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

Answer and Explanation

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.

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Correct Answer is D

Explanation

a. Involving the client's partner may be helpful for additional support, but it does not ensure accurate communication if the partner also does not speak the same language as the client.
b. While incorporating gestures and hand signals can be useful, they may not fully convey complex medical information and may lead to misunderstandings.
c. Interpreting the client's body language can provide some insight into their understanding, but it may not accurately represent their comprehension of the information.
d. Providing an interpreter ensures accurate communication and understanding between the nurse and the client, promoting effective teaching and informed decision-making.

A. A client who is scheduled for an endoscopy later today and requires an enema B. A newly admitted client who has sickle cell anemia and requires the development of an initial plan of care C. A client who had a myocardial infarction and will be transferring to the unit from the CCU D. A newly admitted client who has diabetes mellitus and requires initial teaching on self-administration of insulin

Correct Answer is A

Explanation

Rationale:
a. Administering an enema for a scheduled endoscopy is within the scope of practice for an LPN. It involves a task that is repetitive, stable, and does not require critical thinking.
b. Developing an initial plan of care for a client with sickle cell anemia involves critical thinking and assessment, which are within the scope of practice for an RN.
c. A client transferring from the CCU after a myocardial infarction requires close monitoring and assessment, which are typically within the scope of practice for an RN.
d. Teaching a newly admitted client about self-administration of insulin involves education, assessment, and critical thinking, which are typically within the scope of practice for an RN.

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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?

Nursing Test Bank

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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?