The patient has morphine sulfate ordered for pain every 4 hours "prn." The patient complains of severe pain and usually requests more morphine an hour before it is due. The nurse should:

Question

(Select all that apply.)
a. Request a "placebo order" from the physician.
b. Offer the patient medication "around the clock" instead of "prn".
c. Offer the patient massage between medication doses.
d. Offer the patient a nonopioid medication between morphine doses if ordered.

Answer 1

B, C, D
Some patients exhibit drug-seeking behaviors when in fact they are seeking pain relief. Occasionally, a physician will order a placebo to discredit a patient's report of pain. This is unethical and should be avoided. Timely administration before a patient's pain becomes severe is crucial to ensure optimal relief. Pain is easier to prevent than to treat. In most circumstances, administration of pharmacological agents "around-the-clock" rather than on an "as-needed" (prn) basis is preferable. Often a combination of nonopioids and opioids is effective in managing pain. Using an integrated approach that considers both pharmacological and nonpharmacological therapies in managing pain is recommended.