A child is in the intensive care unit after a motor vehicle collision. The child has numerous fractures and is in pain that is rated 9 or 10 on a 10-point scale. In planning care, the nurse recognizes that the indicated action is which?
a. Give only an opioid analgesic at this time.
b. Increase dosage of analgesic until the child is adequately sedated.
c. Plan a preventive schedule of pain medication around the clock.
d. Give the child a clock and explain when she or he can have pain medications.
ANS: C
For severe postoperative pain, a preventive around the clock (ATC) schedule is necessary to prevent decreased plasma levels of medications. The opioid analgesic will help for the present, but it is not an effective strategy. Increasing the dosage requires an order. The nurse should give the drug on a regular schedule and evaluate the effectiveness. Using a clock is counterproductive because it focuses the child's attention on how long he or she will need to wait for pain relief.
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