The nurse is caring for a patient with severe chronic pain. The ...

[Jramos095]

The nurse is caring for a patient with severe chronic pain. The nurse applied the first 50 mcg transdermal fentanyl (Duragesic) patch 2 hours ago. The patient states that the pain is presently rated at 9 on a 1-10 scale. What is the nurse's best action?
 
  a. Instruct the patient that the Duragesic patch will start to work soon.
  b. Administer a short-acting narcotic medication like morphine liquid (Roxanol).
  c. Give the patient a gentle back rub and encourage guided imagery.
  d. Apply a second 25-mcg transdermal fentanyl (Duragesic) patch now.

Question 2

The nurse is caring for a patient who is recovering from knee replacement surgery. The patient complains of severe pain in the knee after receiving hydrocodone with acetaminophen (Vicodin) 2 hours previously. What is the nurse's best action?
 
  a. Administer another dose of Vicodin.
  b. Apply ice packs to the knee.
  c. Apply heat packs to the knee.
  d. Perform gentle range of motion.

[bulacsom]

Answer to Question 1

ANS: B
Transdermal administration of medication does not become effective for 12 to 16 hours after application. Short-acting narcotic medication like Roxanol morphine liquid should be given in the meantime to make the patient comfortable.

Answer to Question 2

ANS: B
Application of ice packs will help reduce swelling and pain that was not relieved with the patient's pain medication. The nurse should not administer another dose of Vicodin without an order from the physician. Heat will increase blood flow to the area rather than reduce swelling. Gentle ROM will increase pain if done at this time.

[Jramos095]

Gracias!

[ghepp]

TYSM