A nurse is caring for an older adult client who reports dry, itchy skin. Which of the following actions should the nurse take?

Choice A Reason:

The surgeon is incorrect. Surgeons primarily focus on the surgical procedure itself and the immediate postoperative care related to the surgery. They may not have a direct role in medication management or overall postoperative care beyond the surgical site.

Choice B Reason:

The pharmacist is incorrect. While pharmacists play a vital role in medication management, they typically focus on dispensing medications, providing drug information, and ensuring proper dosages and administration. They may not be directly involved in assessing fall rates or postoperative outcomes.

Choice C Reason:

The case manager is incorrect. Case managers are responsible for coordinating a patient's care and ensuring that it meets their overall healthcare needs. They may not have the expertise or authority to investigate and address specific safety concerns related to medication use and fall rates.

Choice D Reason:

The risk manager is correct. When a nurse identifies an issue related to patient safety, such as an increased fall rate associated with a specific medication like zolpidem, it is important to report these findings to the risk manager. The risk manager is responsible for assessing and addressing issues related to patient safety and quality improvement within the healthcare facility. They can investigate the matter further, collaborate with other members of the healthcare team, and implement necessary changes or protocols to mitigate the risk and improve patient safety. Reporting such findings to the risk manager is a crucial step in ensuring patient safety and quality of care.

Choice A Reason:

Urinary retention can be a side effect of opioids used in PCA, but it is not a direct indicator of unrelieved pain.

Choice B Reason:

Constipation is a potential side effect of opioid medications, but it does not directly indicate unrelieved pain.

Choice C Reason:

Difficulty swallowing is not a typical indicator of unrelieved pain but may be related to other factors such as postoperative effects or medication side effects.

Choice D Reason:

Clenched teeth can be an indicator of unrelieved pain in a client receiving patient-controlled analgesia (PCA). It suggests that the client is experiencing discomfort and may be trying to endure the pain rather than using the PCA pump to self-administer pain relief. Clients who are in pain may clench their teeth as a response to pain or discomfort.