A client who has neuropathy of the lower extremities is ...

[crobinson2013]

A client who has neuropathy of the lower extremities is prescribed an opioid analgesic for pain. The provider adds a tricyclic antidepressant medication (TCA) for pain management. The client asks the nurse, Why am I getting this new drug?
 
  I am not depressed, my feet just burn. What is the best response from the nurse?
  1. This drug will also help with the nerve pain you are having in your feet.
  2. It is to help you sleep at night instead of using the opioid.
  3. Sometimes people get depressed with chronic pain.
  4. Maybe this is a mistake, if you are not depressed.

Question 2

The nurse is interviewing the client before minor surgery. The client is worried about pain management: I have a history of addiction; I have to be careful what I get for pain. What is the best response from the nurse?
 
  1. Maybe you should put off having surgery until you don't have the urge to abuse drugs.
  2. We will have to use only complementary therapies for you. I am afraid you may still have some pain.
  3. We can use nonopioid drugs, which have a very low risk of dependency.
  4. How long have you been drug-free? If it has been more than two years, we can use opioids.

[FergA]

Answer to Question 1

Correct Answer: 1
Rationale 1: TCAs are often added as an adjuvant medication in neuropathic pain management, as with this client.
Rationale 2: While a benefit of TCA administration is that the client often sleeps better at night, this is not the reason the drug is being added to this client's regimen.
Rationale 3: Although clients might become depressed with chronic pain, the TCA is used for neuropathic pain management.
Rationale 4: In this case the purpose of the antidepressant does not involve depression.
Global Rationale: TCAs are often added as an adjuvant medication in neuropathic pain management, as with this client. While a benefit of TCA administration is that the client often sleeps better at night, this is not the reason the drug is being added to this client's regimen. Although clients might become depressed with chronic pain, the TCA is used for neuropathic pain management. In this case the purpose of the antidepressant does not involve depression.

Answer to Question 2

Correct Answer: 3
Rationale 1: This does not address the client's need for pain management. Nonopioid drugs have a low risk of dependency, and are ideal for this client.
Rationale 2: Complementary therapies might not completely relieve pain. This client certainly can also use nonopioid drugs with a low dependency risk.
Rationale 3: Nonopioid analgesics have a very low rate of dependency, and might be the ideal drug choice for this client.
Rationale 4: Clients with a history of addiction do not have a time period when they are not at risk again for addiction.
Global Rationale: Nonopioid analgesics have a very low rate of dependency, and might be the ideal drug choice for this client. There is no reason to postpone the surgery as nonopioid drugs have a low risk of dependency, and are ideal for this client. Complementary therapies might not completely relieve pain. This client certainly can also use nonopioid drugs with a low dependency risk. Clients with a history of addiction do not have a time period when they are not at risk again for addiction.

[crobinson2013]

Both answers were spot on, thank you once again

[FergA]

Great! Please up vote