Which of the following represents an ethical/legal issue in pain management that requires further assessment and investigation?
1. Withholding information from the supervisor that a narcotic was taken for personal use by a staff member
2. Administering a higher-than-usual dose of an opiate analgesic to a patient with malignant pain
3. Managing pain in a client with a history of narcotic addiction
4. Utilizing sedation with analgesia during the management of pain
1. Withholding information from the supervisor that a narcotic was taken for personal use
Rationale: Diverting narcotics or controlled substances for personal use is illegal and unethical. Impaired nurses should be reported to the supervisor so appropriate treatment may be given. Clients with malignant pain may develop tolerance to opiates over time and require more analgesic than the opiate-"naïve" client. Clients with narcotic addiction and abuse will still require analgesic medication if pain is present, following the stepladder approach outlined by the World Health Organization. Using sedation with analgesic medications is considered and adjunct in pain management and is acceptable practice.
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The nursing instructor is teaching a class in oncology nursing to her junior nursing students. The instructor is aware that infection is a significant consideration when providing care to an oncology patient
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