A nurse in a long-term care facility is reinforcing teaching about pain control with a client who has terminal cancer. Which of the following information should the nurse include?
Analgesia should be used around the clock to promote pain control.
Pain patches are applied each morning and removed at bedtime.
We will use intramuscular medications to control your pain.
A medication dose must be decreased if you develop tolerance.
The Correct Answer is A
Choice A reason: Using analgesia around the clock is an appropriate action. The nurse should follow the principle of prevention rather than rescue when managing pain for a client who has terminal cancer. The nurse should administer analgesics on a regular schedule to maintain a steady level of pain relief and prevent breakthrough pain.
Choice B reason: Applying pain patches each morning and removing them at bedtime is not an appropriate action. The nurse should follow the manufacturer's instructions for applying and removing pain patches. Some patches are designed to be worn for 24 hours, while others are worn for 72 hours. Removing the patches too soon can cause inadequate pain control and withdrawal symptoms.
Choice C reason: Using intramuscular medications to control pain is not an appropriate action. The nurse should avoid using intramuscular route for administering analgesics to a client who has terminal cancer. Intramuscular injections are painful, unreliable, and increase the risk of infection and bleeding. The nurse should use oral, transdermal, or subcutaneous routes whenever possible.
Choice D reason: Decreasing a medication dose if the client develops tolerance is not an appropriate action. The nurse should understand that tolerance is a normal physiological response to long-term opioid use and does not indicate addiction or abuse. The nurse should adjust the medication dose according to the client's level of pain and response to treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Keeping both arms below the level of the client's heart can increase venous pressure and fluid accumulation in the affected arm, which can lead to lymphedema.
Choice B reason: After a mastectomy, it’s important to avoid procedures like blood draws, injections, or blood pressure measurements on the side where the surgery was performed to prevent lymphedema. Therefore, using the client’s left arm for blood samples is a preventive measure.
Choice C reason: Obtaining blood pressure readings using the client's right arm is an incorrect action that can increase lymphatic fluid accumulation and impair circulation in the affected arm.
Choice D reason: Limiting range-of-motion exercises with the affected arm is an incorrect action that can decrease lymphatic drainage and increase swelling in the affected arm. The nurse should encourage the client to perform gentle exercises, such as squeezing a soft ball or raising and lowering the arm, to promote lymphatic flow and prevent stiffness.
Correct Answer is D
Explanation
Choice A reason: Filling the pad with sterile water is not necessary, as tap water can be used for an aquathermia pad without increasing the risk of infection or contamination.
Choice B reason: Using safety pins to secure the pad in place is not appropriate, as they can puncture or damage the pad and cause leakage or electric shock.
Choice C reason: Applying the pad for 45 min at a time is not recommended, as it can cause skin burns or tissue damage due to prolonged exposure to heat. The nurse should apply the pad for no more than 20 min at a time and check the skin frequently for signs of redness or blistering.
Choice D reason: Covering the pad prior to use is an important action, as it can prevent direct contact between the pad and the skin and reduce the risk of burns or irritation. The nurse should use a towel or a cloth to cover the pad before applying it to the affected area.
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