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Pain Management

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Mr. Rogers is 2 days postoperative of a thoracotomy for removal of a malignant mass in his left chest. His pain is being managed via an epidural catheter with morphine (an opioid analgesic). As the nurse assumes care of Mr. Rogers, he is alert and fully oriented, and states that his current pain is 2 on a 1-to-10 scale. His vital signs are 37.8 – 92 – 12, 138/82. (Learning Objective 6)

What are benefits of epidural versus systemic administration of opioids?

  1. The nurse monitors Mr. Rogers’ respiratory status and  vital signs every 2 hours. What is the rationale for these frequent assessments?
  2. The nurse monitors Mr. Rogers for what other   complications of epidural analgesia?
  3. Mr. Rogers complains of a severe headache. What should  the nurse do?
  4. Mr. Rogers’ epidural morphine and decreased mobility  increase his chances of constipation. What interventions should be  included in his plan of care to minimize constipation?

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