An older patient with a history of constipation is prescribed an ...

[dejastew]

An older patient with a history of constipation is prescribed an opioid analgesic for postoperative pain.
 
  What should the nurse include in this patient's plan of care to avoid the pain management complication of constipation? Standard Text: Select all that apply. 1. Mix psyllium in 4 ounces of water.
  2. Provide stool softeners as prescribed.
  3. Monitor for adequate daily fluid intake.
  4. Increase ingestion of fresh fruit each day.
  5. Offer senna tea each evening before sleep.

Question 2

An older patient recovering from surgery is prescribed morphine sulfate 2 to 6 mg every 4 hours prn for pain. What approach will the nurse take to manage this patient's pain?
 
  1. Administer the lowest dose of 2 mg.
  2. Administer the highest dose of 6 mg.
  3. Avoid the narcotic for risk of addiction.
  4. Administer the dose only when the patient asks for the medication.

[frankwu0507]

Answer to Question 1

2,3,4,5
Rationale: A prophylactic bowel regimen must be initiated when opioid analgesics are utilized. Bulking agents such as psyllium should be avoided to prevent fecal impaction.

Answer to Question 2

1
Rationale: Older patients usually have more sensitivity to opioid analgesics, and most often these patients are started on smaller doses to avoid toxicity. The dose is then titrated upward until effective pain relief is achieved without adverse effects.