The patient awakens at 3:00 AM requesting pain medication, but the nurse does not administer additional pain medication. What justifies the nurse's decision to withhold the medication?

Question

a. The patient had a reaction to aspirin 5 years ago.
b. The nurse wants to help the patient avoid drug addiction.
c. The patient is asleep when the nurse re-turns with analgesia.
d. The patient wants pain medication every 3 3/4 hours exactly.

Answer 1

C
The nurse receives contradictory messages about the patient's pain level because the patient is relaxed enough to fall asleep again. To avoid oversedation and complications, the nurse with-holds the medication but assesses the patient for other indicators of pain before leaving the room. The nurse promptly administers pain medication if other indicators of pain are present or when the patient awakens. Frequently nurses feel a duty to protect patients from drug addiction and to withhold pain medication when they suspect that the patient exhibits addictive behavior or asks for too much pain medication. Experts, including The Joint Commission, agree that healthcare professionals should rely on the patient's report of pain. The patient has the right to effective pain management, and the nurse is bound ethically to provide pain relief when the patient asks for it. If the patient asks for pain medication every 3 3/4 hours, he or she may be watching the clock. Many healthcare professionals describe this behavior as "drug seeking," meaning that the patient is seeking pain medication for unrelated reasons; this description labels the patient unfairly. This behavior can also indicate inadequate pain relief or the onset of a new patient health problem. For these reasons this type of patient request for pain medication warrants further investigation. To manage this situation, the nurse remembers the patient's right to pain relief and the nurse's role as patient advocate.