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
I chose #4 because after that type of surgery 3/10 is probably expected. The goal's is not to completely eliminate the discomfort, but to minimize it. All out vital signs are in the normal range. So what is the right answer?
Specializes in med/surg, telemetry, IV therapy, mgmt.
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?
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
stop the infusion and administer a dose of naloxone to reverse the effects of morphine
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
keep the infusion at the current rate
i'm going to say #4 for this reason. . .no where in the stem of the question does it say that the patient is complaining of pain or asking for more pain medication. it says she is sleepy and easily aroused. you don't fiddle with what ain't broke.
btw, i've had a hemicolectomy and a hysterectomy. the hemicolectomy didn't hurt nearly as much as the hysterectomy did.
Spidey's mom, ADN, BSN, RN
11,305 Posts
I didn't think it was either . .. hence my answer.
steph