Question

RITICAL THINKING CASE STUDY RJ, a 79-year-old man, underwent abdominals surgery for 3. What is the significance of the change in vital signs? of his colon. After the surgery, his physician pre- 4. What classic side effects of opioid analgesics should the nurse scribed morphine 10 mg every 3 to 4 hours as needed. RI assess? and not ask for pain medication because he worried he might 5. What are some possible nonpharmacologic measures that become addicted. A day after the surgery, RJ's nurse noted that might be helpful in alleviating RJ's pain? he was restless and grimaced whenever he moved in bed. He The second postoperative day, RJ began asking for morphine refused to breathe deeply or cough when instructed to do so. every 3 hours. On the fifth day, the physician discontinued RJ's The nurse compared RJ's vital signs to his baseline findings morphine and prescribed acetaminophen with codeine. and noted an increased pulse rate and a drop in systolic blood 6. Why was the opioid analgesic order changed? pressure of 6 mm Hg. 7. RJ does not want to ambulate. What is an appropriate nurs- 1. Should the nurse give morphine? Explain your answer. ing response? 2. What would your reaction be to RJ in regard to his rest- lessness, grimacing, and refusal to breathe deeply and cough?

please answer 2,3,4,5,6,7

Answer 1

1.Yes the nurse should give morphine at prescribed interval so the patient will be comfortable.And he can be able able to breath deeply or cough without discomfort.But if the patient refuses the nurse can't give it because the patient have a right to refuse.

2.I would first check his vital signs.And I would ask him if he is feeling pain because all the symptoms he showed is of pain and if he agrees that I would perform intervention.

3.If a person is feeling extreme pain then they would be in shock like symptoms.And narcotics decreased the systolic blood pressure so vital signs may change and so that they should be recorded at required times.

4.Drowsiness, constipation, depression of respiratory system,mental clouding and urinary retention.

5.Relaxation techniques,back rubs,good position,support to body helps allevatinal RJs pain.

6.After 5 days the pain caused by the surgery decreases in intensity and so less potent drugs are prescribed and opiods cause dependency so they are changed.

7.Decrease in pain may be the cause of RJ opinion change.But RJ should be encouraged to ambulate after 1 hour after administering the meperidine.