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 5 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.The nurse has to administer a pain killer for this patient at this time. The need for it can be ruled out from the patient's facial observation.

2.These all are typical sign of pain experienced by a patient who refuses to express their pain in fear and other causes.

3.Any changes in the body for its action ,mechanism,function ,etc., can be easily identified with vital signs. The changes in the vitals are an indicator for alteration or disturbance from a normalcy.

4.The classic signs to be assessed are

• Apnea, assess for respiratory rate, breathing problems
• Miosis ,where the pupil has to be assessed for any constriction
• Stupor ,assess patient for consciousness
• Assess for psychological status like anxiety or fear,felling depressed can make patient option analgesic addict or abuse later.