The nurse receives an order for morphine sulfate 8 mg IV every 1 hour as needed for pain. For which patient would the nurse need to question this order?
A) A 78-year-old with osteoarthritis
B) A 45-year-old, 1-day postoperative mastectomy
C) A 28-year-old with a fractured tibia
D) A 17-year-old, 1-day postoperative appendectomy
A
Feedback:
Older patients are more likely to experience the adverse effects associated with narcotics, including central nervous system, gastrointestinal, and cardiovascular effects. Furthermore, a strong narcotic analgesic would not be indicated for chronic osteoarthritis pain. For both of these reasons, the nurse would question the large dosage of a narcotic. The other patients could appropriately receive morphine 8 mg unless they were smaller than average adults.
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A client is taking Saint John's wort and an SSRI. The nurse observes the client for which symptoms? (Select all that apply.)
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The local high school offers a course for teens on firearm safety that addresses many issues about the proper use of firearms. This course is:
a. Inappropriate because teens have little use for firearms b. Inappropriate because it encourages the use of guns among gangs c. Appropriate because teens often feel that they are indestructible d. Appropriate because many teens carry guns in their cars
To make clinical decisions nurses use various sources of knowledge such as trial and error, tradition, authority, and clinical experience. What problems can results from this approach?
1. Not all sources of information are reliable. 2. Authority always leads to faulty decision making. 3. Experience is the best source of knowledge. 4. Trial and error has lead to poor outcomes.