Fundamentals of Nursing Q 429
When titrating an analgesic to manage pain, what is the priority goal?
A. Administer smallest dose that provides relief with the fewest side effects.
B. Titrate upward until the client is pain-free.
C. Titrate downwards to prevent toxicity.
D. Ensure that the drug is adequate to meet the client’s subjective needs.
Correct Answer: A. Administer smallest dose that provides relief with the fewest side effects.
The goal is to control pain while minimizing side effects. The World Health Organization cancer pain ladder provides a helpful starting point for achieving effective pain management. Clinicians should begin with nonopioid analgesics (e.g., acetaminophen, nonsteroidal anti-inflammatory drugs [NSAIDs]), and gradually progress to more potent analgesics until pain is relieved.
Option B: For severe pain, the medication can be titrated upward until pain is controlled. Many patients with terminal illnesses require immediate opioid therapy or have contraindications to common non-opioid analgesics, such as NSAIDs.
Option C: Downward titration occurs when the pain begins to subside. Acetaminophen is useful as a primary analgesic, or in combination with other drugs, for treating mild to moderate pain. Dosages in healthy persons should be limited to no more than 4,000 mg every 24 hours to reduce the risk of hepatotoxicity.
Option D: Adequate dosing is important; however, the concept of controlled dosing applies more to potent vasoactive drugs. The World Health Organization pain ladder offers a stepwise guideline for approaching pain management. However, for many patients with terminal illnesses, strong opioids are necessary for efficient and effective analgesia.