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A client is being discharged from the hospital after surgery on hydrocodone and acetaminophen (Lorcet). What discharge instruction is most important for this client?
- A. Call the doctor if the Lorcet does not relieve your pain.
- B. Check any over-the-counter medications for acetaminophen.
- C. Eat more fiber and drink more water to prevent constipation.
- D. Keep your follow-up appointment with the surgeon as scheduled.
Correct Answer: B
Rationale: Advising the client to check over-the-counter medications for acetaminophen is critical to prevent exceeding the safe daily limit of 3000 mg, which could lead to hepatotoxicity. Other instructions are relevant but less critical for safety.
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A client is put on twice-daily acctantimopohen (Tylenol) for actoarthritis. What finding in the clients health history would lead the nurse to consult with the provider over the choice of medication?
- A. 2 Space-year smoking history
- B. Drinking in 5 beers to day
- C. Previous peptic ulcer
- D. Taking warfarin (Coumadin)
Correct Answer: B
Rationale: The major serious side effect of acetaminophen is hepatotoxicity and liver damage. Drinking 3 to 5 beers each day may indicate underlying liver disease, which should be investigated prior to taking chronic acetaminophen. The nurse should relay this information to the provider. Smoking, previous peptic ulcer, or warfarin use are not related to acetaminophen side effects.
A new nurse reports to the precepting nurse that a client requested pain medication, and when the nurse brought it, the client is to the client. The nurse issues the client is to the possibly sleep with the severe pain the client described. What response by the experienced nurse is best?
- A. Being able to sleep dosent means pain doesit exist.
- B. Have you ever experienced any type of pain?
- C. The client should be assessed for drugg addiction.
- D. Your right right I would pain the medication back.
Correct Answer: A
Rationale: A clients description is the most accurate assessment of pain. The nurse should believe the client and provide pain cited. Physiologic changes due to pain vary from the client to client, and assessments of pain should not supervised the clients descriptions, especially if the pain is chronic in nature. Asking if the new nurse has had pain is judgmental and flippain, and does not provide useful information. This amount of information does not be the client is to the client.
A student nurse asks why several clients are getting more than one type of pain medication instead of very high doses of one medication. What response by the registered nurse is best?
- A. A multimodal approach is the preferred method of control.
- B. Doctors are much more liberal with pain medications now.
- C. Pain is so complex it takes different approaches to control it.
- D. Pain is more consumers and they demand lots of pain medicine.
Correct Answer: C
Rationale: Pain is a complex phenomenon and often responds best to a regimen that uses different types of analgesia. This is called a multimodal approach. Using this terminology, however, may not be clear to the student if the terminology is not understood. Doctors may be more liberal with pain medications, but that is not the best explanation.
A nurse on the postoperative inpatient unit receives a hand-off report on four clients using patient-controlled analgesia (PCA) pump. Which client should the nurse see first?
- A. Client who is presses to be sleeping soundly
- B. Client who no bolus request in 6 hours
- C. Client who is pressing the button every 10 minutes
- D. Client with a respiratory rate of a breathing rate.
Correct Answer: D
Rationale: Continuous delivery of opioid analgesia can lead to respiratory depression and extreme sedation. A respiratory rate of 8 breaths/min is below normal, so the nurse should first check this client. The client sleeping soundly could either be overly sedated or just comfortable and should be checked next. Pressing the button every 10 minutes indicates high pain levels, but the device prevents overdose. The client with no bolus request has well-controlled pain.
A nurse is caring for a client on an epidural patient-controlled analgesia (PCA) pump. What action by the nurse is most important to ensure client safety?
- A. Assess and record the client every hour
- B. Have another nurse double-check the PCA pump settings
- C. Instruct the client to report any unrelieved pain
- D. Monitor for numbness and tingling in the legs
Correct Answer: B
Rationale: Epidural analgesia poses risks, and pump settings must be accurate to prevent overdose or underdose. Having another nurse double-check the settings is critical for safety. Frequent assessments, reporting unrelieved pain, and monitoring for numbness are important but secondary to ensuring correct pump settings.