The nurse caring for a terminally ill client with liver cancer ...

[Charlie]

The nurse caring for a terminally ill client with liver cancer understands which of the following goals would be most appropriate?
 
  1. Increasingly administer narcotics to oversedate the client and thereby decrease the pain.
  2. Continue to change the analgesics until the right narcotic is found that completely alleviates the pain.
  3. Adapt the analgesics as the nursing assessment reveals the need for specific med-ications.
  4. Withhold analgesics because they are not being effective in relieving discomfort.

Question 2

The nurse knows that a PCA pump would be most appropriate for the client who:
 
  1. Has psychogenic discomfort
  2. Is recovering after a total hip replacement
  3. Experiences renal dysfunction
  4. Recently experienced a cerebrovascular accident (stroke)

[kswal303]

Answer to Question 1

ANS: 3
The best choice of treatment often changes as the client's condition and the characteristics of pain change. It is realistic to expect that a terminally ill client's need for pain medication will change over time with disease progression. The goal is not to oversedate the client but to provide pain control without excessive sedation. It would be unrealistic to expect that the pain of termi-nal cancer will be completely alleviated. Analgesics should not be withheld, because this would only increase the client's level of pain. The medication regimen may need to be adapted to meet the client's needs.

Answer to Question 2

ANS: 2
Patient-controlled analgesia is a safe method for postoperative pain management, such as the cli-ent recovering from total hip replacement surgery. PCA would not be the mode of choice for treating psychogenic pain or for the client with renal dysfunction. The client with renal impair-ment would be at increased risk for drug toxicity because of decreased drug excretion. Clients must be able to understand the use of the equipment and be physically able to locate and press the button to deliver the dose. The client who recently experienced a cerebrovascular accident may have difficulty managing the PCA system.

[Charlie]

Excellent

[cpetit11]

TYSM