Question

Mr. Will, a 67-year-old patient, is postoperative day 2 after a coronary artery bypass graft operation to revascularize his coronary arteries that were significantly blocked. He has a midline incision of his chest and a 7-inch incision on the inner aspect of his right thigh where a saphenous vein graft was harvested and used to vascularize the blocked coronary artery. The surgeon ordered Oxycodone 5 mg every 4 hours PRN for moderate pain and Oxycodone 10 mg every 4 hours PRN for severe pain. (Learning Objectives 7 and 8)

Considering the patient’s age, what medication administration considerations should the nurse incorporate into the pain management plan and why?

What measures should the nurse provide the patient to prevent adverse effects of analgesic agents from occurring?

What nonpharmacologic pain management methods should the nurse teach to Mr. Will to assist with pain management?

Answer 1

Considering the patient’s age, what medication administration considerations should the nurse incorporate into the pain management plan and why?

Taking into consideration of patients age, nurse may plan for morphine instead of codene as it needs higher dosage compared with morphine. Morphine can relieve pain of patient even in the lower dose as it is strong acting opioid. And also continuous monitoring of vital signs are mandatory as the patient may have chances for respiratory depression. By administering morphine patient may have less load of pharmacological agent with minimal need for metabolizing the drug.

What measures should the nurse provide the patient to prevent adverse effects of analgesic agents from occurring?

Dose reduction- Start low and go slow protocol

Opioid rotation or opioid switching inorder to prevent or lessen side effects

Route of administration may be altered frequently as it can be given in multiple routes

Symptomatic intervention according to adverse effects

What nonpharmacologic pain management methods should the nurse teach to Mr. Will to assist with pain management?

Non pharmacologic interventions of pain management such as:

Distraction

Imagery

Massage

Relaxation

Music

Heat/Cold therapy

Meditation