The nurse is caring for a client in the hospital who has been taking an analgesic for pain related to a chronic illness and has developed a tolerance to the medication. What is the most appropriate action by the nurse?

A) Inform the client that he will not be able to receive more medication than the physician has ordered.
B) Suggest a consultation with a psychiatrist to treat the client's addiction.
C) Inform the client that you will ask the physician to order a non-narcotic analgesic.
D) Consult with the physician regarding the need for an increased dose of the drug and not to reduce its dosage or frequency of administration.


D
Feedback:
The most appropriate action by the nurse would be to consult with the physician regarding the need for an increased dose of the drug and not to reduce its dosage or frequency of administration. As a rule of thumb, an ineffective dose should be increased by 25% to 50%. Informing the client that he will not be able to receive more medication is not acting as a patient advocate nor acting in the best interest of the client. Suggesting a psychiatrist consultation would not be an appropriate action because the client has a chronic illness that requires medication. Taking a non-narcotic analgesic would not provide the client with the pain relief that he has.

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