A hospice nurse is caring for a client who has terminal cancer and takes PO morphine for pain relief. The client reports that he had to increase the dose of morphine this week to obtain pain relief. Which of the following scenarios should the nurse document as the explanation for this situation?
The client has become addicted to the medication.
The client is experiencing episodes of confusion.
The client not been taking the medication properly.
The client developed tolerance to the medication.
The Correct Answer is D
Tolerance refers to where there is reduced responsiveness to a drug due to prolonged exposure to the drug requiring higher doses to achieve the same effect. This effect requires progressive increment in dosages of the medication which may increase the risk for toxicity.
A. Addiction is characterized by compulsive efforts to acquire the drug despite being aware of its adverse consequences
C and D are not related to the continuous need for higher doses of morphine
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Related Questions
Correct Answer is D
Explanation
During the first week or last week of a 28-day cycle pack of oral contraceptives increases the risk of contraceptive failure. However, the client should take the missed dose as soon as they remember, even if it means taking two pills in one day. After taking the missed dose, the client should continue taking the remaining pills in the pack at the usual time, one pill per day. Due to increased risk of failure, client should use an emergency pill or condom for the next 7 days
A -stopping the pills and switching to a different contraceptive method is not necessary after missing one dose
B –missing a pill does not automatically indicate pregnancy. Testing can be considered in presence of typical signs and symptoms of pregnancy
C- abstaining from vaginal intercourse until after the next period is not necessary. Risk of pregnancy can be addressed by use of back up contraception like condoms.
Correct Answer is A
Explanation
After a pneumonectomy, positioning the client on the nonoperative side helps maximize ventilation to the remaining lung and facilitates drainage of secretions. Placing the client on the nonoperative side allows for better perfusion and ventilation of the remaining lung, which can improve oxygenation and respiratory function.
B-sims position is used during insertion of suppository of a rectal exam
C -Semi-Fowler's position is used in clients with heart failure and pulmonary edema to promoted ventilation in the upper lungs
D-Prone position is used during surgical procedures involving the back in the operating room
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