A patient with progressive multiple myeloma is being cared for in a hospice facility. The nurse should include which of the following in the plan of care?

Administer a combination of opioid and non-opioid analgesics.
Be cautious with repositioning.
Monitor fluid and electrolytes.

Explanation

• In multiple myeloma, cancerous plasma cells infiltrate the bone and cause osteoporosis. Patients are at high risk for pathological bone fractures and therefore, nurses and patients should be cautious with normal activity and repositioning.

• Bone cancers cause deep bone pain and most patients require a combination of opioid and non-opioid analgesics to control that pain.

• Fluid and electrolytes should be monitored because renal dysfunction is common with multiple myeloma.  

• Hypokalemia is generally not associated with multiple myeloma.

• The patient does not need to be placed on airborne isolation, but steps should be taken to reduce the risk of infection for this immunocompromised patient.

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