A client is requesting medicine for pain 30 minutes after receiving morphine sulfate 5 mg intravenously. Which intervention should the nurse implement next?
Ask the UAP to offer a backrub to the client.
Reassess the client and the level of pain.
Tell the client the medication needs more time to work.
Encourage the client to focus on taking deep breaths.
The Correct Answer is B
A. Asking a UAP to offer a backrub is not appropriate if the pain assessment indicates that the current pain management strategy is insufficient. The nurse needs to reassess the pain to determine the effectiveness of the medication and whether additional interventions are needed.
B. Reassessing the client and the level of pain is essential to evaluate the effectiveness of the morphine sulfate administered and to guide further pain management decisions. This step is crucial for understanding the client's current pain status and determining the next steps in pain management.
C. Telling the client that the medication needs more time to work does not address the client's immediate concern or pain relief. Reassessing pain and potentially adjusting the treatment plan is more appropriate.
D. Encouraging deep breathing may help with pain management but does not address the need for further assessment of the pain level or potential adjustment in medication. Reassessing pain is the priority.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. A family attorney is the most appropriate professional to contact for more information about advance directives. Attorneys are knowledgeable about the legal aspects of advance directives, including living wills and durable power of attorney for healthcare, and can provide guidance on how to properly complete these documents.
B. A nurse manager may provide general information, but an attorney is more suited to address the legal aspects of advance directives.
C. A hospice nurse focuses on end-of-life care but may not have the expertise to provide comprehensive information about the legal requirements for advance directives.
D. A chaplain can offer spiritual support but is not the best resource for legal information regarding advance directives.
Correct Answer is B
Explanation
A. Leaving the dressing off could increase the risk of infection and delay wound healing. It is important to follow established wound care protocols and consult the healthcare provider if necessary.
B. Applying a hydrocolloidal gel dressing is appropriate for a stage 3 pressure ulcer with significant granulation tissue as it helps maintain a moist wound environment conducive to healing and protects the wound from external contaminants.
C. Replacing gauze with a transparent dressing might not provide adequate moisture control for a granulating wound and could potentially cause damage when removed.
D. Increasing the frequency of dressing changes may not be necessary and could potentially disrupt the healing process. It is important to balance between protecting the wound and allowing it to heal properly.
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