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.