A patient who is receiving sustained-release morphine sulfate (MS Contin) every 12 hours for chronic pain experiences level 9 (0 to 10 scale) breakthrough pain and anxiety. Which action by the nurse is appropriate for treating this change in assessment?
Administer lorazepam (Ativan) 1 mg orally.
Offer immediate-release morphine 30 mg orally.
Suggest the patient take amitriptyline 10 mg orally.
Give Ibuprofen 400 to 800 mg orally.
The Correct Answer is B
B. Immediate-release morphine provides rapid pain relief and can effectively address breakthrough pain. The dose of 30 mg is reasonable given the severity of the pain.
A. Lorazepam is a benzodiazepine used to treat anxiety. While it may help with anxiety, it does not directly address the severe breakthrough pain experienced by the patient.
C. Amitriptyline is a tricyclic antidepressant used to treat neuropathic pain and depression. While it may help with chronic pain management, it is not appropriate for providing rapid relief for breakthrough pain or acute anxiety.
D. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used for mild to moderate pain relief and inflammation. However, it is not typically used for severe breakthrough pain, especially in a patient already receiving opioid therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
B. Applying ice to the affected knee is a common postoperative instruction after arthroscopic knee surgery. Ice helps reduce swelling, inflammation, and pain in the surgical area. It is usually recommended to apply ice intermittently for short periods during the first 24 to 48 hours following surgery.
A. Keeping the leg in a dependent position, where it is hanging down, is not typically recommended following arthroscopic knee surgery.
C. Complete bedrest for the first 24 hours after arthroscopic knee surgery is not typically necessary or recommended. Early mobilization and gentle range of motion exercises are usually encouraged to prevent complications such as blood clots and joint stiffness.
D. These exercises help restore joint mobility, prevent stiffness, and promote healing of the surgical site. However, the timing and specific exercises should be guided by the surgeon's instructions and individual patient factors.
Correct Answer is C
Explanation
C. The patient's calf being swollen and warm to touch is concerning for a possible deep vein thrombosis (DVT), a clot formation in the deep veins of the leg. DVT is a serious complication post-surgery that requires immediate attention to prevent the clot from dislodging and causing a pulmonary embolism (PE), which can be life-threatening.
A. Abdominal pain after a total abdominal hysterectomy is common and can be expected due to the surgical incision and manipulation of abdominal tissues.
B. Fluid balance is important postoperatively to prevent complications like dehydration or fluid overload. A significant imbalance, with intake substantially greater than output, could indicate issues which may require intervention. However, this is not as urgent as a client with likely DVT.
D. A slight increase in temperature is common in the immediate postoperative period due to the body's response to tissue injury. While it could indicate infection, it's not necessarily alarming on its own.
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