Question

The nurse cares for clients on the pain management unit. Which client does the nurse see first?

1. A client receiving intraspinal anesthesia for pain control with a heart rate of 76 bpm and a respiratory rate of 8 breaths per minute. 2. A client receiving patient-controlled analgesia with a heart rate of 112 bpm and a respiratory rate of 24 breaths per minute.
3. A client requesting PRN IV medication for severe chronic back pain. 4. A client requesting PRN IV medication for acute abdominal pain.

Answer 1

The nurse should first see the client receiving intraspinal anesthesia with a respiratory rate of 8 breaths per minute due to the immediate risk of respiratory depression.

Step-by-step explanation:

In prioritizing patient care on a pain management unit, the nurse must assess the severity and potential risk associated with each patient's condition. When comparing the scenarios provided:

1. A client receiving intraspinal anesthesia for pain control with a heart rate of 76 bpm and a respiratory rate of 8 breaths per minute is the most critical. A respiratory rate below 12 breaths per minute may be indicative of respiratory depression, which can be life-threatening and necessitates immediate intervention.
2. A client receiving patient-controlled analgesia with a heart rate of 112 bpm and a respiratory rate of 24 breaths per minute seems to be in distress, possibly due to pain or anxiety, but does not present as immediately life-threatening as the first client.
3. A client requesting PRN IV medication for severe chronic back pain, while needing attention, does not present an immediate risk to life or stability.
4. A client requesting PRN IV medication for acute abdominal pain may need prompt evaluation for possible acute conditions but does not come before a client with compromised respiratory function.

The nurse must see the first client immediately to manage the potential for severe respiratory depression due to intraspinal anesthesia.