The client has hypotension, receives as much opioid analgesia as the prescription allows, and continues to have difficulty sleeping at night from pain. Which should the nurse implement to relieve pain and improve sleep?

Question

1. Encourage controlled breathing.
2. Provide a glass of wine at bedtime.
3. Give a sedative 1 hour before sleep.
4. Increase fluids and reposition client.

Answer 1

1
1. The nurse encourages the client with controlled breathing exercises serving as a distraction to increase relaxation, decrease pain, and promote sleep. The nurse applies a nonpharmacologic relaxation technique because the client has hypotension and ad-ditional analgesia is likely to lower the blood pressure further potentially leading to serious complications including loss of consciousness, decreased perfusion to vital organs, and cardiopulmonary arrest.
2. Alcohol is contraindicated for use with opioids; in addition, alcohol consumption is likely to lower the blood pressure by vasodilation.
3. The nurse avoids administering a sedative because hypotension is an adverse effect of most sedatives and that will aggravate the client's hypotension.
4. The nurse increases fluid if the client has a fluid volume deficiency; however, res-toring fluid balance is unlikely to promote relaxation to relieve pain and improve sleep. Until the client's hypotension is resolved, the nurse repositions the client in the supine position or with the head slightly elevated to prevent increasing venous return from the head to the heart.