A hospice nurse is caring for a client who has 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 D
a. Continuing both medications may exacerbate the somnolence and difficulty arousing experienced by the client. It's essential to address the adverse effects promptly.
b. NSAIDs are not typically the first choice for severe pain management in terminal illness, especially when opioids are already prescribed. Moreover, replacing the opioid with an NSAID may not adequately address the pain.
c. Administering the benzodiazepine alongside the opioid may further potentiate the sedative effects and worsen the client's condition.
d. This is the most appropriate action. Withholding the benzodiazepine can help mitigate the sedation while continuing the opioid ensures ongoing pain relief for the client's comfort without introducing additional sedating medications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
a. “You should contact the provider about your wishes for your family member”: While involving the provider is essential, it doesn’t directly address the conflicting wishes between the partner and the family member.
b. “You should speak with the facility’s ethics committee about your concerns”: While acknowledging the need for ethical guidance, this option may not be the most immediate step.
c. “We’ll need to have the nursing supervisor review the client’s advance directives”: Although reviewing advance directives is crucial, it doesn’t directly address the current disagreement.
d. “As the health care surrogate, the client’s partner can make this decision”: This response recognizes the legal authority of the health care surrogate (partner) to make decisions on behalf of the unconscious client. It aligns with established principles.
Correct Answer is B
Explanation
Rationale for A: The abbreviation "MS" is not recommended for use in prescriptions because it can be confused with magnesium sulfate or morphine sulfate. This can lead to medication errors, making this option unsafe for transcription.
Rationale for B: This prescription is the correct choice because it clearly spells out "morphine sulfate," avoiding any potential confusion with similar abbreviations. It also uses the appropriate dosage and frequency without unnecessary trailing zeros, reducing the risk of errors.
Rationale for C: The abbreviation "MSO4" is considered dangerous because it can be confused with magnesium sulfate (MgSO4). Additionally, using abbreviations in prescriptions can lead to misinterpretation and medication errors.
Rationale for D: Although this option spells out "morphine sulfate," it uses a trailing zero in "10.0 mg," which can be misinterpreted as a higher dose, such as 100 mg. Trailing zeros should be avoided to prevent potential overdose.
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