A client reports a great deal of pain following a fairly minor ...

[Capo]

A client reports a great deal of pain following a fairly minor operation. The surgeon leaves a prescription for the nurse to administer a placebo instead of pain medication. What actions by the nurse are most appropriate? (Select all that apply.)
 
  a. Consult with the prescriber and voice objections.
  b. Delegate administration of the placebo to another nurse.
  c. Give the placebo and reassess the client's pain.
  d. Notify the nurse manager of the physician's request.
  e. Tell the client what the prescriber ordered.

Question 2

A nurse on the postoperative unit administers many opioid analgesics. What actions by the nurse are best to prevent unwanted sedation as a complication of these medications? (Select all that apply.)
 
  a. Avoid using other medications that cause sedation.
  b. Delay giving medication if the client is sleeping.
  c. Give the lowest dose that produces good control.
  d. Identify clients at high risk for unwanted sedation.
  e. Use an oximeter to monitor clients receiving analgesia.

[Shshxj]

Answer to Question 1

ANS: A, D
Nurses should never give placebos to treat a client's pain (unless the client is in a research study). This practice is unethical and, in many states, illegal. The nurse should voice concerns with the prescriber and, if needed, contact the nurse manager. The nurse should not delegate giving the placebo to someone else, nor should the nurse give it. The nurse should not tell the client unless absolutely necessary (the client asks) as this will undermine the prescriber-client relationship.

Answer to Question 2

ANS: A, C, D, E
Sedation is a side effect of opioid analgesics. Some sedation can be expected, but protecting the client against unwanted and dangerous sedation is a critical nursing responsibility. The nurse should identify clients at high risk for unwanted sedation and give the lowest possible dose that produces satisfactory pain control. Avoid using other sedating medications such as antihistamines to treat itching. An oximeter can alert the nurse to a decrease in the client's oxygen saturation, which often follows sedation. A postoperative client frequently needs to be awakened for pain medication in order to avoid waking to out-of-control pain later.

[Capo]

Correct answers!

[Shshxj]

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