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?
Continue the medication dosages that relieve the client’s pain
Contact the provider about replacing the opioid with an NSAID
Administer the benzodiazepine but withhold the opioid
Withhold the benzodiazepine but continue the opioid
The Correct Answer is A
A. Continue the medication dosages that relieve the client’s pain:
Opioids and benzodiazepines are commonly used for pain and anxiety management in terminally ill patients. Somnolence is an expected side effect and does not necessarily warrant withholding medication unless the client shows signs of respiratory depression.
B. Contact the provider about replacing the opioid with an NSAID: NSAIDs are not sufficient for severe pain in terminal illness. Opioids are the gold standard for palliative pain management, and switching to an NSAID would likely lead to uncontrolled pain and unnecessary suffering.
C. Administer the benzodiazepine but withhold the opioid: This would leave the client in severe pain, which is unethical in hospice care. Pain relief should not be withheld solely due to sedation.
D. Withhold the benzodiazepine but continue the opioid: Benzodiazepines are often used to relieve anxiety, dyspnea, and agitation in end-of-life care. Withholding it could cause increased distress for the client. Instead of discontinuing the medication, the nurse should monitor for respiratory depression and adjust doses only if necessary.
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Related Questions
Correct Answer is B
Explanation
a. Rotavirus: Rotavirus is a common cause of diarrheal illness, especially in infants and young children. While it can cause significant morbidity and mortality, it typically does not require reporting to the state health department unless there is an unusual outbreak or cluster of cases.
b. Pertussis: Pertussis, also known as whooping cough, is a highly contagious bacterial respiratory infection caused by Bordetella pertussis. It can lead to severe coughing fits, especially in infants and young children, and can be life-threatening, particularly in vulnerable populations. Due to its potential for causing outbreaks and serious illness, cases of Pertussis are typically reportable to the state health department for surveillance and control measures.
c. Respiratory syncytial virus (RSV): RSV is a common respiratory virus that can cause mild to severe respiratory illness, particularly in young children, older adults, and individuals with weakened immune systems. While RSV infections can lead to hospitalizations, they are not typically reportable to the state health department unless there is a concern for a widespread outbreak or unusual pattern of cases.
d. Group B streptococcus (GBS) is a bacterium commonly found in the genital tract of adults, and while it can cause serious infections in newborns, it's not typically reportable to the state health department unless there are specific circumstances such as outbreaks or unusual patterns of infection.
Correct Answer is B
Explanation
A. The client covers electrical cords with a throw rug: This action is unsafe. Placing a throw rug over electrical cords poses a fire hazard and could lead to tripping. Electrical cords should be secured and kept out of walkways to prevent accidents.
B. The client set the water heater to 49 degrees Celsius (120 degrees Fahrenheit): The water heater should be set to a maximum temperature of 49°C (120°F) to prevent scalding injuries, which are a concern for older adults whose skin may be more sensitive. Temperatures higher than this increase the risk of burns.
C. The client has the refrigerator set to 7.2 degrees Celsius (45 degrees Fahrenheit): This temperature is too high. A refrigerator should be set at or below 4°C (40°F) to properly preserve food and prevent bacterial growth. Setting the refrigerator to 7.2°C (45°F) can result in foodborne illnesses.
D. The client has a standard height toilet seat in the bathroom: This may be inadequate for older adults, particularly those with mobility issues. A raised toilet seat may be recommended for better comfort and safety, as it reduces the risk of falls while sitting down or standing up.
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