Published Jun 8, 2009
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
What are your thoughts on the question?
i am picking number 4
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 am picking number 4ans1) hysterectomy??ans2) pt is not airway compromised why would we do that? pt's pain can be back without morphineans3) she is already giving pain score 3/10, no reason to increase the dose at allans4)do nothing is the best response
I like 4 as well, for the same reasons you mentioned.
Spidey's mom, ADN, BSN, RN
I'd be wondering why the report was a hemicolectomy but the real operation was a hysterectomy.
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.
I would chose #4 too. She is stable and 3/10 maybe her comfort zone.
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?
None of the above?
None of the above? steph
Interesting NCLEX strategy.....I might try a different one though.
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.
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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