A nurse is reinforcing teaching for a client who has been receiving a PCA pump following a hysterectomy. Which of the following medications should the nurse anticipate the provider to prescribe?

A. Librium: Librium (chlordiazepoxide) is a benzodiazepine used primarily for anxiety and alcohol withdrawal management. It is not typically prescribed for pain control after surgery and would not be expected in a client using a PCA pump.

B. Disulfiram: Disulfiram is used to deter alcohol consumption by causing unpleasant effects when alcohol is ingested. It has no role in pain management and would not be associated with postoperative care or PCA use.

C. Phenobarbital: Phenobarbital is a barbiturate used to control seizures and sometimes for sedation. It is not prescribed for pain relief and would not be expected for a client recovering from a hysterectomy with a PCA pump.

D. Clonidine: Clonidine can be used as an adjunct to pain management, particularly to enhance the effects of opioids and reduce the amount needed. It can help manage withdrawal symptoms and pain, making it a medication the provider might prescribe alongside a PCA pump.

A. Difficulty swallowing: Difficulty swallowing, or dysphagia, is not typically a direct indicator of unrelieved pain. It could suggest neurological or throat-related issues rather than being a primary symptom associated with inadequate pain control.

B. Constipation: Constipation is a common postoperative complication, often related to anesthesia, immobility, or opioid use. While it is important to address, it does not directly reflect the client's current pain level or effectiveness of pain management.

C. Urinary retention: Urinary retention can occur due to anesthesia effects, pelvic surgery, or opioid administration. Although it is a significant postoperative concern, it is not a reliable or direct indicator of unrelieved pain.

D. Restlessness: Restlessness is a common sign of unrelieved pain, particularly in postoperative clients. When clients are uncomfortable or in significant pain, they may appear restless, anxious, or unable to remain still, signaling the need for further pain assessment and intervention.