Rita Manson presents to the emergency department with vomiting, severe abdominal and back pain, and jaundice. Her jaundice is recent but the pain and vomiting have continued for a couple of months....

Rita Manson presents to the emergency department with vomiting, severe abdominal and back pain, and jaundice. Her jaundice is recent but the pain and vomiting have continued for a couple of months. Her diagnostic work-up reveals advanced pancreatic cancer with metastasis to the spine.

1. What is the drug of choice for Rita’s pain management? Which route of administration would be expected initially?

2. Her prescribed pain medication is morphine sulphate 2 to 10 mg IV every 2 hours as needed for pain. Outline a nursing approach to pain management for the first 24 hours.

3. What adverse effects would the nurse expect?

4. As part of the patient’s pain management, dexamethasone (Decadron) 5 mg IV is prescribed every 6 hours for 2 days. Explain the use of corticosteroids in pain management.

5. After several days, Rita expresses her concern about “becoming hooked on that narcotic.” How would the nurse respond?