A 78-year-old client with congestive heart failure (CHF) is reporting

A 78-year-old client with congestive heart failure (CHF) is reporting vascular pain in his lower legs and requests his oral narcotic analgesic. The nurse recognizes that the client’s pain relief will be negatively affected primarily because of:

1. The client’s age
2. The systemic effects of CHF
3. The route of administration
4. The status of the peripheral vessels

ANSWER

ANS: 2
Clients with congestive heart failure have impaired circulation, which impairs medication delivery to the intended site of action. Therefore the efficacy of medications in these clients is delayed or altered. The other options reflect possible barriers, but they are not as directly responsible as is the heart’s functional capacity