by Linda Edgeton

Nursing

A middle-aged man with glomerulonephritis was admitted to a medical unit. During the night, he developed a nose bleed which could not be stopped by either the registered nurse or the licensed practical nurse for quite a while. Later the patient complained of nausea and vomited. However, he denied having any pain or discomfort.

The registered nurse contacted the resident on call for orders. The resident ordered an antiemetic for nausea and a pain medication. The nurse informed the resident that the patient was not having any pain. After being questioned by her about the need for the pain medication, the resident vehemently told the nurse to do as ordered--give both medications--and he hung up.

The nurse remembered vaguely from her nursing education that the pain medication that was ordered should not be given to patients with renal problems. At that moment, the nurse was paged to another unit for an emergency.

Questions:

What action, consistent with her scope of practice, should the nurse take?

Should she give both medications as ordered?

Should she give only the antiemetic?

Should she call another doctor?

Should she give neither, and leave the patient alone?

Could the patient actually need some pain medication, but not that one?