A client admitted with acute pyelonephritis now reports having a severe migraine, but declines PRN analgesics. What should the nurse discuss with this client?

A client admitted with acute pyelonephritis now reports having a severe migraine, but declines PRN analgesics. What should the nurse discuss with this client?

• A. Ask the client which migraine treatments are helpful when at home.
• B. Explain that only medications can help migraines.
• C. Suggest nonpharmacologic options are not useful.
• D. Coerce the patient to take analgesics.

Answer: (A)

Respecting the patient’s autonomy and personal experience with migraines is the key idea here. When a patient declines a standard pain medication, the nurse’s role is to explore what has helped the patient manage migraines in daily life and use that information to guide a plan that matches the patient’s preferences and safety in the hospital. Asking which migraine treatments are helpful at home invites the patient to share effective strategies—whether specific medications, timing, doses, triggers, or nonpharmacologic approaches. This conversation helps tailor care to the individual, ensures any proposed hospital options are acceptable, and supports shared decision-making. It also opens discussion about whether nonpharmacologic methods (rest, hydration, cool compresses, quiet environment, relaxation techniques) could be appropriate adjuncts, respecting that the patient may prefer a combination or alternative approach. The other options are less appropriate because they either assume only medications work, dismiss nonpharmacologic options, or involve pressuring the patient to accept analgesics. Coercion is not ethical or acceptable, and neither universality of pharmacologic relief nor the exclusion of nonpharmacologic care fits patient-centered practice. In this situation, the best move is to learn what has helped the patient at home and discuss how those strategies could be incorporated safely into current care, aligning treatment with the patient’s values and comfort.

Respecting the patient’s autonomy and personal experience with migraines is the key idea here. When a patient declines a standard pain medication, the nurse’s role is to explore what has helped the patient manage migraines in daily life and use that information to guide a plan that matches the patient’s preferences and safety in the hospital.

Asking which migraine treatments are helpful at home invites the patient to share effective strategies—whether specific medications, timing, doses, triggers, or nonpharmacologic approaches. This conversation helps tailor care to the individual, ensures any proposed hospital options are acceptable, and supports shared decision-making. It also opens discussion about whether nonpharmacologic methods (rest, hydration, cool compresses, quiet environment, relaxation techniques) could be appropriate adjuncts, respecting that the patient may prefer a combination or alternative approach.

The other options are less appropriate because they either assume only medications work, dismiss nonpharmacologic options, or involve pressuring the patient to accept analgesics. Coercion is not ethical or acceptable, and neither universality of pharmacologic relief nor the exclusion of nonpharmacologic care fits patient-centered practice.

In this situation, the best move is to learn what has helped the patient at home and discuss how those strategies could be incorporated safely into current care, aligning treatment with the patient’s values and comfort.