An adult male patient is 1 day postoperative from a total hip ...

[sammy]

An adult male patient is 1 day postoperative from a total hip replacement. On a pain scale of 0 to 10, with 10 being the greatest pain, the patient reports a pain level of 10.
 
  Which medication would be most appropriate for the nurse to administer to this patient?
  a. 60 mg morphine sulfate PO
  b. 75 mg meperidine (Demerol) intramuscularly
  c. 6 mg morphine sulfate intravenously
  d. Fentanyl (Duragesic) patch 50 mcg transdermally

Question 2

A patient is given a prescription for azithromycin (Zithromax) and asks the nurse why the dose on the first day is twice the amount of the dose on the next 4 days. Which reply by the nurse is correct?
 
  a. A large initial dose helps to get the drug to optimal levels in the body faster.
  b. The first dose is larger to minimize the first pass effect of the liver.
  c. The four smaller doses help the body taper the amount of drug more gradually.
  d. Tubular reabsorption is faster with initial doses, so more is needed at first.

[ErinKing]

Answer to Question 1

ANS: C
The intravenous route is the fastest route of absorption and the one most appropriate for a patient in extreme pain. With the oral route, the medication would take at least 45 minutes to be effective, too long for a patient in extreme pain. With the intramuscular route, the medication would take at least 15 minutes to be effective; although faster than the oral route, this is not as fast as the intravenous route. A Duragesic patch would be the most inappropriate route because of the long drug half-life. This is a more appropriate route for long-term use.

Answer to Question 2

ANS: A
A large initial dose is often used as a loading dose to help get serum drug levels to plateau levels more quickly. Larger doses do not prevent first pass effects in drugs susceptible to this type of metabolism. Tapering of doses sometimes is used to prevent rebound or withdrawal effects and is done by stepping down the amount of drug with each dose. Tubular reabsorption is a process that allows drugs to be reabsorbed from the urine into the blood.

[sammy]

Both answers were spot on, thank you once again

[ErinKing]

Great! Please up vote