There are three types of sleep apnea: obstructive, central, and mixed complex.

Obstructive apnea is the most common type.

It is caused by the relaxation of the soft tissues, which allows partial to total obstruction of the airway.

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 C rationale:
The most crucial instruction regarding the safety of fentanyl patches is to apply them as directed by the primary care provider. Fentanyl is a potent opioid medication, and its misuse or improper application can lead to serious health risks, including overdose. Therefore, following the prescriber's instructions is of utmost importance to ensure the patient's safety.
Choice A rationale:
Storing fentanyl patches in a locked cabinet is a good practice to prevent unauthorized access and to keep them out of reach of children or individuals who should not have access to the medication. However, it is not the most critical safety instruction. Proper application and usage are more important.
Choice B rationale:
While preparing the skin by cleaning with an antiseptic scrub solution is a necessary step when applying a transdermal medication like a fentanyl patch, it is not the most critical safety instruction. It is a standard part of the application process but does not address the overarching safety concerns related to fentanyl use.
Choice D rationale:
Using fentanyl patches as needed for breakthrough pain without clear guidance from a healthcare provider is not a safe practice. Fentanyl is a potent medication with a high risk of overdose, and its use should always be closely monitored and directed by a healthcare professional. Self-adjusting the dosage without medical supervision can lead to serious safety issues.