A postoperative client is reluctant to participate in physical ...

[Cooldude101]

A postoperative client is reluctant to participate in physical therapy. What action by the nurse is best?
 
  a. Ask the client about pain goals and if they are being met.
  b. Ask the client why he or she is being uncooperative with therapy.
  c. Increase the dose of analgesia given prior to therapy sessions.
  d. Tell the client that physical therapy is required to regain function.

Question 2

A nurse is caring for four clients receiving pain medication. After the hand-off report, which client should the nurse see first?
 
  a. Client who is crying and agitated
  b. Client with a heart rate of 104 beats/min
  c. Client with a Pasero Scale score of 4
  d. Client with a verbal pain report of 9

[Sammyo]

Answer to Question 1

ANS: A
A comprehensive pain management plan includes the client's goals for pain control. Adequate pain control is necessary to allow full participation in therapy. The first thing the nurse should do is to ask about the client's pain goals and if they are being met. If not, an adjustment to treatment can be made. If they are being met, the nurse can assess for other factors influencing the client's behavior. Asking the client why he or she is being uncooperative is not the best response for two reasons. First, why questions tend to put people on the defensive. Second, labeling the behavior is inappropriate. Simply increasing the pain medication may not be advantageous. Simply telling the client that physical therapy is required does not address the issue.

Answer to Question 2

ANS: C
The Pasero Opioid-Induced Sedation Scale has scores ranging from S to 1 to 4. A score of 4 indicates unacceptable somnolence and is an emergency. The nurse should see this client first. The nurse can delegate visiting with the crying client to a nursing assistant; the client may be upset and might benefit from talking or a comforting presence. The client whose pain score is 9 needs to be seen next, or the nurse can delegate this assessment to another nurse while working with the priority client. A heart rate of 104 beats/min is slightly above normal, and that client can be seen after the other two clients are cared for.