61. A client with a history of alcohol abuse returns to a postanesthesia care unit (PACU) following abdominal surgery. A nurse knows pain management may be more difficult because of:
61. A client with a history of alcohol abuse returns to a postanesthesia care unit (PACU) following abdominal surgery. A nurse knows pain management may be more difficult because of:
. Potential diminished drug effects related to impaired liver blood flow.
. Possible drug tolerance requiring higher dosages to produce desired effects.
. The need for higher dosages of medications because of accelerated liver detoxification.
. Increased sensitivity to the anesthetic agents used, requiring higher dosages than normal.
Test-Taking Tip
Eliminate the two answers that focus on the liver (Answers 1 and 3). The reason for a higher dose is because alcohol depresses the normal nervous system response to pain.
Content Area: Adult Health, Pain Control; Integrated Process: Nursing Process, Analysis; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Pharmacological Pain Management
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Answer 1 is incorrect because effects of the drug may increase with liver damage because the liver is responsible for detoxification of drugs. Answer 2 is correct because the client will likely need a higher dose because alcohol is a CNS depressant. The client will have developed a drug tolerance to a standard does of pain medication. Answer 3 is incorrect because the dosage should be lowered if there is liver damage, where there would be impaired ability of the liver to detoxify medications. Answer 4 is incorrect because the client will likely have a decreased sensitivity that requires a higher dosage.