Author Question: A patient with chronic back pain has been taking oral morphine sulfate (MS Contin) for the past 2 ... (Read 54 times)

dalyningkenk · **on:** Jul 24, 2018

A patient with chronic back pain has been taking oral morphine sulfate (MS Contin) for the past 2 years. Upon admission to the hospital, the patient receives morphine sulfate for back pain but reports no pain relief.

The nurse notifies the health care provider, recognizing that the reason for the lack of pain relief is which of the following? a. Side effect of the morphine
b. Drug dependence
c. Idiosyncratic response to the morphine
d. Medication tolerance

Question 2

The nurse is caring for a patient who requires assistance with eating. The patient repeatedly apologizes to the nurse, saying, I'm so sorry. I'm like a baby. I'm such a burden since I can't even feed myself.

What is the most appropriate strategy for the nurse to use? a. Feed all of the solid foods first, and then offer liquids.
b. Feed the patient quickly so as not to make the patient feel like it is taking a great deal of time out of the nurse's day.
c. Minimize conversation so that the patient can eat faster.
d. Appear unhurried, sit at the bedside, and encourage the patient to feed himself/herself as much as possible.

jesse.fleming · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

D
Medication tolerance is a decreased physiological response that occurs after repeated administration of a medication. Side effects are predictable and often unavoidable secondary effects produced at a usual therapeutic drug dose. Drug dependence can be physical or psychological. In psychological dependence, patients have an emotional desire for a drug to maintain an effect. A person believes that a desirable effect will result when taking the medication. Physical dependence is a physiological adaptation to a medication that manifests itself by intense physical disturbance when the medication is withdrawn. Medications often cause unpredictable effects, such as an idiosyncratic reaction, in which a patient overreacts or underreacts to a medication or has a reaction that is different from normal.

Answer to Question 2

D
Meals should be a pleasant event for the patient. Conversation promotes socialization. Adults who need help to eat need compassion and understanding. Given the importance of nutrition in the healing process the nurse should use common sense to provide a socially meaningful mealtime. Feeding the patient quickly is likely to accentuate his belief that he is a burden. It is best to offer fluids after every 3 or 4 bites of solid food, or whenever the patient requests a drink.