The nurse is creating a pain management plan using the three-step approach for a client with intractable pain. Which interventions should the nurse include in this plan?
Select all that apply.
A) Administer a nonopioid analgesic first.
B) Administer an opioid analgesic first.
C) Administer a nonopioid with an opioid second.
D) Administer an opioid analgesic last.
E) Administer analgesics upon client request.
Answer: A, C, D
The first step in the three-step approach to pain management involves administering a nonopioid drug first. If pain is not adequately controlled with this mild intervention, clients should advance to step 2 and receive a mild opioid in combination with the same or a new nonopioid drugs. If the client is still experiencing pain, the mild opioid should be replaced with a stronger opioid in step 3. Pain-relieving drugs should be given "by the clock" (every 3-6 hours) rather than on demand to maintain freedom from pain.
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