Nclex Qod 5/13

[Altra, BSN, RN]

The nurse is reviewing the records of a client with sickle cell anemia admitted in a vaso-occlusive crisis (pain episode). The nurse notes that over the past few years the client has reported frequent crises and has received opiates as a component of treatment. The physician has ordered morphine every 3 hours when necessary for pain. Three hours after receiving a dose of morphine, the client requests additional pain medication. The nurse should:

1. Administer the morphine as ordered

2. Seek an order for a pacebo instead of the morphine

3. Question the physician about the need for morphine

4. Report to the physician that this client is displaying drug-seeking behavior

[cursenurse]

1

[AuntMeggie]

1, because the patient's pain is what they say it is.

[grinnurse, RN]

The nurse is reviewing the records of a client with sickle cell anemia admitted in a vaso-occlusive crisis (pain episode). The nurse notes that over the past few years the client has reported frequent crises and has received opiates as a component of treatment. The physician has ordered morphine every 3 hours when necessary for pain. Three hours after receiving a dose of morphine, the client requests additional pain medication. The nurse should:

1. Administer the morphine as ordered

2. Seek an order for a pacebo instead of the morphine

3. Question the physician about the need for morphine

4. Report to the physician that this client is displaying drug-seeking behavior

Admin as ordered. Accept the pain level the pt states.

[Imafloat, BSN, RN]

#1 pain is what they say it is.

To say they are experiencing drug seeking behavior is being judgemental.

[ckh23, BSN, RN]

1

[colleennurse, ASN, RN]

1

[HyperRNRachel]

:uhoh21: 3, morphine is not given for sickle cell., something about the breakdown of the medication causes a negative side effect for the sickle cell patient.

But the question is asking about their pain. So, pain is whatever the patient says their pain is. In that case I would go with 1.

I had to testify in court yesterday for 2 hours straight. I'm brain dead and very defensive. Sorry.

Does anyone else remember something about demerol being the drug of choice for sickle cell? Am I now making up my own medical rules? Will I get over the anger of how I was treated in court yesterday? H*** I DO NOT KNOW!

I need a hug. :uhoh21:

[debbieGa]

Hyperstudent, I have in my notes that Demerol may cause seizures so now they use morphine. So I choose #1

[HyperRNRachel]

I have been corrected. Thank you Debbie. :blushkiss

I am now going with 1.

[grinnurse, RN]

I have never heard that Demerol would cause seizures in SC crisis, so thanks for the FYI. Also, could morphine be preferred now more than demerol b/c of the ceiling that it has on it as in its use with cancer patients? Just thought that I would throw that out there for sh**s and giggles!!!..........LOL

Have a wonderful night!!