Question

1. Mr. Walter, a 39-year-old man who is opioid naive and weighs 60 kg, He has an order for Morphine Sulfate 30mg PO Daily. During your visit to his house his BP is 135/86, P is 90, RR is 22, and his O2 saturation is 98%. Preoperatively he indicated that he had a very low tolerance for pain. His goal for therapy was no pain and he thought he could tolerate pain at only a level of 1 on a 0-10 scale. What would you do and why? a) b) When you question him about how much pain he has, he reports his pain is a 9 on the 0 to 10 scale. What should you do? His orders are for Percocet 1 tab for pain 3 to 6/10; Percocet 2 tabs PO for pain 7 to 10/10. c) What would be your first action? d) What dose would you administer and why? e) Thirty minutes after administering one dose, his pain is rated as a 7 on 0-10 scale. What do you do now? f) Three hours after administering the medication dose, he rates his pain a 3 on 0-10 scale. Now what would you do? g) How would you document this episode?

this is nursing care plan, please type your work. Thanks.

Answer 1

1. Answers:

a) Ask him to report his pain in detail such as location, intensity, radiation, frequency, the duration for better assessment of pain.

b) I will check his PAR orders for pain.

c) I would ask him to rate the pain on the pain scale. Check his vital signs.

d) If he reports 9 out of 10, then I administer Percocet 2 tab according to the order.

e) Then I will assess the peak effects of the drug, vital signs, and assess for side effects of the drug. If no side effects, then I will administer another 2 tabs of Percocet.

f). Now, I will avoid administering any medication because already the patient has received the highest dose. Repetition of highest dose produces side effects and harm to the patient. So I will wait for another 30 minutes to assess the pain level.

g). I document as pain scale rate is 3. A maximum dose of Percocet has been administered. No side effects. vital stable.  The pain level is monitored. pain is reduced and tolerable. the patient's goal has met.