The client receives opioid analgesia with naproxen (Naprosyn) after a total abdominal hysterectomy. Which client data is the nurse's priority?
1. Client has not had a bowel movement since surgery.
2. Client declines massage after analgesic administration.
3. Respiratory rate drops from 22 to 16 breaths per minute.
4. Client receives famotidine (Pepcid) for esophageal reflux.
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4. Combining a nonsteroidal anti-inflammatory agent (NSAID) with an opioid can provide effective pain relief for clients after surgery once hemostasis is established at the surgical site; however, client history of esophageal reflux is usually a contraindi-cation for NSAID administration because of the increased risk of bleeding from prostaglandin inhibition.
1. Constipation is a complication of surgery and opioid analgesia, but the nurse manages client constipation by increasing client ambulation and client intake of fiber, fluid, and stool softeners. If clients receive opioids around the clock, the nurse pro-vides stimulant laxatives in place of stool softeners.
2. Declining a massage after receiving pain medication potentially indicates that the client is satisfied with her comfort and relaxation status; as long as the client's non-verbal cues are not contradictory to her statements; this is probably a benign event.
3. Respirations at 16 per minute are in within normal limits.
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