If analgesia is not effective one hour after administration, what is the appropriate nurse action?

• A. Redose without an order.
• B. Call the physician.
• C. Wait and reassess later.
• D. Discharge the patient.

Answer: (B)

When analgesia isn’t providing relief within the expected time frame, the nurse must escalate the plan by contacting the physician for a new order or adjustments. Pain medications have a predictable onset and duration, and if relief isn’t achieved after about an hour, continuing the same approach without input risks under-treating pain or causing unnecessary side effects from inappropriate dosing. The physician can reassess the patient’s pain, review the current regimen, consider dose changes, different routes, alternative medications, or add adjuvants to improve control. This step also ensures safety, including monitoring for respiratory or sedation concerns if opioids are involved.

Rationale against the other options: giving more medication without an order can lead to overdose or adverse effects; waiting and reassessing later delays needed relief and patient safety; discharging the patient ignores ongoing pain management needs and is inappropriate in a setting where pain is not controlled.