The hospice nurse is making a home visit to a client with ...

[kodithompson]

The hospice nurse is making a home visit to a client with terminal cancer. The client reports poor pain control, and the client's spouse says, I'm giving such big doses of medication,
 
  I'm afraid she is going to overdose if I give her more. Which response by the nurse is the most appropriate?
  1. You're wise to be concerned. These are very strong medications you're administering.
  2. You want her to be comfortable but you don't want to endanger her life. Let's talk about the medication you're giving and warning signs you'll see if the dosage you're administering is too high.
  3. I hear what you're saying, but you're not giving enough pain medication, so she is in severe pain. You need to give more.
  4. You aren't giving adequate pain relief, and she is in severe pain as a result.

Question 2

The nurse working in a surgical center is caring for a client who had an abdominal nevus removed. The client is complaining of intense pain. Which action by the nurse is the most appropriate?
 
  1. Administer a nonnarcotic analgesic because the client had minor surgery.
  2. Attempt to divert the client without administering an analgesic because the surgery was so minor.
  3. Administer the stronger analgesic ordered by the primary care provider.
  4. Notify the health care provider that the client's pain is excessive for the minor surgery performed.

[cadimas]

Answer to Question 1

Correct Answer: 2

It is not unusual for a family caregiver to withhold medication out of fear of overdosing the cancer client. It is important for the nurse to inform the caregiver that his feelings are not unusual, and then provide him with the information he needs to make an informed and appropriate decision that will make the client more comfortable. Telling the spouse it is wise to be concerned is untrue. The other options make the caregiver feel guilty, and do not provide him with the information he needs to perform better.

Answer to Question 2

Correct Answer: 3

Pain perception is what the client says it is, and the nurse should medicate the client based on the client's description of the pain, not what the nurse anticipates. If the client reports severe pain, the nurse should administer strong analgesics. Clients who have minor surgery can still experience severe pain, and administering weaker analgesics when the client reports severe pain would not be responsible practice. Diverting the client most likely will not be effective alone, although diversion might be possible after administering the analgesic. There is no need to notify the health care provider unless the nurse's assessment indicates there is something unusual occurring.

[kodithompson]

TYSM

[ktidd]

Gracias!