A patient experiencing discomfort because of severe arthritis would be described as having:

Choice A rationale:
Patient-controlled analgesia (PCA) is a method of pain management that allows the patient to administer their own pain medication within specified limits, but it doesn't reduce the workload of the nurse. The nurse is responsible for setting up and monitoring the PCA pump, educating the patient, assessing their pain, and ensuring safety. Therefore, this choice is incorrect.
Choice B rationale:
PCA does not completely eliminate pain. It provides the patient with control over their pain relief by allowing them to self-administer medication within preset limits. However, it does not guarantee the complete absence of pain. Pain relief is provided within a safe dosage range, but some level of pain may still be experienced. Therefore, this choice is incorrect.
Choice C rationale:
PCA does not eliminate the risk of adverse drug effects entirely. The nurse must monitor the patient for signs of adverse effects, such as respiratory depression or sedation. While the patient has control over medication administration, there are still risks associated with opioid analgesics. Therefore, this choice is incorrect.
Choice D rationale:
The principal advantage of using patient-controlled analgesia (PCA) is that it reduces patient anxiety about pain by giving the patient more control over its management. This choice is correct because PCA empowers the patient to self-administer pain medication when needed, which can lead to better pain control and reduced anxiety. The nurse sets safe dosage limits and monitors the patient, ensuring safety while providing a sense of control.

Choice A rationale:

Constipation is not a common adverse effect of pain medication administered by the epidural route. Pain medication primarily affects the central nervous system and does not typically impact the gastrointestinal system in a way that would lead to constipation.

Choice B rationale:

Hypoventilation is the correct answer. When opioids or other potent pain medications are administered by the epidural route, they can depress the respiratory center in the brain, leading to hypoventilation (slow or inadequate breathing). This is a critical concern and the most important adverse effect to monitor because it can lead to respiratory compromise or even respiratory arrest.

Choice C rationale:

Nausea can be a side effect of some pain medications, but it is not the most important adverse effect to monitor in a patient receiving epidural pain medication. Nausea can often be managed with antiemetic medications.

Choice D rationale:

Headache is not a common adverse effect of epidural pain medication. The administration of pain medication into the epidural space is localized to the spinal area and does not typically lead to headaches.