A client is in the hospital with an exacerbation of a chronic pain condition. Orders are for prn morphine IV push. When the primary nurse left for the weekend, the client's pain was under control
When the nurse returns to work, the client is reporting wild swings in pain control, being oversedated at some times and having extreme pain at other times. Which action by the primary nurse would best get this client's pain under control? a. Ask the physician to order the pain medication on a round-the-clock schedule.
b. Observe the client for behaviors that might indicate possible addiction.
c. Plan to administer the maximum amount of pain medication the next time it is due.
d. Question the client about the pain to determine if he/she is exaggerating.
A
Intermittent dosing, such as seen with prn orders, causes wild swings in the blood levels of the pain medication, leaving the client overly sedated or undertreated. Nurses are typically uncom-fortable with clients who demonstrate pain behavior or who request pain medication and often give the smallest doses possible while waiting the longest amount of time between doses that is possible. The client would respond best to scheduled pain medication given around the clock without having to ask for it and wait for the nurse to prepare and administer it. Another option would be a PCA pump.
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