A nurse is assisting in the care of a patient who is receiving pain medication by the epidural route.
It is most important to monitor this patient for which adverse drug effects?

Choice A rationale:
Chronic pain is defined as pain that lasts for an extended period, typically more than 3-6 months, and is often associated with conditions like arthritis. Severe arthritis is a common cause of chronic pain, as it persists over a long duration.
Choice B rationale:
Episodic pain refers to pain that occurs intermittently, with pain-free intervals in between. This term is not appropriate for describing the continuous discomfort associated with severe arthritis.
Choice C rationale:
Phantom pain is the sensation of pain in a body part that has been amputated or lost, which is not relevant to a patient with severe arthritis.
Choice D rationale:
Acute pain is typically short-term and results from a specific injury or illness. It is not the appropriate term for describing the long-lasting pain associated with severe arthritis.

Choice C rationale:
The most crucial instruction regarding the safety of fentanyl patches is to apply them as directed by the primary care provider. Fentanyl is a potent opioid medication, and its misuse or improper application can lead to serious health risks, including overdose. Therefore, following the prescriber's instructions is of utmost importance to ensure the patient's safety.
Choice A rationale:
Storing fentanyl patches in a locked cabinet is a good practice to prevent unauthorized access and to keep them out of reach of children or individuals who should not have access to the medication. However, it is not the most critical safety instruction. Proper application and usage are more important.
Choice B rationale:
While preparing the skin by cleaning with an antiseptic scrub solution is a necessary step when applying a transdermal medication like a fentanyl patch, it is not the most critical safety instruction. It is a standard part of the application process but does not address the overarching safety concerns related to fentanyl use.
Choice D rationale:
Using fentanyl patches as needed for breakthrough pain without clear guidance from a healthcare provider is not a safe practice. Fentanyl is a potent medication with a high risk of overdose, and its use should always be closely monitored and directed by a healthcare professional. Self-adjusting the dosage without medical supervision can lead to serious safety issues.