A narcotic substance abuser complains of severe incisional pain 1 hour after receiving 4 mg of intravenous morphine
When collaborating with the provider, which statement by the nurse indicates correct knowledge of pain management in opiate-tolerant patients? 1. "I think the patient has a tolerance to opiates and needs a higher dose than ordered.".
2. "The patient continually complains of pain to get more narcotics.".
3. "Perhaps administering a saline flush as a placebo will help the pain.".
4. "The patient should be getting ketorolac (Toradol) for pain, not morphine.".
"I think the patient has a tolerance to opiates and needs a higher dose than ordered.".
Rationale: An opiate abuser will be tolerant to the effects of narcotics; it will take more medication to gain the same level of relief than it would for a nontolerant client. If the nurse accepts the patient's definition of pain as the standard, the nurse would not judge the patient as a "drug seeker" and infer the patient is not in pain. Placebos are considered unethical and should not be used. Administering a non-narcotic pain reliever such as ketoralac, an NSAID, will precipitate withdrawal symptoms, causing the patient further discomfort.
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The client at 39 weeks' gestation is undergoing a cesarean birth due to breech presentation. General anesthesia is being used. Which situation requires immediate intervention?
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A client is experiencing weight gain and foamy dark urine 4 weeks after being treated with antibiotics for a sore throat
Which client statement, made during the health history assessment, should the nurse provide further instruction? A) "I have been trying to get plenty of rest since I have been sick." B) "I have changed to a more nutritious diet." C) "I felt better after 1 week of the antibiotics, so I stopped taking them." D) "I have gained weight in the last 2 weeks."
A nurse has received report on assigned patients and is prioritizing their care. Which of the following patients should the nurse assess first?
a. A female patient who is complaining of a headache b. A patient who has just returned from sur-gery and has saturated his dressing c. A patient with a femur fracture that is re-questing pain medications d. A male patient who needs to use the bathroom