A patient with bone cancer has recently undergone chemotherapy ...

[james0929]

A patient with bone cancer has recently undergone chemotherapy and radiation therapy to reduce the size of the tumor.
 
  The patient is taking a large dose of an opioid analgesic, along with acetaminophen and an antidepressant. The nursing student caring for this patient is concerned that the patient is showing drug-seeking behaviors, because the individual requested an increased dose of the opioid. The student discusses this concern with the nurse. Which statement by the student indicates a need for further teaching?
  a. It would probably help this patient more to give a larger antidepressant dose.
  b. Patients often need more drug to achieve the same effect.
  c. Radiation and chemotherapy can damage bone tissue and cause increased pain.
  d. The patient's description of pain is the most important part of the assessment of pain.

Question 2

A patient with cancer who has been receiving an opioid analgesic reports having pain at a new location even though the previous pain is well controlled. The nurse will contact the provider to discuss:
 
  a. breakthrough pain.
  b. drug-seeking behavior.
  c. infection or metastasis.
  d. tolerance to drug therapy.

[lgoldst9]

Answer to Question 1

ANS: A
Pain in cancer patients can arise both from the cancer itself and from the treatments. This patient has bone cancer, which causes somatic pain, and the treatments can increase this pain. Although neuropathic pain can occur as well, this patient is more likely to need analgesia for the nociceptive pain, so increasing the antidepressant dose is not indicated. Patients very often require more drug to achieve the same effect as tolerance develops. Radiation and chemotherapy can damage tissue and increase pain. When assessing pain in patients, the patient's own description of pain intensity is the most important.

Answer to Question 2

ANS: C
Caregivers should be alert for new pain; this usually results from a new cause, such as metastasis, infection, or fracture, and should be investigated. Breakthrough pain is pain that occurs even when adequate levels of analgesics are given. Drug-seeking behavior refers to patients who use drugs for euphoric effects instead of for intended effects. Tolerance occurs when more drug is required to receive the same effect.

[james0929]

Gracias!

[kusterl]

TYSM