A postoperative patient one day after nephrectomy reports pain despite analgesic; what should the nurse do first?

• A. Call the physician.
• B. Administer a second dose of analgesic without order.
• C. Document and monitor.
• D. Offer distraction.

Answer: (A)

Pain that remains after the initial analgesic after a major surgery signals the need to reassess and adjust the plan for pain control. The safest next step is to notify the physician so there are new orders for stronger or alternative analgesia and to evaluate whether there could be a complication contributing to the pain. Giving a second dose without an order risks overdose or respiratory depression, and simply documenting or monitoring won’t address the inadequate pain relief. Distraction may help briefly, but it doesn’t treat the underlying pain or address potential postoperative issues. Prompt communication with the physician ensures the patient’s comfort is properly managed and safety is maintained.