A nurse is teaching a client about using a patient-controlled analgesia (PCA) device for postoperative pain management. Which statement should the nurse make?
"You will have control of administering your own pain medication."
"The pain medication is delivered into your muscle for optimal absorption."
"A large dose of pain medication is administered with each injection."
"Your partner can push the PCA button for you only if you are asleep."
The Correct Answer is A
A. Patient-controlled analgesia allows the client to self-administer small, predetermined doses of analgesic medication, usually opioids, to maintain a consistent therapeutic level of pain relief. This method empowers the client and addresses the subjective nature of pain more effectively than traditional nurse-administered PRN schedules. The nurse must emphasize that the client is the only person authorized to operate the device to ensure safety and prevent overdose.
B. PCA medications are typically delivered via the intravenous route or sometimes through an epidural catheter, rather than the intramuscular route. Intramuscular injections are associated with inconsistent absorption rates and local tissue trauma, making them unsuitable for the frequent, small-dose delivery required by PCA systems. The intravenous route provides immediate bioavailability and allows for precise titration based on the client's immediate analgesic needs and respiratory status.
C. PCA devices are specifically programmed to deliver small, frequent doses of medication to keep the client's pain within a manageable range while minimizing sedative side effects. Administering large doses with each injection would increase the risk of respiratory depression and profound hypotension. The system includes a lockout interval that prevents the client from receiving excessive amounts of medication, maintaining a safe balance between analgesia and drug toxicity.
D. "PCA by proxy," where a family member or partner pushes the button, is strictly prohibited due to the high risk of oversedation and fatal respiratory depression. The client is the only one who can accurately gauge their level of pain and sedation; if they are asleep, they do not require a dose. The nurse must educate the family that only the client should touch the PCA button to maintain clinical safety.
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Related Questions
Correct Answer is ["B","C","D"]
Explanation
A.A high intake of red meat is actually a protective factor against iron deficiency anemia because red meat is a rich source of heme iron. Heme iron has a higher bioavailability and is absorbed more efficiently by the intestinal mucosa than non-heme iron found in plant sources. Therefore, a diet high in red meat would decrease rather than increase the risk of developing a depleted iron store in the body.
B.Gastrointestinal bleeding is a primary cause of iron deficiency anemia in adults because it results in the chronic loss of hemoglobin-bound iron. Even occult blood loss from ulcers, diverticulosis, or malignancies can gradually deplete the body's iron reserves faster than they can be replenished through dietary intake. Identifying potential sites of blood loss is a critical step in diagnosing the underlying etiology of microcytic, hypochromic anemia.
C.Current pregnancy significantly increases the physiological demand for iron to support the expansion of maternal red cell mass and the development of the fetus and placenta. If dietary intake or supplementation is insufficient to meet these elevated requirements, the mother is at high risk for gestational iron deficiency anemia. This state of increased demand is a well-recognized risk factor requiring routine monitoring of hemoglobin and ferritin levels during the prenatal period.
D.A poor appetite often leads to inadequate dietary intake of essential nutrients, including iron, which is necessary for the synthesis of hemoglobin. Over time, a caloric or nutrient-restricted diet prevents the body from replacing the iron lost through normal cellular turnover and excretion. This risk factor is particularly common in geriatric populations or individuals with chronic illnesses where nutritional intake is compromised, leading to a gradual depletion of iron.
E.While some vegetables contain non-heme iron, a low intake of vegetables is not as significant a risk factor for iron deficiency as the lack of animal proteins or the presence of active bleeding. Many individuals maintain adequate iron levels through other food groups, and the iron in vegetables is less easily absorbed than that found in meat. Therefore, focusing on vegetable intake alone is not a primary diagnostic indicator for this type of anemia.
Correct Answer is B
Explanation
A.The Recommendation section of SBAR is reserved for suggesting specific actions, immediate needs, or the desired plan of care for the patient. It focuses on what should happen next, such as the frequency of vital signs or specific medication orders. Comorbidities like diabetes and hypertension are historical facts rather than future-oriented suggestions for the incoming nurse's immediate action.
B.The Background section is used to provide clinical context by detailing the patient's past medical history, comorbidities, and the reason for the current admission or surgery. Describing chronic conditions like diabetes and hypertension allows the receiving nurse to anticipate potential complications, such as impaired wound healing or blood pressure lability. This information provides the necessary framework for understanding the patient's overall health status.
C.The Situation section is a concise statement that identifies the nurse, the patient, and the most immediate reason for the communication. In a PACU hand-off, this would typically involve stating the patient's name and the specific procedure they just completed. It does not include long-term medical history or chronic comorbidities, as those details would dilute the urgency of the immediate situation statement.
D.The Assessment section involves communicating the nurse's professional conclusion regarding the patient's current status based on clinical findings and observations. This includes recent vital signs, pain levels, and physical exam results obtained during the previous shift or procedure. Chronic history and established comorbidities are considered pre-existing data rather than findings from the nurse's current, active assessment of the patient.
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