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.

Answer and Explanation

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 B

Explanation

A. While elevated blood pressure may be a concern, frequent coughing while eating indicates a risk of aspiration, which is a more immediate priority.
B. Frequent coughing while eating suggests a risk of aspiration, which can lead to serious respiratory complications such as pneumonia.
C. Leaning to the left side while sitting may indicate weakness or postural instability but is not as immediately concerning as a risk of aspiration.
D. Low food intake is a concern but does not present an immediate risk to the client's safety compared to the risk of aspiration.

A. "Enjoy the time you have and do the things you want to do." B. "You need to understand that you have very little time left." C. "Hospice care is the best thing for you at this time. D. "I will contact your provider to discuss your options."

Correct Answer is D

Explanation

A. While this response is supportive, it does not address the client's desire for further treatment.

B. This response may be seen as dismissive or discouraging to the client's wishes.

C. While hospice care may be appropriate, it should be discussed as an option with the client rather than being presented as the only choice.
D. This response acknowledges the client's wishes while also ensuring that further discussion and exploration of treatment options occur with the healthcare provider.

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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?

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