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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Offering a sedative might not address the situation appropriately; the client's decision to leave needs to be managed through proper channels.
B. Informing the client about the discharge process and the requirement of a discharge prescription from the provider is appropriate and educates the client on the necessary steps.
C. Assigning a security officer might not be necessary unless there are safety concerns or imminent risks.
D. Having the client sign the Against Medical Advice (AMA) form might be necessary if the client insists on leaving against medical advice, but explaining the proper discharge process should be attempted first.
Correct Answer is D
Explanation
Rationale for A: An open fracture of the femur is serious and requires prompt treatment, but it does not typically indicate an immediate life threat compared to other conditions.
Rationale for B: Periorbital ecchymosis can indicate facial trauma, but it is not necessarily life-threatening and would not be prioritized as emergent.
Rationale for C: A deep partial thickness burn on the lower extremities is significant and requires treatment, but unless the burn covers a large area or is complicated by other factors, it is not the most critical issue compared to respiratory or cardiovascular threats.
Rationale for D: An asymmetrical thorax may suggest a possible pneumothorax or other significant respiratory issue, which could lead to respiratory distress or failure. This client should be tagged as emergent due to the potential for rapid deterioration.
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