Question

The nurse is caring for an 81-year-old client with colorectal cancer. Previously, the client's pain was managed with acetaminophen with codeine. However, the client is now experiencing frequent, severe pain, and intravenous morphine has been prescribed. What should the nurse recognize about this order?

A
Appropriate despite the risk of diarrhea and abdominal upset
B
Appropriate pain management and should be available around the clock Correct Answer (Blank)
C
Inappropriate and demonstrates lack of knowledge related to pain control
D
Inappropriate due to the potential of respiratory depression

Answer 1

The order for intravenous morphine for an 81-year-old client with colorectal cancer experiencing severe pain is an appropriate pain management strategy. Morphine is a stronger opioid than codeine and can effectively manage severe pain, often necessitating administration around the clock for stable pain control, despite potential risks which can be managed with proper medical supervision.

Step-by-step explanation:

A student asked what the nurse should recognize about the prescription of intravenous morphine for an 81-year-old client with colorectal cancer, who was previously managed with acetaminophen with codeine but is now experiencing frequent, severe pain. The more correct understanding of this medication order is that it is an appropriate pain management strategy, often necessary for severe pain not adequately controlled by less potent opioids like codeine, and indeed could require around-the-clock administration.

Morphine, an opioid analgesic derived from the opium poppy plant, is well-established in the management of moderate to severe pain. It is significantly more potent than codeine, which is typically used for mild to moderate pain, often in combination with non-opioid analgesic like acetaminophen. The switch from codeine to morphine in a patient experiencing severe pain signifies a step up in the analgesic ladder, reflecting the need for a stronger medication to manage the patient's symptoms effectively.

It is important to note that while opioids like morphine are effective for pain relief, they come with potential side effects and risks, including respiratory depression. However, under proper medical supervision, these risks can be managed. Nurses and healthcare providers monitor patients closely for signs of adverse effects, adjusting dosages as necessary. Providing morphine around the clock ensures stable pain control and prevents the peaks and troughs in pain levels that can occur with as-needed dosing.

Lastly, while opioids like morphine could potentially cause gastrointestinal side effects like nausea, diarrhea, or constipation, in the case of severe pain from conditions such as cancer, the benefit of adequate pain control generally outweighs these risks.