Question

T.M, a 72 year old female was admitted to the medical-surgical floor for abdominal pain. The nurse is reviewing the orders and sees that the patient is scheduled for surgery (a laparotomy) in the morning. The nurse discusses post-op orders with the patient. The provider prescribes morphine.

1. Why was morphine ordered? What are the nursing considerations for patients who are prescribed morphine?

2.What are your concerns? Explain your answer. Would a PCA pump be appropriate for this patient? Explain your answer.

3.What are the advantages of patient controlled analgesia? T.M asks if he can have aspirin for his headache- that's what usually helps at home. 4.How would you respond? Explain your answer. Due to low urinary output, T.M stays in the hospital for 2 days. After clear diagnostic renal workup, T.M is discharged with a prescription for acetaminophen.

5. What drug classification is acetaminophen? How does it work?

6.What are the nursing considerations and patient teaching for acetaminophen?

7.What are the nursing considerations and patient teaching for acetaminophen?

Answer 1

1.Morphine is a strong pain killer (opioid analgesic) which can control pain very effectively by acting on the central nervous system. Some of the things which the nurse has to consider in a patient who is prescribed morphine are

• Assess the patient for respiratory status because this can cause respiratory depression. So continuous monitor of respiratory rate is essential. To be used in caution if patient has any respiratory problems.
• Assess the bowel pattern ,because this can cause constipation. Ensure there is prescription for laxative after the bowel sounds are heard postoperatively
• Mental status examination to assess the central nervous system and consciousness. This can sedate an individual so the consciousness has to be monitored frequently
• Monitoring for side effects is a must
• Assess the pain level after administration

2.PCA pump can be appropriate in case of laparotomy abdominal surgery to control pain efficiently. The pain after abdominal surgery are intolerable so patient can be given this option to control pain

3.The advantages of the PCA pump are

• Can be used whenever patient required the medication for pain
• The action of the medication is much faster
• Patients can be involved in the care
• A minimal dose is delivered to control pain

Aspirin should not be generally recommended after surgery because this can increase the chance of bleeding .The headache can be controlled with the medication which is given for abdominal surgery pain

4.Acetaminophen is a mild pain killer generally recommended to treat pain(analgesics).The morphine has a side effects of lowering urine output so after discharge a painkiller which doesn't affect the renal system to be prescribed.