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 B

Explanation

A. "This test can determine your risk for bleeding.": Serum prealbumin does not provide information about clotting or bleeding risk. Coagulation studies, such as PT, aPTT, or platelet count, are used to assess bleeding risk, not prealbumin levels.

B. "This test can measure your nutritional status.": Serum prealbumin is a sensitive marker for assessing short-term nutritional status and protein-calorie malnutrition. Because it has a short half-life, changes in prealbumin levels can reflect recent dietary intake and effectiveness of nutritional interventions.

C. "This test can determine your risk for cardiovascular disease.": Prealbumin is not used to assess cardiovascular risk. Lipid profiles, cholesterol levels, and other biomarkers are used for cardiovascular disease risk evaluation, making this statement inaccurate.

D. "This test can measure your kidney function.": Kidney function is assessed through tests such as serum creatinine, BUN, and estimated GFR. Prealbumin levels are not direct indicators of renal function, although severe kidney disease may indirectly affect protein levels.

A. "I feel emotionally numb and no longer leave the house." B. "I think a part of me died with them. I feel empty inside." C. "I lost trust in health care professionals since they died." D. "I am sad but recognize that this was a blessing for them."

Correct Answer is D

Explanation

A. "I feel emotionally numb and no longer leave the house.": This statement reflects complicated or prolonged grief, characterized by social withdrawal, emotional numbness, and difficulty functioning. It may indicate the need for additional support or referral to mental health services rather than a typical grief response.

B. "I think a part of me died with them. I feel empty inside.": While feelings of emptiness are common in grief, expressing a sense of self-loss that is pervasive and debilitating can suggest a more complicated grief process. It requires careful assessment and monitoring rather than being considered a fully appropriate grief response.

C. "I lost trust in health care professionals since they died.": This statement indicates anger, mistrust, or possible blame associated with grief. While emotional reactions vary, a persistent sense of mistrust can interfere with adaptive coping and may require guidance and support to process feelings constructively.

D. "I am sad but recognize that this was a blessing for them.": This statement demonstrates an adaptive grief response, acknowledging sadness while also finding meaning or acceptance in the situation. It reflects the ability to process loss realistically, maintain perspective, and integrate the experience into ongoing life.

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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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