The nurse is performing an admission assessment on an adolescent ...

[swpotter12]

The nurse is performing an admission assessment on an adolescent who reports taking extra-strength acetaminophen (Tylenol) regularly to treat daily headaches. The nurse will notify the patient's provider and discuss an order for
 
  a. a selective serotonin receptor agonist (SSRA).
  b. hydrocodone with acetaminophen for headache pain.
  c. liver enzyme tests.
  d. serum glucose testing.

Question 2

The nurse is caring for a postoperative older patient who received PO hydrocodone with acetaminophen (Lortab) 45 minutes prior after reporting a pain level of 8 on a scale of 1 to 10.
 
  The patient reports a pain level of 4, and the nurse notes a respiratory rate of 20 breaths per minute, a heart rate of 92 beats per minute, and a blood pressure of 170/95 mm Hg. Which action will the nurse take?
  a. Contact the provider and request an order for a more potent opioid analgesic.
  b. Reassess the patient in 30 minutes.
  c. Request an order for ibuprofen to augment the opioid analgesic.
  d. Suggest that the patient use nonpharmacologic measures to relieve pain.

[shoemake]

Answer to Question 1

ANS: C
Large doses or overdoses of acetaminophen can be toxic to hepatic cells, so when large doses are administered over a long period, liver function should be assessed. Daily headaches are not typical of migraine headaches, so SSRA medication is not indicated. Hydrocodone with acetaminophen is not indicated without further evaluation of headaches. Serum glucose is not indicated.

Answer to Question 2

ANS: A
Even though the patient reports decreased pain, the patient's vital signs indicate continued discomfort. The nurse should contact the provider to request a stronger analgesic. The pain medication should have been effective within 30 minutes. Ibuprofen is used for musculoskeletal pain. Nonpharmacologic measures may be useful, but the patient still needs a stronger analgesic.

[swpotter12]

TY

[shoemake]

You're welcome