Brunner & Suddarth's Textbook of Medical-Surgical Nursing 13th Edition by Kerry Cheever, Janice Hinkle

Exercise 3

A 78-year-old woman is admitted to the orthopedic unit after repair of a righthip fracture. Her comfort-function goal is "mild pain" on the verbal descriptor scale torest adequately. She received a total of 1 mg of hydromorphone in IV boluses in thePACU followed by initiation of IV PCA hydromorphone with a prescription thatprovides a basal rate of 0.1 mg per hour and allows the patient to self-administer 0.2mg every 8 minutes as needed.She reports "moderate pain" and moans whentransferred from the stretcher to the bed. She has an adequate respiratory status but isexcessively sedated and unable to respond to a question without falling asleep in themiddle of a sentence. Identify the first action to take for this patient. Who would youconsult to implement this action? Describe other actions that could be taken toprovide safer pain control for this patient.