Question

The patient describes her pain as an 8 on a scale of 0 - 10, occurring constantly in the perineum, but is worsened when she voids. She is currently taking hydrocodonelacetaminophen 2 tablets every 4 hours. She frequently awakens and takes the medications during the night. She states that the medicines relieve the pain by approximately 25%. Examination of the perineum reveals inflamed excoriated tissue from the labia to the rectum. Stool appears to extrude from the vagina. The excoriation is cleared and the pain is under control with 10mg of morphine 44 hours (6 doses a day). She uses approximately 3 additional doses of 10mg of morphine for breakthrough pain per day. Thus she is using approximately 9 doses / 24 hours. Unfortunately, she awakens at night in pain. She describes no adverse effects to the medications. 1. What might be the best analgesic regimen for this patient? One patient is being prepared for discharge to hospice at home when she expresses some concern regarding her son who has a history of substance abuse. She is afraid he might use her medications 1. What might you do as a nurse?

Answer 1

Image 1: explain best analgesic in perineal pain

Image 2 : explain education provided to patient during discharge

Ist

* Best Analgesics Helps'ndthe patient pain uelieving as we know acetaminophen Melieve pain 304. and Morphine vielieves pain upto 60-70%. - Beat analgesic in perineum pain acetaminophen as it has no severe side-effect as compared to mouphine.

2nd

Nurse should advice the patient as patient us prepared for discharge for hospice at Home as Below : - - - Nurse should advice patient to keep the medicine away from his son who has Habit of Substance abuse Advice the patient to take plenty of fluids. Educate the patient to avoid spicy food. Advice the patient to take medicine timely Educate the patient to clean perineum to Reduce musk of Infection.