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 ["B","C","D"]
Explanation
Choice A rationale
While pain management is crucial postoperatively, teaching the client how to use a PCA pump does not directly prevent common postoperative complications like pneumonia, deep vein thrombosis, or wound infections. These complications are more directly addressed by respiratory exercises and early mobilization.
Choice B rationale
Instructing the client on coughing and deep breathing exercises is essential for preventing postoperative pulmonary complications such as atelectasis and pneumonia. These exercises help to expand the lungs, mobilize secretions, and improve oxygenation, reducing the risk of infection and respiratory distress.
Choice C rationale
Explaining the importance of early ambulation is vital in preventing several postoperative complications. Mobilization improves circulation, reducing the risk of deep vein thrombosis and pulmonary embolism. It also helps to promote bowel function and prevent constipation, as well as aiding in lung expansion and preventing atelectasis.
Choice D rationale
Discussing the use of incentive spirometry is important for preventing postoperative respiratory complications. Incentive spirometry encourages deep and sustained inhalation, which helps to expand the alveoli, improve lung volume, and prevent atelectasis and pneumonia.
Correct Answer is D
Explanation
Choice A rationale
Milk can temporarily buffer stomach acid, but it also stimulates acid production due to its fat and calcium content, potentially worsening GERD symptoms in the long run. Therefore, this is not a recommended instruction for managing GERD.
Choice B rationale
Sleeping on the left side may help reduce nighttime reflux in some individuals because the esophagus enters the stomach on the right side. This positioning can keep the lower esophageal sphincter above the level of gastric contents, reducing the likelihood of reflux.
Choice C rationale
Lying down shortly after eating can increase the risk of stomach acid refluxing into the esophagus. Gravity helps to keep stomach contents down when a person is upright. Waiting at least 2 to 3 hours after eating before going to bed is generally recommended to manage GERD.
Choice D rationale
Eating larger meals can increase gastric pressure and the volume of stomach contents, both of which can contribute to reflux. Consuming four to six smaller meals throughout the day can help reduce gastric distension and acid production after meals, thereby minimizing GERD symptoms.
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