A nurse is teaching a client who had a total knee arthroplasty about self-administering morphine via a patient-controlled analgesia (PCA) infusion device.
Which of the following client statements indicates an understanding of the teaching?
"I should only use the device when it's absolutely necessary.”.
"I'll be careful about pushing the button so I don't overdose.”.
"I will ask my family to push the dose button when I am asleep.”.
"I should tell the nurse if I can't control my pain with this device.”.
The Correct Answer is D
Choice A rationale
Patient-controlled analgesia is designed to allow patients to manage their pain proactively. Waiting until the pain is severe before using the device can lead to inadequate pain control and increased discomfort. The goal of PCA is to maintain a consistent level of analgesia by allowing the patient to self-administer small doses as needed.
Choice B rationale
PCA devices are programmed with safety limits, including lockout intervals and maximum doses, to prevent accidental overdosing. While the patient should understand how to use the button, the primary responsibility for preventing overdose lies with the device's safety mechanisms and the healthcare team's programming.
Choice C rationale
Allowing family members to push the PCA button bypasses the safety mechanisms built into the device, which are based on the patient's demand for pain relief. This practice can lead to over-sedation and respiratory depression if the patient is not the one experiencing the pain and needing the medication. The patient must be the only one to activate the PCA device.
Choice D rationale
If the PCA device is not effectively controlling the patient's pain, it indicates a need for reassessment of the medication, dosage, or delivery method. The nurse can then collaborate with the provider to make necessary adjustments to ensure adequate pain management. This statement demonstrates the client's understanding of the importance of communicating their pain level.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Insertion of a nasogastric tube is expected in a client with paralytic ileus to decompress the bowel by removing accumulated fluids and gas. Paralytic ileus is a non-mechanical obstruction of the bowel characterized by a lack of peristalsis, often occurring after abdominal surgery like an appendectomy. This decompression helps relieve abdominal distension, pain, and nausea, facilitating the return of bowel function.
Choice B rationale
Providing a bulk-forming agent, such as psyllium, is contraindicated in paralytic ileus. Bulk-forming agents work by increasing the volume of stool, which would exacerbate the obstruction and potentially cause further discomfort and complications in the absence of peristalsis. These agents are typically used to treat constipation by adding fiber to the diet and promoting bowel movements.
Choice C rationale
Administering an antacid, such as aluminum hydroxide or calcium carbonate, is not a primary intervention for paralytic ileus. Antacids work by neutralizing stomach acid and are used to treat conditions like heartburn and acid reflux. While a client with paralytic ileus might experience some gastric upset, the underlying issue is the lack of bowel motility, which antacids do not address.
Choice D rationale
Applying a truss is used to provide support for hernias, a condition unrelated to paralytic ileus following an appendectomy. A truss helps to keep the protruding tissue in place and reduce discomfort associated with the hernia. It does not address the underlying lack of bowel motility characteristic of paralytic ileus.
Correct Answer is D
Explanation
Choice A rationale
Echinacea is an herb often used to support the immune system, particularly for colds and flu. There is no strong scientific evidence to support its effectiveness in managing the joint pain associated with osteoarthritis, which is a degenerative joint disease.
Choice B rationale
Applying ice to a joint before exercising can decrease pain and inflammation, but it can also stiffen the joint and potentially limit range of motion during activity. Heat application is generally recommended before exercise in osteoarthritis to warm up the muscles and tissues.
Choice C rationale
Purines are compounds that break down into uric acid. Reducing purine intake is important for managing gout, a type of inflammatory arthritis caused by the deposition of uric acid crystals in the joints, not osteoarthritis, which is characterized by cartilage breakdown.
Choice D rationale
Maintaining a recommended body weight is crucial for managing osteoarthritis. Excess weight puts additional stress on weight-bearing joints like the hips and knees, accelerating cartilage breakdown and increasing pain. Weight loss can significantly reduce these stresses and alleviate symptoms.
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