A nurse is reinforcing teaching about pain control with a client who has acute pain following a subtotal gastric resection.
Which of the following client statements indicates an understanding of pain control?

Choice A rationale:

Constipation is not a common adverse effect of pain medication administered by the epidural route. Pain medication primarily affects the central nervous system and does not typically impact the gastrointestinal system in a way that would lead to constipation.

Choice B rationale:

Hypoventilation is the correct answer. When opioids or other potent pain medications are administered by the epidural route, they can depress the respiratory center in the brain, leading to hypoventilation (slow or inadequate breathing). This is a critical concern and the most important adverse effect to monitor because it can lead to respiratory compromise or even respiratory arrest.

Choice C rationale:

Nausea can be a side effect of some pain medications, but it is not the most important adverse effect to monitor in a patient receiving epidural pain medication. Nausea can often be managed with antiemetic medications.

Choice D rationale:

Headache is not a common adverse effect of epidural pain medication. The administration of pain medication into the epidural space is localized to the spinal area and does not typically lead to headaches.

Choice A rationale:
The primary care provider (PCP) is responsible for prescribing the PCA but does not typically program the PCA pump. The PCP may set the initial parameters for the PCA, such as the dose and lockout interval, but the actual programming and operation of the PCA pump is typically carried out by the nursing staff.
Choice B rationale:
Pharmaceutical companies manufacture and provide medications, including the medications used in PCA, but they do not program PCA pumps. Programming and administration of the PCA are nursing responsibilities.
Choice D rationale:
Licensed Practical Nurses (LPN) or Licensed Vocational Nurses (LVN) can assist in the administration and monitoring of PCA, but they do not typically program the PCA pump. Registered nurses are usually responsible for the programming and operation of PCA pumps.