A client who has a terminal illness and is receiving hospice care at home has a prescription for morphine sulfate 10 mg PO every 4 hr PRN for pain. The client's family member tells the nurse that the client is experiencing increased pain and asks if he can give him more morphine.
Which of the following responses should the nurse make?
"Yes, you can give him more morphine, but only if his respiratory rate is above 12 breaths/min."
"No, you cannot give him more morphine, because it can cause respiratory depression and hasten his death."
"Yes, you can give him more morphine, but you need to call the hospice nurse first to get an order for a higher dose."
"No, you cannot give him more morphine, because he may develop tolerance and dependence on the drug."
The Correct Answer is C
The nurse should instruct the family member to call the hospice nurse first to get an order for a higher dose of morphine, if needed. The hospice nurse can assess the client's pain level, vital signs, and response to the medication, and adjust the dose accordingly.
Option A is incorrect because although respiratory rate is one of the factors to monitor when administering opioids, it is not the only one; other factors include level of consciousness, oxygen saturation, and presence of adverse effects. Moreover, the family member should not increase the dose of morphine without consulting the hospice nurse.
Option B is incorrect because although respiratory depression is a potential side effect of opioids, it is not a common cause of death in clients receiving palliative care; rather, opioids are considered safe and effective for managing pain and dyspnea in dying clients, as long as they are prescribed and administered appropriately.
Option D is incorrect because tolerance and dependence are not major concerns in clients receiving palliative care; rather, the goal is to provide adequate pain relief and comfort for the client.
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Related Questions
Correct Answer is B
Explanation
End-of-life care is based on the ethical principles of beneficence (doing good) and nonmaleficence (doing no harm), which guide the health care team in providing compassionate and respectful care that alleviates suffering and promotes dignity for dying clients.
Option A is incorrect because end-of-life care can be provided in various settings, such as hospitals, nursing homes, or home health agencies, depending on the client's needs and preferences.
Option C is incorrect because informed consent is not required for end-of-life care; however, it may be needed for specific treatments or procedures that are part of end-of-life care, such as pain medication, blood transfusions, or organ donation.
Option D is incorrect because end-of-life care does not necessarily include interventions such as artificial nutrition and hydration, which may be considered futile or burdensome for some clients; rather, the decision to use or withhold these interventions should be based on the client's wishes, values, and goals of care.
Correct Answer is A
Explanation
Palliative care is a holistic approach to care that focuses on improving the quality of life for clients with serious illnesses and their families. It addresses physical, emotional, social, and spiritual needs, and can be provided at any stage of illness, along with curative treatments.
Option B is incorrect because palliative care does not necessarily involve withdrawing treatments or medications, unless they are causing more harm than benefit.
Option C is incorrect because palliative care does not aim to cure the disease, but rather to manage the symptoms and enhance comfort.
Option D is incorrect because palliative care is not the same as hospice care, which is a specific type of palliative care for clients who have a life expectancy of six months or less and have decided to forego curative treatments.
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