The nurse is caring for two clients who both are in pain due to sickle cell anemia. One of the clients rates his pain as a 7 out of 10 (1 is no pain and 10 is the worst pain possible)
This client is moving around easily and is eating well, but has asked for pain medicine. The nurse would choose which of the following actions? 1. Wait 30 minutes and see if the client is still requesting the pain medicine.
2. Administer half the ordered does of pain medication.
3. Administer the pain medication if it is has been longer than the ordered interval.
4. Notify the healthcare provider that the client is faking his pain.
3
Rationale 1: Waiting to administer the medication is inappropriate and is an action that appears to negate the client's reports.
Rationale 2: Administration of only a portion of the ordered medication places the nurse in a position of prescribing medications and is outside the nurse's scope of practice.
Rationale 3: Since pain occurs whenever the experiencing person says it does and is whatever the experiencing person says it is, the nurse should accurately assess and treat the pain with the pain medication if that is what is ordered.
Rationale 4: Notification to the healthcare provider that the patient is faking the pain is inappropriate as there is no evidence of this action.
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