The patient has advanced cancer and is experiencing pain. How ...

[haleyc112]

The patient has advanced cancer and is experiencing pain. How should the nurse plan to manage this pain? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply.
 
  1. Monitor for subtle signs of pain.
  2. Set up a dosing schedule that provides for around-the-clock doses.
  3. Encourage the patient to wait 10 minutes after pain medication is required to ask for a dose.
  4. Augment the patient's regimen with other pharmaceutical and nonpharmaceutical pain relief measures for breakthrough pain.
  5. Counsel the patient that it is not possible to eliminate all the pain of cancer and that some must be tolerated.

Question 2

A woman brings her husband to the emergency department and tells the nurse that her husband just had a stroke. The physician verifies a thrombotic stroke occurred and plans to use alteplase (Activase). What priority assessment question will the nurse ask the wife?
 
  1. What other medications does your husband take?
  2. Does your husband have hypertension?
  3. What other medical illnesses does your husband have?
  4. What time did your husband have the stroke?

[meltdown117]

Answer to Question 1

1,2,4
Rationale 1: Subtle signs of pain such as hesitancy to move and grimacing may occur and should be recognized.
Rationale 2: Often the problem in controlling pain of any type is that the patient gets behind the pain rather than medicating for it before it gets severe. Around-the-clock dosing helps to prevent playing catch-up to the pain.
Rationale 3: This plan would allow the pain to worsen before medication is given and would result in the patient getting behind the pain.
Rationale 4: Breakthrough pain is expected and may require additional pharmaceutical or nonpharmaceutical measures.
Rationale 5: While it is true that some cancer patients develop intractable pain, many are able to control pain to a level that is very tolerable.
Global Rationale: Subtle signs of pain such as hesitancy to move and grimacing may occur and should be recognized. Often the problem in controlling pain of any type is that the patient gets behind the pain rather than medicating for it before it gets severe. Around-the-clock dosing helps to prevent playing catch-up to the pain. Breakthrough pain is expected and may require additional pharmaceutical or nonpharmaceutical measures. While it is true that some cancer patients develop intractable pain, many are able to control pain to a level that is very tolerable.

Answer to Question 2

4
Rationale 1: Asking about medications is a good question but is not the priority.
Rationale 2: Asking about hypertension is a good question but is not the priority.
Rationale 3: Asking about illnesses is a good question but is not the priority.
Rationale 4: Alteplase (Activase) must be given within 3 hours of a thrombotic stroke for maximum effectiveness.
Global Rationale: Alteplase (Activase) must be given within 3 hours of a thrombotic stroke for maximum effectiveness. Asking about hypertension is a good question but is not the priority. Asking about medications is a good question but is not the priority. Asking about illnesses is a good question but is not the priority.

[haleyc112]

TYSM

[Kedrick2014]

Excellent