A nurse is providing preoperative teaching about patient-controlled analgesia (PCA) to a client. Which of the following statements should the nurse include in the teaching?

"You should push the button before physical activity to allow maximum pain control.”

"Continuous PCA infusion is designed to allow fluctuating plasma medication levels."

"You can adjust the amount of pain medication you receive by pushing on the keypad."

"The PCA will deliver a double dose of medication when you push the button twice."

Answer and Explanation

The Correct Answer is A

A. "You should push the button before physical activity to allow maximum pain control.": Preemptively using the PCA before activities such as ambulation or physical therapy helps prevent breakthrough pain, allowing the client to perform activities more comfortably. This approach maximizes the effectiveness of pain control.

B. "Continuous PCA infusion is designed to allow fluctuating plasma medication levels.": Continuous PCA is designed to maintain consistent plasma levels of medication, not fluctuating levels. This ensures steady pain control rather than peaks and troughs.

C. "You can adjust the amount of pain medication you receive by pushing on the keypad.": Clients cannot override the preset dosage limits on a PCA pump. The device is programmed by the healthcare provider to deliver safe doses, so self-adjusting the amount is not permitted.

D. "The PCA will deliver a double dose of medication when you push the button twice.": PCA pumps have lockout intervals to prevent overdosing. Pressing the button multiple times during the lockout period will not deliver extra doses, so this statement is incorrect and could be dangerous if misunderstood.

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Correct Answer is D

Explanation

A. "I have headaches in the evening.": Headaches associated with sleep apnea typically occur in the morning due to nocturnal hypoxia and carbon dioxide retention, not in the evening. Evening headaches are not a common presenting symptom.

B. "I feel rested upon wakening.": Clients with sleep apnea often experience non-restorative sleep and wake feeling tired or unrefreshed. Feeling rested upon waking would not be expected in untreated sleep apnea.

C. "I feel alert during the day.": Daytime sleepiness is a hallmark symptom of sleep apnea due to fragmented sleep and oxygen desaturation. Feeling alert would not align with the typical presentation.

D. "My spouse says I snore.": Loud, habitual snoring is a common and expected symptom of obstructive sleep apnea. It is often reported by bed partners and is an important clinical clue for diagnosis.

A. The client drank 240 mL of water at 0800. B. The client's gait is steady while using a walker. C. The client cries while answering questions. D. The client points to a 6 on the visual analog pain scale.

Correct Answer is D

Explanation

A. The client drank 240 mL of water at 0800: This is objective data because it is a measurable and observable fact that can be verified by the nurse. Documentation of intake is based on direct observation rather than the client’s perception.

B. The client's gait is steady while using a walker: This is objective data as it is based on the nurse’s direct observation of the client’s physical performance. It can be measured or assessed without relying on the client’s personal experience.

C. The client cries while answering questions: Crying is an observable behavior, making it objective data. While it may indicate distress, the nurse is reporting what was seen rather than the client’s internal experience.

D. The client points to a 6 on the visual analog pain scale: This is subjective data because it reflects the client’s personal perception of pain, which cannot be independently measured or verified. Pain is inherently subjective, relying on the client’s self-report.

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A nurse is providing preoperative teaching about patient-controlled analgesia (PCA) to a client. Which of the following statements should the nurse include in the teaching?

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