: D
Limit the amount of acetaminophen to 3,000 mg per day in the client with malnutrition to avoid hepatotoxicity. Pain medication, not normal saline, should be administered. While alternative approaches to pain relief may be warranted, this does not necessarily mean that a pain-controlled analgesia (PCA) was the ideal delivery method. Step 2 of the World Health Organization pain relief ladder suggests adding an opioid. The use of stronger opioids is Step 3.

Answer to Question 2

Ans: D
The need for adequate pain control is paramount in the care of older adults. The fact that the woman has a history of persistent pain has little bearing on her present complaint and the need for relief. Addiction to analgesics is a rare development. Women do report a higher prevalence of persistent pain than men and are also undertreated for pain.

[karlynnae]

Excellent

[Joy Chen]

Gracias!