A nurse is planning care for an older-adult patient who is experiencing pain. Which statement made by the nurse indicates the supervising nurse needs to follow up?
a. "As adults age, their ability to perceive pain decreases."
b. "Older patients may have low serum albumin in their blood, causing toxic effects of analgesic drugs."
c. "Patients who have dementia probably experience pain, and their pain is not always well controlled."
d. "It is safe to administer opioids to older adults as long as you start with small doses and frequently assess the patient's response to the medication."
ANS: A
Aging does not affect the ability to perceive pain. This misconception must be corrected by the supervising nurse. All the other statements are true and require no follow-up. Opioids are safe to use in older adults as long as they are slowly titrated and the nurse frequently monitors the patient. Patients with dementia most likely experience unrelieved pain because their pain is difficult to assess. Older adults frequently eat poorly, resulting in low serum albumin levels. Many drugs are highly protein bound. In the presence of low serum albumin, more free drug (active form) is available, thus increasing the risk for side and/or toxic effects.
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