A nursing student caring for a patient with cancer tells the ...

[dalyningkenk]

A nursing student caring for a patient with cancer tells the nurse that the patient seems to be exaggerating when reporting the degree of pain. Which statement by the nurse is an appropriate response to this concern?
 
  a. Evaluation of the patient's vital signs can help you tell if this patient is exaggerating.
  b. It is important to give pain medication as ordered for the degree of pain the patient reports.
  c. We may need to evaluate the patient for the development of metastasis or infection.
  d. You should monitor this patient's behavior and facial expressions for a more accurate assessment.

Question 2

A patient who is taking a fixed-dose combination drug with an opioid and acetaminophen for cancer pain reports increased muscular pain. The patient asks the nurse if the pain medication dose can be increased.
 
  What will the nurse tell this patient?
  a. An adjuvant analgesic medication will probably be used to help with this pain.
  b. An additional dose of acetaminophen can be used to enhance pain relief.
  c. Increasing the dose is possible, because there is no ceiling to opioid pain relief.
  d. The provider will prescribe separate dosing of the opioid and acetaminophen.

[smrerig]

Answer to Question 1

ANS: B
The patient's description of his or her pain is the cornerstone of assessment. Pain is a personal experience, and caregivers must act on what the patient says, even if they suspect the patient is exaggerating or not telling the truth. Evaluation of vital signs can be used to monitor responses to pain medication, as can assessments of behaviors and facial expressions, but they are not determinants of the level of pain in initial assessments. Patients with pain in new locations should be evaluated for metastases or infection or other causes.

Answer to Question 2

ANS: D
Fixed-dose combination products are not useful as pain increases, because the side effects of the nonopioid drug become intolerable as the dosage increases. As pain becomes more severe, the components of the combined regimen should be given separately. Adjuvant analgesics are used for neuropathic pain and not nociceptive pain (which this patient has described). Acetaminophen doses should not be increased. Increasing the dose of a fixed-dose combination drug is not recommended.

[dalyningkenk]

Excellent

[shailee]

Gracias!