A client on the post-op floor underwent surgery 4 days ago. The night nurse reports to the nurse coming on to dayshift that the client complained all night of pain, even though she received every dose of prescribed pain medication. The client currently rates the pain at a 10 out of 10. The day shift nurse should first

  1. call the physician and ask her to prescribe a different medication.
  2. work with the client on alternative pain relief measures such as guided imagery.
  3. administer the next dose of pain medication, but observe the client swallow it to ensure she is really taking the medication.
  4. complete a full head-to-toe assessment on the client.
Number 4 is correct.
Rationale: The nurse should fully assess the client to determine the source and cause of the pain before attempting any interventions. Based on the findings of the assessment, he would then provide pain medication and contact the physician. The nurse could work with the client at a later time when the patient is comfortable to review guided imagery technique.