A nurse receives an order from a health care provider to administer Vicodin ES, which contains 750 mg acetaminophen and 7.5 mg hydrocodone, to a patient who is experiencing 8/10 postsurgical pain
The order is to give 2 tablets every 6 hours by mouth as needed for pain. What is the nurse's best next action?
a. Give the Vicodin ES to the patient immediately because the patient is experiencing severe pain.
b. Ask the health care provider to verify the dosage and frequency of the medication.
c. Ask the health care provider for an order for a nonsteroidal antiinflammatory drug (NSAID).
d. Ask the health care provider for an order to play music for the patient, in addition to providing the pain medication.
ANS: B
The maximum 24-hour dosage for acetaminophen is 4 grams. If the patient took 2 tablets of Vicodin ES every 6 hours, the patient would take in 6 grams of acetaminophen in 24 hours. This exceeds the safe dosage of acetaminophen, so the best action is to question this order. Giving the medication as ordered would possibly result in the patient taking more acetaminophen than what is considered a safe dose. Acetaminophen overdose can result in liver failure. NSAIDs are used to treat mild to moderate pain. At this moment, the patient is experiencing severe pain. Implementing music therapy is a nursing intervention and is an independent nursing action. Thus, an order to start music therapy is not needed.
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