Mr. Roger is 2 days postoperative of a thoracotomy for removal of a malignant ma

Question

Mr. Roger 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 apioid analgesic).As the nurse assumes care of Mr. Roger's, he is alert and fully oriented, and states that this current pain is 2 on a 1-to-10 scale. His vital signs are 37.8-92-12,138/82.(Learning objective 6).
a. what are benefits of epidural versus systematic administration of opioids?
b. The nurse monitors Mr.Rogers' respiratory status and vital signs every 2 hours. What is the rationale for this frequent assessments?
c.The nurse monitors Mr.Rogers for what other complications of epidural analgesia?
d. Mrs. Roger's complains of a severe headache. What should the nurse do?
e. Me. Rogers' epidural morphine and decreased mobility increase his chances of constipation. What interventions should be included in his plan of care to minimize constipation?

Explanation / Answer

  1) Opoid acts as analgesic which reduces the pains experience by the patient. The drug acts on the nervous system and reduces the pains. The epridural route of administration will ensures the event he low dosage of drug is sufficient to shows its effect which is administered in the middle of the spinal chord using catheter. While in case of the systemic administration the drug reaches all parts of the body by dissolving in the blood results in reaching of drug to the nervous system late and a high amounts of drug is required which may be harmful.

2) Opioids administration causes changes in breathing patterns and it may lowered the breathing rate. This may also causes irregular breathing rate and increased or slower heart rate hence nurse is checking eh breathing rate frequently.

3) Epidural analgesia causes the numbness of the nervous which may less the sensation. Epidural analgesia causes the lower blood pressure and heart beat which leads to lower circulation of oxygen. This might be lead heat stroke.

4) Opiods lower the pains experience by acting the pain receptors on the nervous system. As overdode of opiods may cause head ache and pins in nervous system. The nurse should check for any overdose of the drug and treatment with Naloxone will reverse the overdose action of opiod.

5) Opiod may cause inappropriate bowel movements and gastric movements. Treating with Naloxone will reverse the effects of the opiod and treatment with other antibiotics for secondary infections will make the risk of infection lower. Administration of intravenous fluids will help in regular bowel movements and reverse gastric trouble.

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