A nurse is caring for a postoperative client who has an IV PCA delivering opioids. The client rates their pain as 2 on a scale of 0 to 10 and has not pressed the button to deliver a bolus dose in over 2 hr. Which of the following actions should the nurse take?
Inform the provider that the PCA is not providing adequate pain relief.
Ask the provider for a prescription to decrease the continuous rate.
Instruct the client to push the button more frequently.
Instruct the client's caregiver to push the PCA button when the client is resting.
The Correct Answer is B
A. Informing the provider that the PCA is not providing adequate pain relief is not accurate in this scenario because the client rates their pain as 2, indicating that they are experiencing minimal discomfort.
B. Asking the provider for a prescription to decrease the continuous rate is appropriate since the client has not needed to deliver any bolus doses for over 2 hours, suggesting that the current continuous rate may be higher than necessary for their pain level. Adjusting the PCA settings can help to prevent potential over-medication and side effects while maintaining adequate pain control.
C. Instructing the client to push the button more frequently is unnecessary as the client is already reporting low pain levels and has not expressed a need for additional medication.
D. Allowing the caregiver to push the PCA button when the client is resting is not recommended because PCA systems are designed for patient-controlled analgesia, ensuring that the patient manages their own pain without risking over-medication.
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Correct Answer is C
Explanation
A. Using a straw can increase the risk of aspiration for a client with dysphagia.
B. Dysphagia clients should receive medications with meals or snacks to help with swallowing and reduce the risk of aspiration.
C. Administering medications one at a time allows the nurse to closely monitor the client's swallowing ability and reduces the risk of choking or aspiration.
D. Semi-Fowler's position may not significantly improve swallowing for a client with dysphagia and is not specifically related to medication administration.
Correct Answer is C
Explanation
A. Dentures should be left in place unless otherwise requested by the family or according to cultural practices.
B. Soft lighting is typically preferred in postmortem care to create a peaceful atmosphere.
C. Involving the family in washing the body can be a meaningful part of the grieving process for some cultures and individuals.
D. Closing the client's eyes is typically part of postmortem care to create a peaceful appearance.
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