A nurse cares for an older adult client with multiple fractures. Which action should the nurse take to manage this client's pain?
a. Meperidine (Demerol) injections every 4 hours around the clock
b. Patient-controlled analgesia (PCA) pump with morphine
c. Ibuprofen (Motrin) 600 mg orally every 4 hours PRN for pain
d. Morphine 4 mg intravenous push every 2 hours PRN for pain
ANS: B
The older adult client should never be treated with meperidine because toxic metabolites can cause seizures. The client should be managed with a PCA pump to control pain best. Motrin most likely would not provide complete pain relief with multiple fractures. IV morphine PRN would not control pain as well as a pump that the client can control.
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