The nurse caring for a 79-year-old man who has just returned to the medical–surgical unit following surgery for a total knee replacement received report from the PACU

Question

Part of the report had been passed on from the preoperative assessment where it was noted that he has been agitated in the past following opioid administration. What principle should guide the nurse's management of the patient's pain?
A) The elderly may require lower doses of medication and are easily confused with new medications.
B) The elderly may have altered absorption and metabolism, which prohibits the use of opioids.
C) The elderly may be confused following surgery, which is an age-related phenomenon unrelated to the medication.
D) The elderly may require a higher initial dose of pain medication followed by a tapered dose.

Answer 1

Ans: A
Feedback:
The elderly often require lower doses of medication and are easily confused with new medications. The elderly have slowed metabolism and excretion, and, therefore, the elderly should receive a lower dose of pain medication given over a longer period time, which may help to limit the potential for confusion. Unfortunately, the elderly are often given the same dose as younger adults, and the resulting confusion is attributed to other factors like environment. Opioids are not absolutely contraindicated and confusion following surgery is never normal. Medication should begin at a low dose and slowly increase until the pain is managed.