A hospice nurse is caring for a client who has a terminal illness and reports severe pain. After the nurse administers the prescribed opioid and benzodiazepine, the client becomes somnolent and difficult to arouse. Which of the following actions should the nurse take?
Administer the benzodiazepine but withhold the opioid.
Continue the medication dosages that relieve the client's pain.
Contact the provider about replacing the opioid with an NSAID.
Withhold the benzodiazepine but continue the opioid.
The Correct Answer is B
A. Withholding the opioid may lead to inadequate pain relief, which isn't the best approach, especially in a terminally ill patient experiencing severe pain.
B. Continuing the medication dosages that relieve pain is important for the client's comfort, even if it causes somnolence.
C. Contacting the provider to consider an NSAID might be an option, but immediate relief should not be compromised while awaiting a change in medication.
D. Withholding the benzodiazepine might be considered if the sedation is excessive, but prioritizing pain relief is crucial in end-of-life care unless there are severe adverse effects.
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Related Questions
Correct Answer is C
Explanation
A. Contacting the provider may be part of the process, but it does not directly address the conflict between the family members' wishes and the health care surrogate's legal authority.
B. While the ethics committee can be a valuable resource in resolving disputes, it is not the first step in this situation, as the health care surrogate has the legal right to make decisions on behalf of the unconscious client.
C. The health care surrogate is legally designated to make health care decisions for the client when they are unable to do so themselves. This includes decisions about life-sustaining treatments such as a feeding tube.
D. Reviewing the client's advance directives is important, but it does not supersede the authority of the health care surrogate unless the directives explicitly limit the surrogate's decision-making power.
Correct Answer is C
Explanation
A. Inadequate food supply is important but might not be the most immediate concern following coronary artery bypass grafting surgery.
B. Limited social support is significant for the client's recovery but might not directly impact the immediate post-operative care.
C. Low pain tolerance after a major surgery like coronary artery bypass grafting can impede recovery, affect mobility, and hinder the client's ability to participate in rehabilitation exercises or manage post-operative pain effectively. Addressing pain
tolerance is crucial for post-operative recovery.
D. Decreased self-esteem, while important for the client's overall well-being, might not be an immediate priority in the early stages following surgery compared to managing physical recovery and pain tolerance.
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