A patient who has fibromyalgia tells the nurse, I feel depressed ...

[saliriagwu]

A patient who has fibromyalgia tells the nurse, I feel depressed because I ache too much to play golf. The patient says the pain is usually at a level 7 (0 to 10 scale).
 
  Which patient goal has the highest priority when the nurse is developing the treatment plan?
  a. The patient will exhibit fewer signs of depression.
  b. The patient will say that the aching has decreased.
  c. The patient will state that pain is at a level 2 of 10.
  d. The patient will be able to play 1 to 2 rounds of golf.

Question 2

A patient who has just started taking sustained-release morphine sulfate (MS Contin) for chronic arthritic joint pain following a traumatic injury complains of nausea and abdominal fullness. Which action should the nurse take initially?
 
  a. Administer the ordered antiemetic medication.
  b. Tell the patient that the nausea will subside in about a week.
  c. Order the patient a clear liquid diet until the nausea decreases.
  d. Consult with the health care provider about using a different opioid.

[dmurph1496]

Answer to Question 1

ANS: D
For chronic pain, patients are encouraged to set functional goals such as being able to perform daily activities and hobbies. The patient has identified playing golf as the desired activity, so a pain level of 2 of 10 or a decrease in aching would be less useful in evaluating successful treatment. The nurse should also assess for depression, but the patient has identified the depression as being due to the inability to play golf, so the goal of being able to play 1 or 2 rounds of golf is the most appropriate.

Answer to Question 2

ANS: A
Nausea is frequently experienced with the initiation of opioid therapy, and antiemetics usually are prescribed to treat this expected side effect. There is no indication that a different opioid is needed, although if the nausea persists, the health care provider may order a change of opioid. Although tolerance develops and the nausea will subside in about a week, it is not appropriate to allow the patient to continue to be nauseated. A clear liquid diet may decrease the nausea, but the best choice would be to administer the antiemetic medication and allow the patient to eat.

[saliriagwu]

Excellent

[T4T]

Gracias!