Apply the concepts you learned from this chapter to the following client scenario:

Mr. Jones is a 67-year-old male who was recently diagnosed with colon cancer last week and underwent a colon resection three days ago. See Figure 11.15 for an image of Mr. Jones.^[1] In the change of shift report, you hear that he is receiving morphine by PCA pump for pain, but he is not using it very often. Staff reports he “needs much encouragement” to get out of bed and participate in self-cares. He has crackles in his lung bases and his oxygen saturation is 88% on room air.

1. What additional assessments (subjective and objective) will you perform for the client and why?
2. List the top three priority nursing diagnoses for Mr. Jones.
3. Mr. Jones states, “I don’t want to use morphine. I am afraid I will become addicted to it like my friend did after he came home from the war.” How will you respond to therapeutically address his concerns, yet also teach the client about good pain management?
4. What are common side effects of opioids and how will you plan to manage these side effects?
5. Emotional issues could also be affecting Mr. Jones’ perception of pain. What will you further physically assess and therapeutically address?
6. After providing client education about morphine and the PCA pump, you check on Mr. Jones later in the day and notice he has had five self-doses every hour with 15 attempts in the past hour. The pump is set for a maximum of six doses per hour. What further assessments will you perform?