A nurse is providing teaching to a client who is about to begin using a PCA pump to deliver morphine for postoperative pain management. Which of the following statements by the client indicates an understanding of the teaching?

"The lockout interval prevents me from receiving too much medication."

"Each time I push the button, I receive the same amount as a morphine injection."

"My family can push the button for me on a regular basis."

"It will take about 30 minutes to feel relief after I push the button."

Answer and Explanation

The Correct Answer is A

A. "The lockout interval prevents me from receiving too much medication.": The lockout interval on a PCA pump ensures that the client cannot administer more medication than is safe within a set period, preventing overdose or over-sedation.

B. "Each time I push the button, I receive the same amount as a morphine injection.": The PCA pump delivers a smaller, controlled dose of morphine each time the button is pressed, rather than the same dose as a traditional injection.

C. "My family can push the button for me on a regular basis.": The client should be the only one pressing the PCA button to prevent overdose and ensure safe administration. Family members should not push the button for the client.

D. "It will take about 30 minutes to feel relief after I push the button.": PCA delivers pain medication on demand, and the client may feel relief within a few minutes, not 30 minutes. Pain relief can be quicker depending on the medication’s action and how it’s delivered.

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Correct Answer is A

Explanation

A. Flush the PICC line with 0.9% sodium chloride after medication administration: This is essential to maintain patency and prevent occlusion as it helps clear any medication residue from the line and ensures proper blood flow.

B. Monitor for a pneumothorax following insertion of the PICC line: A pneumothorax is a potential complication following the insertion of a central venous catheter in the subclavian or internal jugular vein, not typically associated with PICC line insertion.

C. Use a 3 mL syringe when flushing the PICC line: A 10 mL or larger syringe is recommended. Using a 3 mL syringe could generate high pressure, causing damage to the PICC line or the vein, leading to complications such as catheter rupture or vein injury.

D. Expect the PICC line to be inserted into a lower extremity vein: PICC lines are typically inserted into veins in the upper extremities, such as the basilic or cephalic veins. Inserting a PICC line into a lower extremity vein can increase the risk of complications such as DVT.

A. Place a mask on the client during the procedure B. Cleanse the catheter site using a side-to-side motion. C. Tape down the corners of the dressing D. Secure an occlusive dressing over the gauze pads.

Correct Answer is A

Explanation

A. Place a mask on the client during the procedure: A mask should be placed on the client to reduce the risk of infection during the dressing change. Peritoneal dialysis involves accessing the peritoneal cavity, and maintaining a sterile environment is crucial to prevent contamination.

B. Cleanse the catheter site using a side-to-side motion: The catheter site should be cleansed using a circular motion starting from the site of insertion and moving outward. This helps avoid introducing bacteria into the insertion site. Side-to-side motion may push bacteria into the area.

C. Tape down the corners of the dressing: While securing the dressing is important, taping the corners may not provide the optimal seal and could risk introducing contaminants. The dressing should be secured properly, but not necessarily with just tape at the corners.

D. Secure an occlusive dressing over the gauze pads: An occlusive dressing over gauze pads is not ideal for peritoneal dialysis catheters. A sterile, breathable dressing is recommended to allow for proper airflow and prevent moisture accumulation, which can promote infection.

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A nurse is providing teaching to a client who is about to begin using a PCA pump to deliver morphine for postoperative pain management. Which of the following statements by the client indicates an understanding of the teaching?

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