The nurse is caring for an older adult patient diagnosed with ...

[lak]

The nurse is caring for an older adult patient diagnosed with diverticulitis. Which medication is the best choice to manage the patient's pain?
 
  a. Meperidine (Demerol)
  b. Morphine
  c. Nalbuphine hydrochloride (Nubain)
  d. Naloxone (Narcan)

Question 2

A 36-year-old woman who had an ascending colostomy angrily declares, I don't want this hateful thing on my body This nasty thing is not me. Which response is most appropriate for the nurse to make?
 
  a. The colostomy is part of you now.
  b. Let me change the collection bag so you don't stay nasty.
  c. All ostomates feel this way at first. I'll go get a list of support groups you may want to join.
  d. What about this colostomy concerns you the most?

[ansleighelindsey]

Answer to Question 1

B
Morphine is acceptable for pain management and has fewer side effects than meperidine (De-merol). In earlier recommendations, Demerol was the drug of choice based on a theoretical risk not shown in studies. A metabolite of meperidine (Demerol) is toxic, and the older adult has dif-ficulty metabolizing and eliminating it. The buildup of the toxin in the blood can cause seizures and other mental status changes such as acute confusion. Ask for an alternate analgesic for these patients.

Answer to Question 2

D
Asking the patient to name the specific concerns helps to conceptualize where the adjustment problem lies. All other options negate the patient's feelings, reinforce the patient's negative feel-ings, and do not offer any therapeutic response.