Test Question bugging me

GRASSCUTTER · Apr 26, 2008

A client has a patient controlled anagesia pump for pain control. The basal rate of the morphine is 2mg per hour with added demand dosing of 1 mg every 15 min PRN. What is tje anticipated outcome?
1. Increase risk of nausea and vomiting due to frequent demand dosing
2. Respiratory rate of 16-20 per min
3. increase risk of developing narcotic tolerance
4. Increased risk for oversedation due to basal rate

Bad stand alone question. Needs more information. What type of pain?

Bone pain, CA pain, PE pain????

morte, LPN, LVN · Apr 26, 2008

have to agree, poor question....if forced to answer, would say 2, doesnt seem like a large dose, and the demand is less frequent than i have seen.....

allnurses Guide · Apr 26, 2008

A "client" has a "patient" controlled analgesia pump?

(Sorry, couldn't resist . . . .).

I started to post on each possible answer but realized that I simply hate these questions. I will mention that the instructors do not want you to read anything into the question or assume anything.

So, I'll gladly read others responses.

steph

mystcnurse, MSN, APRN, NP · Apr 27, 2008

Not such a great question, but the anticipated outcome is not a nursing diagnosis. It is what you WANT to see happen. So the respirations between 16 and 20 has to be the right answer.

RN1989 · Apr 27, 2008

I say the resp ?. The dose does not seem excessive to me and a pt in pain will often have an INCREASED resp rate, so a normal respiratory rate is what you would be expecting as that pain would be controlled.

mystcnurse, MSN, APRN, NP · Apr 27, 2008

Also, just for future reference, almost any time that you have three answers that are the same and one answer that is different (remember sesame street) the one that is different is the correct answer. Also, again, with this question, there is only ONE outcome listed, the rest are nursing diagnoses. I don't think the instructor was really asking about a PCA pump or pain, or morphine, as much as making sure you knew the difference between an outcome and a nursing diagnosis. My guess is that this is a first year class.

mike.m · Apr 28, 2008

Thanks guys... I was leaning toward 2 also just wanted to see how you all felt.

MB37 · Apr 28, 2008

I agree- an expected outcome is what you want to see, not the possible things that go wrong. Definitely 2.

CISCOPATRICK06 · May 1, 2008

I agree with everyone. The question asked for the anticipated outcome or what you would expect to happen. Since an adverse reaction to morphine is CNS and respiratory depression, I would choose 2 which is the opposite and what I want to see after the med is administered through the PCA.

Tait, MSN, RN · May 22, 2008

A client has a patient controlled anagesia pump for pain control. The basal rate of the morphine is 2mg per hour with added demand dosing of 1 mg every 15 min PRN. What is tje anticipated outcome?
1. Increase risk of nausea and vomiting due to frequent demand dosing
2. Respiratory rate of 16-20 per min
3. increase risk of developing narcotic tolerance
4. Increased risk for oversedation due to basal rate

I am selecting 4 as my answer. Critical thinking for me would place that as a priority in my thinking process because it is a very strong risk that the person may become oversedated due to the basal, and may be at a higher risk. N/V won't kill you, normal respiratory rates are like "w/e", narcotic tolerance in a s/p patient is very low on the probabilty scale, so the only valid response is the very real threat of death from oversedation.

But it is a poorly worded question. If it had been in my nursing class, they would have been fishing for #4.

Tait

mystcnurse, MSN, APRN, NP · May 22, 2008

I am selecting 4 as my answer. Critical thinking for me would place that as a priority in my thinking process because it is a very strong risk that the person may become oversedated due to the basal, and may be at a higher risk. N/V won't kill you, normal respiratory rates are like "w/e", narcotic tolerance in a s/p patient is very low on the probabilty scale, so the only valid response is the very real threat of death from oversedation.
But it is a poorly worded question. If it had been in my nursing class, they would have been fishing for #4.
Maybe so, but that answer would be wrong. The question is asking for an anticipated OUTCOME. In otherwords, it is asking for the outcome you are seeking. Plus, honestly, for an adult, this is NOT alot of morphine. But even if it were, that is not the OUTCOME you are looking for. Good luck!