The hospice nurse is making a home visit to a client with terminal cancer. The client reports poor pain control, and the client's spouse says, "I'm giving such big doses of medication,
I'm afraid she is going to overdose if I give her more." Which response by the nurse is the most appropriate?
1. "You're wise to be concerned. These are very strong medications you're administering."
2. "You want her to be comfortable but you don't want to endanger her life. Let's talk about the medication you're giving and warning signs you'll see if the dosage you're administering is too high."
3. "I hear what you're saying, but you're not giving enough pain medication, so she is in severe pain. You need to give more."
4. "You aren't giving adequate pain relief, and she is in severe pain as a result."
Correct Answer: 2
It is not unusual for a family caregiver to withhold medication out of fear of overdosing the cancer client. It is important for the nurse to inform the caregiver that his feelings are not unusual, and then provide him with the information he needs to make an informed and appropriate decision that will make the client more comfortable. Telling the spouse it is wise to be concerned is untrue. The other options make the caregiver feel guilty, and do not provide him with the information he needs to perform better.
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