A nurse is caring for a client who has developed a paralytic ileus related to acute pancreatitis and reports pain as 8 on a scale of 0 to 10. The client has prescriptions for multiple PRN pain medications. Which of the following medications should the nurse administer?
PO oxycodone
Ibuprofen via NG tube
IV hydromorphone
Topical lidocaine patch
The Correct Answer is C
A. PO oxycodone: Oral medications are contraindicated in clients with paralytic ileus because of impaired gastrointestinal motility, which prevents proper absorption and increases the risk of gastric retention. IV administration is preferred for effective pain control in this scenario.
B. Ibuprofen via NG tube: NSAIDs can cause gastric irritation and increase the risk of gastrointestinal bleeding, especially in clients with pancreatitis. Additionally, an NG tube is not an appropriate route for medication administration in the presence of an ileus due to impaired intestinal function.
C. IV hydromorphone: IV opioids provide effective and rapid pain relief for clients with severe pain, especially when oral or enteral administration is not feasible. Hydromorphone is commonly used in acute pancreatitis because it controls pain effectively without exacerbating the underlying condition.
D. Topical lidocaine patch: While lidocaine patches provide localized pain relief, they are not sufficient for managing severe visceral pain associated with pancreatitis and ileus. Systemic analgesia via IV opioids is more appropriate for controlling this level of pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. "Your provider would not prescribe this treatment if it weren't necessary.": While the provider recommends treatment based on medical necessity, the decision to continue or discontinue chemotherapy ultimately lies with the client. This response does not acknowledge the client’s autonomy.
B. "Chemotherapy is your best chance for survival.": This response focuses on treatment efficacy rather than addressing the client's emotional and personal concerns. It may also create pressure rather than supporting the client’s decision-making process.
C. "It is your decision whether to continue chemotherapy.": This response is appropriate as it acknowledges the client’s autonomy and right to make healthcare decisions. It validates the client’s concerns while offering support without imposing an opinion.
D. "Why don't you want to continue treatment?": Asking "why" may make the client feel defensive or pressured to justify their decision. A more open-ended approach, such as "Can you tell me more about your concerns?" would be a better way to explore the client’s feelings.
Correct Answer is D
Explanation
A. "I have trouble urinating if I eat acidic foods.": Difficulty urinating after consuming acidic foods is not associated with latex allergy. This symptom may be related to bladder irritation or interstitial cystitis rather than an immune response to latex-related proteins.
B. "I often have diarrhea after eating scrambled eggs.": Diarrhea after consuming eggs suggests a food intolerance or an allergy to egg proteins. However, egg allergy is not linked to an increased risk of latex allergy.
C. "I sometimes start to wheeze when I eat peanuts.": Wheezing after peanut consumption suggests a peanut allergy, which is not directly associated with latex allergy. However, individuals with multiple allergies may be at higher risk for allergic reactions in general.
D. "I break out in a rash when I eat strawberries.": A history of allergic reactions to strawberries suggests a possible latex-fruit syndrome. Certain fruits, such as strawberries, bananas, avocados, and kiwis, contain proteins similar to those found in latex, increasing the risk of latex hypersensitivity.
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