The nurse is caring for a cancer patient with ongoing pain from ...

[cdr_15]

The nurse is caring for a cancer patient with ongoing pain from widespread metastasis to her bones. The nurse notes that the patient's morphine dosage had to be increased to sufficiently manage her discomfort.
 
  What is the nurse's interpretation of this assessment finding?
  a.
  The patient became tolerant to the previous morphine dosage.
  b.
  The patient is becoming addicted to her pain medication.
  c.
  The patient has been abusing her prescribed pain medications.
  d.
  The patient is seeking to end her life with an overdose of morphine.

Question 2

The nurse is caring for a patient who is recovering from thoracotomy surgery. The patient's respirations are regular but very shallow. Which intervention is the highest priority for the nurse to include in the patient's care plan for the diagnosis:
 
  Ineffective breathing pattern r/t fatigue and pain?
  a.
  Encourage the patient to use incentive spirometer after administration of pain medication.
  b.
  Ask the patient to describe prior pain experiences and effectiveness of methods used to manage pain.
  c.
  Help the patient to understand that comfort is a priority goal of nursing care in the postoperative period.
  d.
  Assist the patient to minimize the effects of pain on interpersonal relationships with family members.

[gcook]

Answer to Question 1

ANS: A
The patient is requiring higher doses of narcotic pain medication because her body has become tolerant to the medication. This is common when patients require long-term pain medication. Since the patient is taking morphine to control ongoing pain, the patient is not addicted to it. Need for increased morphine dosage is not indicative of drug abuse or a wish to end her life.

Answer to Question 2

ANS: A
The highest priority intervention for the ineffective breathing pattern diagnosis is to have the patient use the incentive spirometer after pain medication has been given. The spirometer will encourage the patient to take needed deep breaths, and pain medication will make it less painful for the patient to do so. The other interventions do not address breathing pattern.