The patient has advanced cancer and is experiencing malignant pain. How should the nurse plan to manage this pain?
1. Use the intravenous route for pain medication administration.
2. Set up a dosing schedule that provides for around-the-clock doses.
3. Encourage the patient to wait 10 minutes after pain medication is required to ask for a dose.
4. Augment the patient's regimen with other pharmaceutical and nonpharmaceutical pain relief measures for breakthrough pain.
5. Counsel the patient that it is not possible to eliminate all the pain of cancer and that some must be tolerated.
Correct Answer: 2,4
Rationale 1: Approximately 90% of cancer pain can be controlled by use of oral medications if they are dosed appropriately.
Rationale 2: Often the problem in controlling pain of any type is that the patient "gets behind" the pain rather than medicating for it before it gets severe. Around-the-clock dosing helps to prevent "playing catch-up" to the pain.
Rationale 3: This plan would allow the pain to worsen before medication is given and would result in the patient getting "behind" the pain.
Rationale 4: Breakthrough pain is expected and may require additional pharmaceutical or nonpharmaceutical measures.
Rationale 5: While it is true that some cancer patients develop intractable pain, many are able to control pain to a level that is very tolerable.
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