A patient has been experiencing severe chronic pain for 2 months. The nurse anticipates that the prescriber will order which medication, which would have a more consistent effect for the pa-tient's chronic pain?
a. Meperidine (Demerol) via patient-controlled analgesia pump
b. Morphine (morphine sulfate) given intravenously
c. Fentanyl (Duragesic) transdermal patch
d. Hydromorphone hydrochloride (Dilaudid) orally
C
Fentanyl's half-life is very long; with transdermal application, levels remain steady for 24 to 48 hours.
Demerol is not a long-acting formula because of its short half-life, and it would not be used for chronic pain.
Morphine has a very short half-life and would not be used for chronic pain.
Hydromorphone given orally is not a long-acting formulation and would not be used to manage chronic pain.
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The nurse is interviewing an overweight adolescent who looks downward and speaks softly when answering questions. The nurse identifies a problem with client's self-concept. Which finding supports the nurse's conclusion?
1. Increased desire to form lasting relationships. 2. Decreased ability to form attachments with other people. 3. Inability to maintain stable employment. 4. Feelings of worthlessness, anxiety, and/or depression.
An advanced practice nurse is preparing to assess the external genitalia of a 25-year-old American woman of Chinese descent. Which of the following nursing actions does the nurse do first?
a. Place the patient in the lithotomy position. b. Drape the patient to enhance patient comfort. c. Assess the patient's feelings and explain the purpose of the examination. d. Ask the patient if she would like her mother to be present in the room during the examination.
A layperson asks, "What is new in the area of diagnosis and treatment for the mentally ill?" The nurse should mention which two new advances in neuroscience?
1. Insulin therapy and wet packs 2. Neurogenomics and neuroimaging techniques 3. Community settings for care of depressed persons 4. Electroconvulsive shock treatments and antipsychotics medications
To maintain normal elimination patterns in a hospitalized patient, the nurse should encourage the patient to take time to defecate 1 hour after meals because:
A. the presence of food stimulates peristalsis. B. mass colonic peristalsis occurs at this time. C. irregularity helps to develop a habitual pattern. D. neglecting the urge to defecate can cause diarrhea.