Author Question: Which patient with pain should the nurse assess first? a. Patient with postoperative pain who ... (Read 112 times)

brutforce · **on:** Jun 25, 2018

Which patient with pain should the nurse assess first?

a. Patient with postoperative pain who received morphine sulfate IV 15 minutes ago
b. Patient with neuropathic pain who has a dose of hydrocodone (Lortab) scheduled now
c. Patient who received hydromorphone (Dilaudid) 1 hour ago and currently has a sedation scale of 2
d. Patient who returned from the postanesthesia care unit 2 hours ago and has a respiratory rate of 10

Question 2

The health care provider orders a patient-controlled analgesia (PCA) machine to provide pain relief for a patient with acute surgical pain who has never received opioids in the past.

Which nursing actions regarding opioid administration are appropriate at this time (select all that apply)?
a. Assess for signs that the patient is becoming addicted to the opioid.
b. Monitor for therapeutic and adverse effects of opioid administration.
c. Emphasize that the risk of some opioid side effects increases over time.
d. Teach the patient about how analgesics improve postoperative activity levels.
e. Provide instructions on decreasing opioid doses by the second postoperative day.

olivia_paige29 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: D
This patient's respiratory rate indicates possible respiratory depression. The risk for oversedation is greatest in the first 4 hours after transfer from the postanesthesia care unit. Patients should be reassessed 30 minutes after receiving IV opioids for pain. A scheduled oral mediation does not need to be administered exactly at the scheduled time. A sedation scale of 2 indicates adequate pain control from hydromorphone.

Answer to Question 2

ANS: B, D
Monitoring for pain relief and teaching the patient about how opioid use will improve postoperative outcomes are appropriate actions when administering opioids for acute pain. Although postoperative patients usually need a decreasing amount of opioids by the second postoperative day, each patient's response is individual. Tolerance may occur, but addiction to opioids will not develop in the acute postoperative period. The patient should use the opioids to achieve adequate pain control, and so the nurse should not emphasize the adverse effects.