The nurse is completing a home care visit of an 86-year-old client who is dying of end-stage pulmonary disease and dementia. The client has been taking narcotic medication for the treatment of chronic arthritic pain
During the visit, the family tells the nurse that the client seems more restless and is grimacing and crying. The nurse interprets this report by the family as which of the following? 1. The client being uncooperative because of a personality disorder
2. Not an unusual finding and the family should continue to administer the medication as needed
3. A sign that the client may be in pain and adjustment to the pain medication or administration schedule is needed
4. A need for the client to try alternative methods for pain relief instead of pain medication
3. A sign that the client may be in pain and adjustment to the pain medication or administration schedule is needed
Rationale:
Clients with dementia may not be able to accurately express their pain. Other behavior changes, such as agitation, restlessness, and grimacing, often indicate ineffective management of pain. Therefore, adjustments to the pain medication or schedule are warranted. Personality disorders with the presence of dementia are difficult to identify and to differentiate the source of the behavior. Although alternative measures augment pain relief, medications and their administration should be examined as a priority of the assessment.
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