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, Pis 90, RR is 22, and his 02 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. a) What would you do and why? 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? c) Thirty minutes after administering one dose, his pain is rated as on 0-10 scale What do you do now? f) Three hours after administering the medication dose he rates his pain 3 on 0-10 scale Now what would you do? B) How would you document this episode

Answer 1

Answers:

a). I will ask him to explain the intensity of pain. I clear with the frequency and duration of pain. Ask him about the aggravating factors that interfere with the pain.

b). I will check his analgesics orders.

c) I will check the peak effects and duration of the effects of medication. I will assess the time of previous dose of analgesics before administering Percocet.

d)Percocet 2 tabs are administered based on his pain scale as per orders.

e) Now I will administer the Percocet 1 tab because administering again 2 tabs will reach the maximum peak level and increases the risk of side effects.

f) Again to assess his pain and intensity level. Confirm his pain level using other techniques such as facial expression, discomfort. If still pain is present, then administer one more tab of Percocet. Monitor his vital signs. Assess the side effects to prevent complications.

g) I document the each episode of pain with a detailed explanation of the intensity level, medication administered, outcomes, vital signs and side effects with date and time. Note clearly whether goal has been achieved or not.