The patient has hypotension, receives as much opioid analgesia as the prescription allows, and continues to have difficulty sleeping at night because of pain. Which should the nurse implement to relieve pain and improve sleep?
a. Encourage controlled breathing.
b. Provide a glass of wine at bedtime.
c. Give a sedative 1 hour before sleep.
d. Increase fluids and reposition the patient.
A
The nurse encourages the patient with controlled breathing exercises that serve as a distraction to increase relaxation, decrease pain, and promote sleep. The nurse applies a nonpharmacological relaxation technique because the patient has hypotension and additional analgesia is likely to lower the blood pressure further, potentially leading to serious complications, including loss of consciousness, decreased perfusion to vital organs, and cardiopulmonary arrest. Alcohol is con-traindicated for use with opioids; in addition, alcohol consumption is likely to lower the blood pressure by vasodilation. The nurse avoids administering a sedative because hypotension is an adverse effect of most sedatives and sedatives will aggravate the patient's hypotension. The nurse increases fluid if the patient has a fluid volume deficiency; however, restoring fluid balance is unlikely to promote relaxation to relieve pain and improve sleep. Until the patient's hy-potension is resolved, the nurse repositions him or her in the supine position or with the head slightly elevated to prevent increasing venous return from the head to the heart.
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When looking for a position, look only at want ads and local hospitals and nursing homes for reliable sources
True False