Professional Documents
Culture Documents
ANALGESICS
Yes, since the patient shown signs of pain and discomfort. And since it is
prescribed, giving it to the patient is allowed. Also, the nurse should inform the
patient that morphine will not give him an addiction if and only if it is used
properly and that the nurse will monitor his vital signs regularly. But if RJ refuses
to take the medication, the nurse cannot force him. Simply, find other alternatives
to alleviate his pain. The nurse then should report these symptoms to the doctor.
Since RJ showed signs of high pulse rate, it is from the pain he is feeling.
Increased pain may cause shock-like symptoms. The nurse should administer
morphine and continually monitor his vital signs.
4. What classic side effects if opioid analgesics should the nurse assess?
The second postoperative day, RJ began asking for morphine every 3 hours. On
the fifth day, the physician discontinued RJ’s morphine and prescribed
acetaminophen with codeine.
The order was changed to prevent opioid dependency. By the third to the fifth day,
pain should have lessened, and a less potent opioid or mixed drug is usually
prescribed.
Pain may diminish the capacity and willingness of R.J. to ambulate. Encourage
R.J. to ambulate 1 hour after morphine administration.
MT, age 16 years, is a high school senior who is 59.3 inches tall and weighs
126 pounds. He is having increased feelings of discomfort about not fitting in
with the other students at school because he has not yet begun sexual
maturation. He is a good student and an accomplished violinist in the school
orchestra. His father states that he also was a “late bloomer”, but both parents
are concerned about MT’s increasing social withdrawal and seem determined to
seek medical intervention for him. The nurse at the clinic assesses the needs and
status of MT and his parents.
He feels he does not fit in with the other students because of the fact that he has
not yet begun sexual maturation and that he’s a “late bloomer,” thus, making him
feel uncomfortable and withdrawn.
They are concerned about the increasing social withdrawal of MT and are
determined to seek medical intervention for him.
3. What information must be included in the history and physical
examination?
4. What education should the nurse prepare before the parents decide
whether to start their son on androgen therapy? The decision is made to
prescribe testosterone 30 mg every 12 hours by buccal tablet (held inside
the cheeks until it dissolves). MT will be on this regimen for 4 months,
during which time he is to come to the clinic at monthly intervals.
The nurse needs to educate the parents and the patient himself about the
androgen therapy effects. Androgens will help maintain and sustain masculine traits
growth, and that androgens will have the same impact on male reproductive organs
as testosterone. This drug can decrease the function of the thyroid and boost the
clearance of creatinine. With this in mind, MT has to visit the clinic on a regular
basis.
5. MT asks why he will be treated for 4 months. What will the nurse reply?
The nurse will tell him that he must be treated for 4 months in order to improve
the secretions of his gonadotropins. After 4 months, the progress will be checked
again to see if endogenous puberty has occurred or not and if no further
interventions are required.
6. About what adverse effects do MT and his parents need to be educated?
MT is advised to frequently wash his face with mild soap to avoid spreading or w
orsening of his acne as a negative effect of treatment. He must also regularly take
baths to diminish oil in skin and exercises to maintain a healthy body weight since
the treatment enhances growth in height and weight.
Once every four months, depending on the instructions given by the doctor. This
is to verify the status of bone density, as treatment (frequently known as osteopenia)
may have influenced it.
10. During a clinical visit, MT mentions that he heard that the use of anabolic
steroids might improve his chances of making the wrestling team. What
should he be told about the safety and efficacy of anabolic steroid use?
Because of the use and abuse of anabolic steroids, there are several known
health dangers. Short stature and acceleration of epiphyseal maturation of the long
bones may happen for pre-pubertal adolescents. Side effects such as paranoia,
sleeping disorders, euphoria, confusion, hepatic dysfunction, gynecomastia,
testicular atrophy, severe nodular acne and infertility may also happen. Steroid use
must be controlled in order to prevent adverse effects from occurring and possibly
make them severe and hard to cure.