An older client had hip replacement surgery and the surgeon ...

[amal]

An older client had hip replacement surgery and the surgeon prescribed morphine sulfate for pain. The client is allergic to morphine and reports pain and muscle spasms. When the nurse calls the surgeon,
 
  which medication should he or she suggest in place of the morphine?
  a.
  Cyclobenzaprine (Flexeril)
  b.
  Hydromorphone hydrochloride (Dilaudid)
  c.
  Ketorolac (Toradol)
  d.
  Meperidine (Demerol)

Question 2

An older adult client is in the hospital. The client is ambulatory and independent. What intervention by the nurse would be most helpful in preventing falls in this client?
 
  a. Keep the light on in the bathroom at night.
  b. Order a bedside commode for the client.
  c. Put the client on a toileting schedule.
  d. Use siderails to keep the client in bed.

[Danny Ewald]

Answer to Question 1

ANS: B
Cyclobenzaprine (used for muscle spasms), ketorolac, and meperidine (both used for pain) are all on the Beers list of potentially inappropriate medications for use in older adults and should not be suggested. The nurse should suggest hydromorphone hydrochloride.

Answer to Question 2

ANS: A
Although this older adult is independent and ambulatory, being hospitalized can create confusion. Getting up in a dark, unfamiliar environment can contribute to falls. Keeping the light on in the bathroom will help reduce the likelihood of falling. The client does not need a commode or a toileting schedule. Siderails used to keep the client in bed are considered restraints and should not be used in that fashion.

[amal]

Thanks for the timely response, appreciate it

[bulacsom]

TYSM