00:01 A postoperative client is requesting pain medication after receiving morphine, two hours prior. 00:07 The nurse reads the prescription "morphine intravenous 4 milligrams PRN every 6 hours for severe pain." Which response by the nurse is most accurate? All right, let's break it down. Let's look at the first sentence. 00:21 So this is a post op client. 00:23 That's what's particular about them. 00:25 They're requesting pain medication. They got morphine two hours prior. 00:30 Okay, so, post op client, having pain. 00:33 We got morphine two hours prior. 00:36 The nurse looks at the prescription, or we would also call that in order. 00:40 Now, here's what it says, "morphine intravenous 4 milligrams PRN every 6 hours for severe pain." Okay, which response by the nurse is most accurate? So now I have to think through the order. 00:56 I know of a patient who got pain medication, two hours prior. 01:00 They got morphine two hours before. 01:03 Now they're asking for morphine. 01:05 The order reads every 6 hours PRN for severe pain. 01:10 So you're going to look through the answer choices and decide which response by the nurse is most accurate? All right. Run through your answer choices. 01:20 Quickly, write down 1, 2, 3, and 4. Just the numbers on your sheet. 01:24 Work through the answer choices, then come back. 01:27 We'll go through them together. 01:36 Welcome back. 01:37 Now did you do the work? Have you committed to your answer? Good job, if you have. 01:43 That's the way you get the most out of studying with us. 01:46 Okay, so let's look at these again. 01:48 Number one, "I can only administer the medication if your pain is severe." Well, the order does say for severe pain. 01:58 I'm not ready to let that go. 02:00 Number two. 02:01 "I am concerned you're experiencing a side effect." Okay. After surgery, if a client is having pain, that could be a side effect. 02:12 What about number three? "Let me talk to your healthcare provider since your dose is early." Well, is it early? It is. The order says PRN every six hours. 02:25 And we know that this patient is asking for it just two hours after they receive morphine. 02:30 So that one's definitely in. 02:32 What about number four? "Your order is as needed. I will get the medication." No, that one I can immediately take out. 02:41 Because the order doesn't mean as often as you want it. 02:44 It says PRN every six hours. 02:47 Now here's a special tip for NCLEX and real life. 02:51 As a nurse, we can't alter that order in any way. 02:56 So I can only give 4 milligrams every 6 hours PRN. 03:02 I can't adjust the dosage, and I cannot adjust the time. 03:06 So number four, I can cross off. 03:09 We're left with number one, two, and three. 03:12 Which one keeps this particular patient in this particular setting, the safest? Well, number one is true. 03:21 But is it better than two and three? No, it doesn't keep the patient the safest. 03:27 Number two. 03:28 "I'm concerned you're experiencing a side effect." A side effect of morphine? What are they talking about? Now you may have read that is adverse effect. 03:38 But that's not what the answer choice says. 03:40 It says, "I am concerned you may be experiencing a side effect." So more pain is not a side effect of morphine. 03:49 We're rid of number two. 03:51 Number three. 03:53 "Let me talk to your healthcare provider. 03:55 Your HCP sent your doses early." Does that make sense? Sure does. 03:59 Because the order says, "morphine IV 4 milligrams, PRN every 6 hours." This client is requesting it at two hours. 04:10 So the dose is early. 04:13 So this may not be your first statement that you make to a patient. 04:16 But keep in mind, the answer choices on an exam are not meant to be a script on how to take care of patients. 04:23 What they're asking you is of these four choices, which one keeps this particular patient in this particular setting, the safest.
The lecture Walkthrough: Pharmacological and Parenteral Therapies Q10 – NCLEX-RN® by Prof. Lawes is from the course NCLEX-RN® Question Walkthrough: Pharmacological and Parenteral Therapies.
Dilaudid 1 mg IV is ordered every 4 hours as needed for severe pain. The client received Dilaudid 1 mg 1 hour ago and is requesting additional pain medication. Which is the most vital action by the nurse?
Morphine 2 mg IV is ordered every 3 hours as needed for severe pain. The client received the medication 6 hours ago and is requesting additional pain medication. Which action by the nurse is essential?
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