A nurse is preparing to administer three medications to a client who is receiving continuous enteral feeding through an NG tube.
Which of the following actions is appropriate for the nurse to take?

The correct answer is D.

Choice A reason: “A. Using this machine increases my risk of overdose.” This statement is incorrect because PCA pumps are designed with safety mechanisms to prevent overdose. The pump is programmed to deliver a specific dose of medication at set intervals, and it will not dispense more medication than what is prescribed by the healthcare provider.

Choice B reason: “B. I can get pain medication any time as long as I press the button.” While it is true that the patient can self-administer medication, PCA pumps have a lockout interval that prevents the machine from delivering another dose until a certain amount of time has passed, ensuring that the patient cannot receive medication too frequently.

Choice C reason: “C. My partner can press my pain medication button for me if I am sleeping.” This statement is incorrect. Only the patient should press the button on the PCA pump to ensure that the medication is administered safely and according to the patient’s current level of pain. Allowing someone else to press the button could lead to unsafe dosing.

Choice D reason: “D. I will receive a limited amount of pain medication when I press the button.” This is the correct statement. The PCA pump allows the patient to administer a controlled amount of pain medication within safe limits set by the healthcare provider. The pump is programmed to deliver a specific dose of medication, and there is a limit to the number of doses that can be administered per hour.

The correct answer is Choice B: Assign the child to a negative air pressure room.

Choice A rationale: Assessing the child for Koplik spots is not appropriate in this situation because Koplik spots are associated with measles, not varicella. Koplik spots are small, white, irregular lesions that appear on the buccal mucosa during the prodromal phase of measles. They do not present in cases of varicella, which is characterized by a pruritic, vesicular rash.

Choice B rationale: Assigning the child to a negative air pressure room is the most suitable action because varicella is highly contagious and can be transmitted through airborne particles. A negative air pressure room helps to contain these particles and minimize the risk of infection transmission to other patients, healthcare workers, and visitors. Airborne precautions are the recommended infection control measures for managing varicella cases in healthcare settings.

Choice C rationale: Utilizing droplet precautions alone is insufficient for managing varicella because the virus can also be spread through airborne particles. While droplet precautions may be a component of the overall infection control strategy, they are inadequate without the additional implementation of airborne precautions, such as a negative air pressure room.

Choice D rationale: Administering aspirin to a child with a viral illness is generally contraindicated due to the potential risk of Reye's syndrome, a rare but severe condition characterized by liver failure and encephalopathy. It is essential to follow appropriate guidelines for managing fever and discomfort in pediatric patients with varicella, which typically involve using acetaminophen or ibuprofen instead of aspirin.