A patient who has had cancer for 1 year uses a fentanyl transdermal patch for pain relief. The patient reports having three or four episodes of pain (which she rates as 8 or 9 on a scale of 1 to 10) each day, and each episode lasts 15 to 30 minutes
The nurse will contact the provider to:
a. discuss the use of an adjuvant analgesic.
b. request an order for an NSAID.
c. request a strong, short-acting opioid PRN.
d. suggest increasing the dose of fentanyl.
ANS: C
Breakthrough pain can occur in patients who otherwise have well-controlled pain, and it should be managed with extra doses of short-acting, strong opioids. This pain is moderate to severe and is not neuropathic, so adjuvant analgesics or NSAIDs are not useful. Increasing the dose of the long-acting opioid would not alleviate breakthrough pain.
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