Fundamentals of Nursing Q 540
What is the best way to schedule medication for a client with constant pain?
A. PRN at the client’s request
B. Prior to painful procedures
C. IV bolus after pain assessment
D. Around-the-clock
Correct Answer: D. Around-the-clock
If the pain is constant, the best schedule is around-the-clock, to provide steady analgesia and pain control. The other options may actually require higher doses to achieve control. Pain medication prescribed around-the-clock has the purpose of managing a patient’s baseline pain, which is the average pain intensity the patient experiences. This is generally pain that is continuously experienced.
Option A: The use of “as needed” or “pro re nata” (PRN) range opioid analgesic orders is a common clinical practice in the management of acute pain, designed to provide flexibility in dosing to meet an individual’s unique needs. Range orders enable necessary adjustments in doses based on individual response to treatment.
Option B: Of particular importance to nursing care, unrelieved pain reduces patient mobility, resulting in complications such as deep vein thrombosis, pulmonary embolism, and pneumonia. Postsurgical complications related to inadequate pain management negatively affect the patient’s welfare and the hospital performance because of extended lengths of stay and readmissions, both of which increase the cost of care.
Option C: Assessment of pain is a critical step to providing good pain management. In a sample of physicians and nurses, Anderson and colleagues found lack of pain assessment was one of the most problematic barriers to achieving good pain control. The most critical aspect of pain assessment is that it is done on a regular basis (e.g., once a shift, every 2 hours) using a standard format. The assessment parameters should be explicitly directed by hospital or unit policies and procedures.