Question

A nurse is caring for a patient just transferred from the PACU following an abdominal hysterectomy. The patient is receiving PCA with IV morphine sulfate 2 mg every 15 min with a 30 mg/4 hr lockout. One hour after the patient has returned to the unit, the patient tells the nurse that her pain is still unbearable. The nurse checks the PCA monitor and determines that the patient has made six attempts within the last hour. Which of the following actions should the nurse take after performing a pain assessment?

a. Increase the lockout interval
b. Administer a rescue dose of pain medication
c. Instruct the patient on alternative pain management techniques
d. Consult with the healthcare provider for a change in pain management plan

Answer 1

The nurse should assess the patient's pain and consult with the healthcare provider for a potential change in the pain management plan, since the current PCA with morphine sulfate seems insufficient given the patient has made six attempts within the last hour.

Step-by-step explanation:

d. Consult with the healthcare provider for a change in pain management plan.

When a patient's pain remains unbearable despite multiple attempts at PCA (Patient-Controlled Analgesia) with morphine sulfate within a short time frame, it indicates inadequate pain relief. In this situation, the nurse should perform a comprehensive pain assessment to understand the nature and intensity of the pain. Subsequently, consulting with the healthcare provider becomes crucial to reassess the pain management plan and consider alternative or additional pain relief strategies. This may involve adjusting the dosage, frequency, or type of medication, adding supplemental pain medications, or exploring non-pharmacological interventions to ensure effective pain control while minimizing risks of overmedication or side effects. It's essential to involve the healthcare team to address the patient's uncontrolled pain adequately.