A patient with cancer is admitted to the hospital. The nurse obtains an admission history and learns that the patient has been taking oxycodone and a nonsteroidal anti-inflammatory drug (NSAID) for a year
The patient reports a recent increase in the intensity of pain, along with a new pain described as "burning" and "shooting." The nurse anticipates that the prescriber will order:
a. a combination opioid/NSAID and an adjunctive analgesic.
b. a fentanyl transdermal patch, acetaminophen, and an adjunctive analgesic.
c. an increase in the oxycodone and NSAID doses.
d. intramuscular morphine sulfate and acetaminophen.
ANS: B
As pain increases in severity, more powerful opioids should be used. This patient has been taking oxycodone, which is a moderate-strength opioid; fentanyl is stronger. Because the pain is chronic and is now severe and because the patient has opioid tolerance, a transdermal patch may be used. Long-term use of NSAIDs is not recommended because of the risk of thrombotic events. The patient also is describing neuropathic pain, which can be treated with an adjuvant analgesic. Fixed-dose combination drugs are not recommended for increasing pain. NSAIDs are not recommended long term. Intramuscular medications are not recommended because of the pain associated with administration.
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A community health nurse is preparing for a presentation on disabilities and is planning to include information about Healthy People 2010 goals. When addressing these goals, the nurse identifies differences from the goals addressed by Healthy People 2000
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a. Take this medication with juice. b. Take this medication with milk. c. You must maintain a salt-free diet. d. Your meals should be high in fat.
The charge nurse for a medical-surgical unit is notified that a client with tuberculosis (TB) is being transported to the unit. Which actions for infection prevention are the most appropriate in this circumstance?
Select all that apply. A) Stock the client's supply cart at the beginning of each shift. B) Wear a mask and gown when caring for the client. C) Have the client wear a mask when coming from admissions. D) Perform hand hygiene only after leaving the room. E) Test all staff members for TB immediately