morphine infusion, what will you do

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mrs sachett 6 hours post op following hemicolectomy. she has a morphine infusion presently running as a background infusion of 2mg/hr and she describes her pain as 3/10 with respiratory rate of 14, sao2 97%, pulse 98 b/p 104/65 and although sleepy is easily roused. the order indicates she can have from 0-5 mg/hour with a bolus of 1mg twice per hour if necessary. what would you do?

1. decrease the rate of the infusion to 1 mg/hr and assess how she is feeling about her hysterectomy, teach her relaxation and breathing exercises to control the anxiety which is at this stage contributing to the experience of pain

2. stop the infusion and administer a dose of naloxone to reverse the effects of morphine

3. as pain is still present and the current amount is less than the maximum dose it would be appropriate to increase the infusion to 4mg/hr

4. keep the infusion at the current rate

Silverdragon102, BSN

1 Article; 39,477 Posts

Specializes in Medical and general practice now LTC.

What are your thoughts on the question?

jchan0425

13 Posts

i am picking number 4

ans1) hysterectomy??

ans2) pt is not airway compromised why would we do that? pt's pain can be back without morphine

ans3) she is already giving pain score 3/10, no reason to increase the dose at all

ans4)do nothing is the best response

CuriousMe

2,642 Posts

i am picking number 4

ans1) hysterectomy??

ans2) pt is not airway compromised why would we do that? pt's pain can be back without morphine

ans3) she is already giving pain score 3/10, no reason to increase the dose at all

ans4)do nothing is the best response

I like 4 as well, for the same reasons you mentioned.

allnurses Guide

Spidey's mom, ADN, BSN, RN

11,304 Posts

I'd be wondering why the report was a hemicolectomy but the real operation was a hysterectomy. :coollook:

Maybe I got my patients mixed up.

After figuring that out - I'd probably leave it alone. Do some incentive spirometry with the patient. Sit her up.

steph

goodstudentnowRN

1,007 Posts

Specializes in Telemetry.

I would chose #4 too. She is stable and 3/10 maybe her comfort zone.

Snwbdr

198 Posts

First thing is you need to figure out what her target pain level is....3/10 might be tolerable for her, but only way to find out is ask the patient.....some people have high pain tolerances, others might not.....her VS do not indicate any respiratory distress....

CuriousMe

2,642 Posts

First thing is you need to figure out what her target pain level is....3/10 might be tolerable for her, but only way to find out is ask the patient.....some people have high pain tolerances, others might not.....her VS do not indicate any respiratory distress....

Well, yeah...but, since your answer wasn't a choice ;) which answer would you choose?

allnurses Guide

Spidey's mom, ADN, BSN, RN

11,304 Posts

Well, yeah...but, since your answer wasn't a choice ;) which answer would you choose?

None of the above? :D

steph

CuriousMe

2,642 Posts

None of the above? :D

steph

Interesting NCLEX strategy.....I might try a different one though.:D

allnurses Guide

Spidey's mom, ADN, BSN, RN

11,304 Posts

Interesting NCLEX strategy.....I might try a different one though.:D

I just think the question is wrong . ... . hemicolectomy . . hysterectomy . ..

Plus, I hate NCLEX questions . .. . but I get why y'all have to practice. So, I'll bow out. :coollook:

steph

Snwbdr

198 Posts

didn't realize it was a NCLEX question....thought it was a scenario or something.....I wouldn't do anything, so i guess #4

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