The nurse is caring for a client with cancer experiencing chronic pain and episodes of breakthrough pain. Which prescription should the nurse request from the primary healthcare provider (PHCP) to provide effective pain control?A. Hydromorphone via patient-controlled analgesia (PCA)B. Morphine intramuscular (IM) as needed (PRN) for painC. Oxycodone extended-release (ER) by mouth (PO)D. Ketorolac via intravenous (IV) push
Question
The nurse is caring for a client with cancer experiencing chronic pain and episodes of breakthrough pain. Which prescription should the nurse request from the primary healthcare provider (PHCP) to provide effective pain control?A. Hydromorphone via patient-controlled analgesia (PCA)B. Morphine intramuscular (IM) as needed (PRN) for painC. Oxycodone extended-release (ER) by mouth (PO)D. Ketorolac via intravenous (IV) push
Solution
The nurse should request a prescription for option A: Hydromorphone via patient-controlled analgesia (PCA).
Here's why:
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Chronic pain in cancer patients is often best managed with around-the-clock opioid analgesics to maintain a consistent level of pain control.
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Hydromorphone is a potent opioid analgesic that can be administered via a PCA pump. This allows the patient to self-administer doses of the pain medication as needed, providing more consistent and effective pain control.
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PCA is often preferred for managing chronic and breakthrough pain because it allows for immediate administration of medication when pain intensifies.
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The other options (B, C, and D) may not provide as effective or consistent pain control. Morphine IM as needed (option B) may not provide consistent enough pain control, as it relies on nurse administration and can't be given as immediately as with a PCA pump. Oxycodone ER (option C) is an oral medication, which may not be as fast-acting as PCA. Ketorolac (option D) is a nonsteroidal anti-inflammatory drug (NSAID), which may not be potent enough to control severe cancer pain.
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