A patient with cancer has been taking an opioid analgesic four times daily for several months and reports needing increased doses for pain. What will the nurse tell the patient?
a. PRN dosing of the drug may be more effective.
b. The risk of respiratory depression increases over time.
c. The patient should discuss increasing the dose with the provider.
d. The patient should request the addition of a benzodiazepine to augment pain relief.
ANS: C
This patient is developing tolerance, which occurs over time and is evidenced by the need for a larger dose to produce the effect formerly produced by a smaller dose. This patient should be encouraged to request an increased dose. PRN dosing is less effective than scheduled, around-the-clock dosing. The risk of respiratory depression decreases over time as patients develop tolerance to this effect. Benzodiazepines are CNS depressants and should not be given with opioids, as they increase the risk of oversedation.
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