The client is experiencing breakthrough pain while receiving opioids.

The client is experiencing breakthrough pain while receiving opioids. An order is written for the client to receive a transmucosal fentanyl “unit.” In teaching about this medication, the nurse should instruct the client to:

1. Swab the unit over the cheeks
2. Do not chew the unit after administration
3. Take no more than two units per episode of discomfort
4. Allow the unit to dissolve slowly in the mouth over 15 minutes or more

ANSWER

ANS: 2
The unit needs to be left intact and not chewed. The unit is placed in the client’s mouth and swabbed over the inside of the cheeks and lower gums. No more than two units should be used per breakthrough pain episode. The unit needs to be allowed to dissolve and absorb over a 15-minute period.