Question

Transdermal fentanyl (Duragesic) is being used for an adolescent with cancer who is in hospice care. The adolescent has been comfortable for several hours but now complains of severe pain. The most appropriate nursing action is to

a. administer meperidine (Demerol) intramuscularly.
b. administer morphine sulfate immediate release (MSIR) intravenously.
c. use a nonpharmacologic strategy.
d. place another fentanyl (Duragesic) patch on the adolescent.

Answer 1

The most appropriate nursing action is to administer intravenous morphine sulfate for immediate relief of severe pain.

Step-by-step explanation:

The most appropriate nursing action in this scenario is to administer morphine sulfate immediate release (MSIR) intravenously. Transdermal fentanyl (Duragesic) is a long-acting opioid used for chronic pain management, but it may take some time to reach its full effect. In the case of severe pain, immediate relief is necessary, and intravenous morphine sulfate provides faster pain relief.

Meperidine (Demerol) is not recommended due to its potential side effects, such as increased risk of seizures. Using a nonpharmacologic strategy may not provide sufficient pain relief for severe pain. Placing another fentanyl patch on the adolescent may not provide immediate relief as it takes time for the medication to be absorbed.