An older client who was recently admitted to the subacute setting ...

[berenicecastro]

An older client who was recently admitted to the subacute setting after having a knee replace-ment is very anxious and refuses to get out of bed, stating that it is too painful. Which interven-tion will the nurse implement?
 
  a. Share with the patient that it's important to get out of bed and that there is pain medication available if it does hurt.
  b. Use the Hoyer lift to get her out of bed so that the knee will not experience much movement and so there will be little pain.
  c. Offer pain medication, administer the medication, and wait 20 minutes before getting her out of bed.
  d. Allow the patient to remain in bed, but share that getting up will be required at least twice a day starting the next morn-ing.

Question 2

The initial step to effect the safe management of mild to moderate acute pain that has not been controlled with over-the-counter medications is to:
 
  a. begin acetaminophen (Tylenol) every 4 hours for 24 hours.
  b. supplement with nonpharmacological in-terventions.
  c. administer a single low dose of short-acting opioid and monitor for relief.
  d. titrate dosage of a short-acting opioid up-ward over 24 hours to achieve relief.

[TINA]

Answer to Question 1

ANS: C
The administration of an as-needed analgesic 20 to 30 minutes before an activity may eliminate discomfort and fear of discomfort. It may also enhance the individual's capacity for the activity. It is not true that performing an activity quickly will lessen the pain or that the patient will get used to the pain. A Hoyer lift is only indicated when an individual is completely immobile. Ac-tivity is an important part of rehabilitation.

Answer to Question 2

ANS: C
If pain continues, consider a single low-dose, short-acting opioid and observe the effect. Aceta-minophen is an over-the-counter analgesic and so its effect is already determined to be ineffec-tive. Nonpharmacological interventions are only appropriate once pain management has been successfully implemented. Titrating an opioid dose upward is appropriate only after the effects of the initial dose have been determined.

[berenicecastro]

Excellent

[peter]

TYSM