The patient is ordered Percocet (Oxycodone 5mg/Acetaminophen 325 mg) 2 tablets for pain <8/10 and morphine 4 mg IVP for pain >8/10. Which would you administer?
Both Percocet and morphine are pain relief medication used in emergency department. They relief moderate to severe pain in patients. Percocet was ordered because it is an orally therapy medication while morphine IV was ordered because it is intravenous medication. I would administer Percocet because it is 1.5 times more effective than morphine in relieving pain. According to Hovda, Brutlag, Poppenga and Peterson (2016), oral administration route is regarded as the most acceptable and economical route of medication administration. I will not administer morphine IV because it is a narcotic and giving 4mg of morphine medication to John who has a higher blood pressure can cause it to drop to 50 -60 systolic and thus cause the patient become unresponsive. If morphine is given, the patient blood pressure, breathing, allergic reaction, and respiratory arrest should be monitored.
- What would be important to monitor after giving this medication based on this patient’s diagnosis?
The aim of administering the medication was to relieve pain. Therefore, following the administration of these medications, the patient can be monitored for pain to determine if there is any change.
- How do you know that the pain medicine was effective?
I can know that the pain medication was effective by asking the patient himself because pain is subjective.
The chest tube is inserted without difficulty and 50 mL sanguineous drainage is removed. The chest tube is attached to low continuous suction as ordered.
- Upon connecting, you notice some bubbling in the water seal chamber of the chest tube. What would be your next action?
Bubbling could be an indication of an air leak. I would identify the area of air leak, I will clamp the thoracic catheter next to the exit from chest. If air leak continues, I will clamp the chest tube with the physician’s order since clamping could result in tension pneumothorax.
- What outcomes would you anticipate to see in the patient if the chest tube insertion has been effective?
To determine if the chest tube insertion has been effective, I would anticipate to see the patient with an effective or normal respiratory pattern