The nurse has reviewed the Nurses' Notes and Laboratory Results from 11 weeks ago.

The nurse is planning to provide teaching about the client's scheduled procedure.
Select the 3 statements the nurse should include in the teaching.

Rationale:
A. PCA (patient-controlled analgesia) is designed to maintain relatively stable plasma drug levels by providing a basal (continuous) infusion and/or patient-activated bolus doses. The goal is to prevent peaks and troughs in pain control, not to create fluctuating medication levels.

B. Clients are taught to anticipate pain and use the PCA button before activities such as ambulation, coughing, or turning. This allows the medication time to take effect and provides better pain control during movement or procedures.

C. Clients do not control the dosage amount or settings of the PCA. The healthcare provider prescribes the dose limits, lockout interval, and basal rate if ordered. The client can only self-administer preset doses by pressing the button.

D. PCA devices have lockout intervals that prevent additional doses from being delivered too close together. Pressing the button multiple times will not result in a double dose; it will only deliver medication according to the preset safety parameters.

Rationale:

A. Gastroesophageal reflux is related to relaxation of the lower esophageal sphincter and increased intra-abdominal pressure during pregnancy, not dehydration. While reflux is common in pregnancy, it is not caused by dehydration or directly linked to preterm contractions.

B. Dehydration does not result from decreased hemoglobin and hematocrit. In fact, dehydration typically leads to hemoconcentration, which can cause elevated hemoglobin and hematocrit levels due to reduced plasma volume.

C. Dehydration can lead to uterine irritability and increase the frequency of preterm contractions. Reduced circulating volume may stimulate the release of antidiuretic hormone and oxytocin, which can contribute to uterine activity. Therefore, adequate hydration is an important intervention in managing preterm contractions.

D. Dehydration is treated with oral or intravenous fluids, not calcium supplementation. While calcium plays a role in muscle contraction, it is not used to correct fluid volume deficits or manage dehydration-related uterine irritability.