A nurse is reviewing the laboratory results for a client who has Cushing's disease. The nurse should expect the client to have an increase in which of the following laboratory values?

Rationale:

A. Omeprazole: Omeprazole is a proton pump inhibitor used to reduce gastric acid secretion and prevent gastrointestinal irritation, especially in clients taking NSAIDs. It does not interfere with tissue regeneration, collagen formation, or immune responses involved in wound healing. It does not raise concern for impaired postoperative recovery.

B. Prednisone: Prednisone is a corticosteroid that suppresses inflammation and decreases immune system activity, which can impair the normal healing process. It slows collagen synthesis, reduces fibroblast activity, and decreases the inflammatory response needed for effective tissue repair. Clients taking prednisone are at increased risk for delayed wound healing.

C. Digesin: Digesin is an enzyme-based digestive aid used to support gastrointestinal function and has no impact on tissue repair or immune function. It does not influence collagen production, vascularization, or cellular regeneration. Therefore, it does not contribute to postoperative wound healing complications.

D. Morphine: Morphine is an opioid analgesic used for postoperative pain management and does not interfere with the physiologic processes involved in wound healing. Adequate pain control may actually improve recovery by reducing stress responses, enhancing mobility, and promoting better respiratory effort. It does not delay wound tissue repair.

Rationale:

A. "Using this machine increases my risk of overdose.": PCA pumps are designed with safety features, including dose limits and lockout intervals, which reduce the risk of overdose. Understanding this helps the client recognize that PCA is a safe method for self-administered pain control when used correctly.

B. “I can get pain medication any time as long as I press the button”: The client can only receive medication according to the programmed dose and lockout interval. Pressing the button repeatedly will not override the safety mechanism, so this reflects a misunderstanding of how PCA pumps function.

C. "My partner can press my pain medication button for me if I am sleeping": PCA pumps are intended for self-administration only. Allowing someone else to press the button (a practice called “PCA by proxy”) can cause overdose and is unsafe, especially if the client is sleeping or sedated.

D. "I will receive a limited amount of pain medication when I press the button.": PCA pumps deliver a preset dose with a lockout interval to prevent overdose. This statement shows the client understands the safety mechanisms in place, indicating correct comprehension of PCA use.