Which medication order will provide the most consistent control of the patient's chronic pain?

Choice A reason: This is the correct choice because assessment is the step of the nursing process that involves collecting and organizing data about the patient's health status and needs. The nurse who carefully enters a new patient’s medical history and current medication list into the agency’s electronic health record (EHR) is performing an assessment by gathering relevant information from the patient and other sources.

Choice B reason: This is an incorrect choice because implementation is the step of the nursing process that involves carrying out the planned nursing interventions to achieve the patient's goals and outcomes. The nurse who carefully enters a new patient’s medical history and current medication list into the agency’s electronic health record (EHR) is not performing an implementation by executing any actions or treatments for the patient.

Choice C reason: This is an incorrect choice because diagnosis is the step of the nursing process that involves analyzing and interpreting the data to identify the patient's actual or potential health problems. The nurse who carefully enters a new patient’s medical history and current medication list into the agency’s electronic health record (EHR) is not performing a diagnosis by making any judgments or conclusions about the patient's condition.

Choice D reason: This is an incorrect choice because evaluation is the step of the nursing process that involves measuring and comparing the patient's progress and outcomes with the expected goals and outcomes. The nurse who carefully enters a new patient’s medical history and current medication list into the agency’s electronic health record (EHR) is not performing an evaluation by assessing any changes or improvements in the patient's status.

Choice A reason: This is incorrect. Reporting the findings to the health care provider immediately is an important step, but not the priority action of the nurse. The nurse should first assess the patient for orthostatic hypotension, which is a common cause of sudden blood pressure drop.

Choice B reason: This is incorrect. Checking the patient’s apical rate to check for a pulse deficit is a relevant step, but not the priority action of the nurse. A pulse deficit is the difference between the apical and radial pulse rates. The nurse should first check the patient for orthostatic hypotension, which is a condition where the blood pressure drops when the patient changes position, causing dizziness and fainting.

Choice C reason: This is correct. Immediately checking the patient for orthostatic hypotension is the priority action of the nurse. Orthostatic hypotension is a condition where the blood pressure drops when the patient changes position, causing dizziness and fainting. It can be caused by dehydration, medications, blood loss, or autonomic nervous system disorders. The nurse should measure the patient’s blood pressure and heart rate while lying down, sitting, and standing, and observe for any signs of hypoperfusion, such as pallor, sweating, or confusion.

Choice D reason: This is incorrect. Elevating the head of the patient’s bed to at least 45 degrees is a helpful step, but not the priority action of the nurse. Elevating the head of the bed can improve the patient’s breathing and reduce the risk of aspiration, but it can also worsen the orthostatic hypotension by lowering the blood pressure further. The nurse should first check the patient for orthostatic hypotension and then adjust the bed position accordingly.