The nurse is caring for a patient with prostate cancer with metastasis to S-1 and the adjacent nerve root. The patient complains of unrelenting pain
When collaborating with the provider, the nurse would advocate for which example of balanced analgesia? 1. Use escalating doses of an opioid analgesic per the third step of the World Health Organization (WHO) analgesic ladder.
2. Use an opioid around the clock rather than on an as-needed (prn) basis.
3. Begin with the first step of the analgesic ladder as described by the World Health Organization (WHO), and then evaluate the client's response.
4. Use an opioid for background pain and gabapentin (Neurontin) for the neuropathic pain.
4
Rationale 1: Using escalating doses of an opioid does not address balanced analgesia.
Rationale 2: The use of around-the-clock medication over prn is appropriate; however, it does not address balanced analgesia.
Rationale 3: The step approach, in which the provider begins at the lowest step and moves through each step to reach the top, is not necessary, nor does it address balanced analgesia.
Rationale 4: Balanced analgesia or multimodal analgesia facilitates improved analgesia that is not possible with a single medication; various medications and adjunctive therapies are used to target specific types of pain and provide optimal relief in a safe manner.
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A male client with infertility has tremors and yellow sclera. What additional finding should the nurse assess in this client?
1. Deepened voice 2. Shrinking testicles 3. Excess hair growth 4. Poor skin turgor
A mother asks the nurse if there is a treatment of choice for both lice and scabies in persons over two years of age. The nurse's best response is:
a. "Yes, its name is lindane." b. "Yes, its name is trypsin." c. "No, each condition requires a separate medication." d. "Gentamicin can be used for both, but requires a prescription."