A client with metastatic cancer is being dismissed to home health care. The client's orders include both a long-acting opioid analgesic and a short-acting analgesic for breakthrough pain

Question

In addition, the client will be taking an NSAID every 8 hours. The client's spouse is very upset with these directions and voices concern to the nurse that the client "will become an addict." Which information will best help the spouse and client maintain the medication schedule? The nurse should a. call the physician and ask him/her to come speak to the family.
b. help them understand the need for such strong medications.
c. inform them that in time, the medications can be decreased.
d. initiate a referral to a pain specialist.

Answer 1

B
Clients with painful conditions, including metastatic cancers, are often treated at home and are responsible for self-care measures, including pain control. Many people worry about the possi-bility of addiction and as a result do not ask for or take adequate pain medications. Helping the client's spouse understand the rationale behind using such powerful medications may help the spouse overcome irrational fears and may promote self-care in the client. If the spouse is judg-mental and the client wants to please him or her, the client may not take enough pain medication. Having the physician or pain specialist speak to the family is not incorrect, but it avoids the nurses' primary responsibility to the client and family. With metastatic cancer, the need for pain medications will likely increase, not decrease, as the disease progresses.