The nurse is caring for a patient with severe chronic pain. The nurse applied the first 50 mcg transdermal fentanyl (Duragesic) patch 2 hours ago. The patient states that the pain is presently rated at 9 on a 1-10 scale. What is the nurse's best action?
a. Instruct the patient that the Duragesic patch will start to work soon.
b. Administer a short-acting narcotic medication like morphine liquid (Roxanol).
c. Give the patient a gentle back rub and encourage guided imagery.
d. Apply a second 25-mcg transdermal fentanyl (Duragesic) patch now.
ANS: B
Transdermal administration of medication does not become effective for 12 to 16 hours after application. Short-acting narcotic medication like Roxanol morphine liquid should be given in the meantime to make the patient comfortable.
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