A client experiencing chronic pain has been admitted to the unit for increasing pain. The client is currently taking acetaminophen every 4-6 hours, and reports pain of 6 on a 1-10 scale with 1 being the least pain
The nurse anticipates that the physician will order which of the following for this client based on the World Health Organization ladder approach? 1. Ibuprofen
2. Acetaminophen plus an opioid
3. An opioid
4. Acetaminophen plus ibuprofen
3
Rationale: The client was taking the first step in the WHO three-step ladder for pain, which is a nonopioid analgesic. If pain continues, the second tier is to add an opioid for mild-to-moderate pain in addition to the nonopioid medication and re-evaluate the client's level of pain. Changing to a different nonopioid drug such as ibuprofen is not likely to relieve the client's pain. Giving two nonopioids is not recommended, as the two drugs together could cause liver damage, and will not significantly treat the client's pain.
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