The nurse is caring for a patient with trigeminal neuralgia. Which medication to treat the patient's pain would the nurse question?
gabapentin
carbamazepine
baclofen
oxycodone
The Correct Answer is D
A. Gabapentin is an anticonvulsant commonly used to treat neuropathic pain, including trigeminal neuralgia. It works by stabilizing nerve activity and is appropriate for this condition.
B. Carbamazepine is considered the first-line treatment for trigeminal neuralgia as it decreases nerve impulses, which helps reduce pain. It is a commonly prescribed medication for this condition.
C. Baclofen is a muscle relaxant and can be used in combination with anticonvulsants to treat trigeminal neuralgia by reducing muscle spasms associated with nerve irritation.
D. Oxycodone is an opioid analgesic that treats general pain but is not typically effective for the specific type of neuropathic pain experienced in trigeminal neuralgia. Opioids do not address the underlying nerve activity and are not recommended for long-term management of this condition.
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Correct Answer is C
Explanation
A. The absence of bowel sounds shortly after surgery is not uncommon, especially within the first few hours, and does not necessarily indicate a complication at this time.
B. An SPO2 of 90% while the client is asleep may warrant attention, but it is not as critical as signs of a potential surgical complication. The nurse should assess the patient's respiratory status and consider interventions, but immediate notification to the surgeon is not required.
C. Increasing abdominal distention is a concerning sign that may indicate complications such as an anastomotic leak or bowel obstruction, which requires immediate evaluation and possible intervention by the surgeon.
D. A small amount of green-tinged fluid from the nasogastric tube is generally expected postoperatively and does not necessarily indicate a problem, thus does not require immediate notification of the surgeon.
Correct Answer is D
Explanation
A. Calling a rapid response may be necessary if the client's condition deteriorates, but it is not the immediate priority in this scenario where the client is still able to be aroused.
B. Administering naloxone is appropriate if there is suspicion of opioid overdose; however, the priority is to address the low oxygen saturation first with non-invasive measures.
C. Checking the temperature and applying warmed blankets may be important, but the immediate concern is the low oxygen saturation.
D. Encouraging the client to take deep breaths is the most appropriate immediate action to improve oxygen saturation levels and enhance ventilation, as the client is in a post-anesthesia state where respiratory depression can occur.