A nurse is providing preoperative teaching to a client about the administration of morphine via a PCA pump.
Which of the following statements by the client indicates an understanding of the teaching?

"Using this machine increases my risk of overdose."

"I can get pain medication any time as long as I press the button."

"My partner can press my pain medication button for me if I am sleeping."

"I will receive a limited amount of pain medication when I press the button." .

Answer and Explanation

The Correct Answer is D

The correct answer is D.

Choice A reason: “A. Using this machine increases my risk of overdose.” This statement is incorrect because PCA pumps are designed with safety mechanisms to prevent overdose. The pump is programmed to deliver a specific dose of medication at set intervals, and it will not dispense more medication than what is prescribed by the healthcare provider.

Choice B reason: “B. I can get pain medication any time as long as I press the button.” While it is true that the patient can self-administer medication, PCA pumps have a lockout interval that prevents the machine from delivering another dose until a certain amount of time has passed, ensuring that the patient cannot receive medication too frequently.

Choice C reason: “C. My partner can press my pain medication button for me if I am sleeping.” This statement is incorrect. Only the patient should press the button on the PCA pump to ensure that the medication is administered safely and according to the patient’s current level of pain. Allowing someone else to press the button could lead to unsafe dosing.

Choice D reason: “D. I will receive a limited amount of pain medication when I press the button.” This is the correct statement. The PCA pump allows the patient to administer a controlled amount of pain medication within safe limits set by the healthcare provider. The pump is programmed to deliver a specific dose of medication, and there is a limit to the number of doses that can be administered per hour.

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Correct Answer is C

Explanation

Step 1: Convert the dopamine hydrochloride dose from mcg to mg. We know that 1 mg = 1000 mcg. So, 4 mcg = 0.004 mg.

Step 2: Calculate the total amount of dopamine hydrochloride the client needs per minute. We know that the client weighs 80 kg and the dose is 0.004 mg/kg/min. So, 0.004 mg/kg/min × 80 kg = 0.32 mg/min.

Step 3: Convert the total amount of dopamine hydrochloride the client needs per minute to an hourly rate. We know that 1 hour = 60 minutes. So, 0.32 mg/min × 60 min/hr = 19.2 mg/hr.

Step 4: Calculate the volume of the solution that contains 19.2 mg of dopamine hydrochloride. We know that the solution contains 800 mg in 250 mL. So, (19.2 mg ÷ 800 mg) × 250 mL = 6 mL.

Therefore, the nurse should set the IV infusion to deliver 6 mL/hr (rounded to the nearest whole number).

A. Recent myocardial infarction. B. Recent eye surgery. C. Thrombophlebitis. D. Breast cancer.

Correct Answer is B

Explanation

Choice A rationale:

Recent myocardial infarction is not a contraindication for warfarin administration. Warfarin is often prescribed for patients with a history of myocardial infarction to prevent clot formation and reduce the risk of stroke.

Choice B rationale:

Recent eye surgery is a contraindication for the administration of warfarin. Warfarin can increase the risk of bleeding, which is particularly concerning after eye surgery due to the delicate nature of ocular tissues. Using anticoagulants in this scenario can lead to severe complications, including vision loss.

Choice C rationale:

Thrombophlebitis, inflammation of a vein with clot formation, is not a contraindication for warfarin administration. In fact, anticoagulants like warfarin are commonly prescribed to prevent the extension of clots and reduce the risk of complications associated with thrombophlebitis.

Choice D rationale:

Breast cancer is not a direct contraindication for warfarin administration. However, the decision to use anticoagulants in patients with a history of breast cancer should be made carefully, considering individual factors such as the stage of cancer, ongoing treatment, and overall risk of thromboembolic events.

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A nurse is providing preoperative teaching to a client about the administration of morphine via a PCA pump. Which of the following statements by the client indicates an understanding of the teaching?

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Correct Answer is C

Explanation

A nurse is reviewing the medical history of a client who asks about the use of warfarin.The nurse should identify which of the following findings as a contraindication for the administration of this medication?

Correct Answer is B

Explanation

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A nurse is providing preoperative teaching to a client about the administration of morphine via a PCA pump.
Which of the following statements by the client indicates an understanding of the teaching?