Question

PN 200 Fundamentals of Nursing 200 Surgical Pain - Morphine RJ, a 79-year-old man, underwent abdominal surgery for resection of his colon. His physician prescribes morphine 10 mg every 3-4 hours PRN after surgery. RJ did not ask for pain medication after surgery because he worried he might become addicted. A day after the surgery, his nurse noted he was restless and grimaced whenever he moved in bed. He refused to breathe deeply or cough when instructed to do so. The nurse compared RJ's vital signs to his baseline findings and noted an increased pulse rate and a drop in systolic blood pressure of 6 mmHg. 1. Should the nurse give morphine? Explain your answer. 2. What would your reaction be to RJ in regard to restlessness, grimacing, and refusal to deep breath and cough? 3. What is the significance in a change in vital signs? 4. What classic signs of opioid analgesics should the nurse assess? 5. What are some of the nonpharmacologic measures that might be helpful in relieving RJ's pain? The second day postoperatively, RJ begins to ask for morphine every 3 hours. On the 5th day postoperatively, the physician discontinues RJ's morphine and orders acetaminophen with codeine. 6. Why was the opioid analgesic changed? 7. RJ does not want to ambulate. What is an appropriate nursing response? 8. State the antidote for morphine sulfate. Reviewed 9/19

Answer 1

1.This shows withdrawal side effects of morphine.

2.To lessesn the side effects administer tramadol as per doctor's order.

3

• Hypothermia
• Tachycardia
• Hypotension
• Tachypnea

4.

• Impaired mental status such as confusion, delirium
• Dizziness
• Altered vital signs
• Loss of alertness
• Small pupils

5.

• Promote rest
• Position
• Diversional therapy
• Relaxation training

6. Patient shows high dependence to the drug so doctor replaced the drug.

7.

• Teach the patient regarding importance of mobility
• Change position between 2 hours
• Promote independent self care
• Provide assistive devices for support
• Encourage to do physiotherapy.

8. Naloxone