Which medication should the nurse anticipate administering to a patient in severe acute pain who is being treated using the WHO analgesic ladder?
A) Ibuprofen
B) Tramadol
C) Codeine
D) Morphine
D) Morphine
Explanation: A) Because acute pain can be intense, its initial management usually starts at the third step of the WHO ladder with gradual movement down the ladder during the recovery phase. In the first step of the ladder, the pain is initially managed with nonopioids such as nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen, naproxen, ketorolac), COX-2 selective inhibitor (celecoxib), acetaminophen, and aspirin. Severe pain places the patient on the third step of the WHO analgesic ladder.
B) Because acute pain can be intense, its initial management usually starts at the third step of the WHO ladder with gradual movement down the ladder during the recovery phase. In the second step, a weak opioid such as codeine, dihydrocodeine, or tramadol is added to the nonopioid with or without adjuvant medications. Severe pain places the patient on the third step of the WHO analgesic ladder.
C) Because acute pain can be intense, its initial management usually starts at the third step of the WHO ladder with gradual movement down the ladder during the recovery phase. In the second step, a weak opioid such as codeine, dihydrocodeine, or tramadol is added to the nonopioid with or without adjuvant medications. Severe pain places the patient on the third step of the WHO analgesic ladder.
D) Because acute pain can be intense, its initial management usually starts at the third step of the WHO ladder with gradual movement down the ladder during the recovery phase. Medications at this step include a strong opioid such as morphine as well as fentanyl, buprenorphine oxymorphone, oxycodone, hydromorphone, and methadone. Severe pain places the patient on the third step of the WHO analgesic ladder.
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