The patient receives opioid analgesia with naproxen (Naprosyn) after a total abdominal hysterectomy. Which patient datum is the nurse's priority?
a. The patient has not had a bowel move-ment since surgery.
b. The patient declines a massage after anal-gesic administration.
c. Respiratory rate drops from 22 to 16 breaths/min.
d. The patient receives famotidine (Pepcid) for esophageal reflux.
D
A patient history of esophageal reflux is usually a contraindication for nonsteroidal antiinflam-matory drug (NSAID) administration because of the increased risk of bleeding from prostaglan-din inhibition. Constipation is a complication of surgery and opioid analgesia, but the nurse manages patient constipation by increasing patient ambulation and intake of fiber, fluid, and stool softeners. Declining a massage after receiving pain medication potentially indicates that the patient is satisfied with her comfort and relaxation status. Respirations at 16 breaths/min are within normal limits.
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