An older aphasic patient has severe osteoarthritis, bilateral ...

[sarasara]

An older aphasic patient has severe osteoarthritis, bilateral contractures of the lower extremities, and a stage IV pressure ulcer. The nurse practitioner prescribes analgesic medi-cations to be administered around-the-clock, with as-needed doses to be ad
 
  to be administered as appropriate. What observation by the nurse would indicate that the pain regimen is effective? Select all that apply.
  a. Pa-tient slept throughout the night.
  b. Pa-tient winces only when turned and repositioned.
  c. Pa-tient slept during dressing change.
  d. Pa-tient compliant with attempts to provide AM care.
  e. Pa-tient ate 80 of breakfast, 70 of lunch and 100 of dinner

Question 2

An older patient who was recently admitted to the subacute setting after having a knee replacement, is very anxious and refuses to get out of bed, stating that it is too painful. Which intervention 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 move-ment 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 morning.

[kjohnson]

Answer to Question 1

ANS: A, C, D, E
Pain cues presented by this client is the wincing when being turned, indicating that this in-tervention is pain producing. The remaining observations are concurrent with effective pain management.

Answer to Question 2

ANS: C
Administration of an as-needed analgesic 20 to 30 minutes before activity may eliminate discomfort and fear of discomfort, and may 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. Activity is an important part of rehabilitation.

[sarasara]

TYSM

[lkanara2]

Excellent