The nurse cares for a terminally ill patient with continuous, severe pain. How should analgesics be scheduled?

• A. Plan around-the-clock routine administration of analgesics.
• B. Provide PRN doses of medication whenever the patient requests them.
• C. Suggest small analgesic doses to avoid decreasing the respiratory rate.
• D. Offer enough pain medication to keep the patient sedated and unaware of stimuli.

Answer: (A)

For continuous, severe cancer-related pain, the goal is to maintain steady relief by scheduling analgesics around the clock. Regular, round-the-clock dosing keeps drug levels in a therapeutic range, prevents painful spikes between doses, and improves comfort, sleep, and function. Relying on patient requests alone can lead to undertreatment because pain may intensify before a dose is given or patients may delay asking for relief. Giving only small, conservative doses in an attempt to avoid respiratory depression fails to provide adequate analgesia. Sedating the patient to keep them unaware of stimuli misses the aim of relief while preserving quality of life and awareness, and can mask needs or complicate monitoring. Use scheduled analgesia with additional PRN doses for breakthrough pain as needed, titrating to achieve comfort with careful monitoring for side effects.