A patient has fallen and injured her knee.
It is not fractured, but there is considerable swelling and pain.
She asks which over-the-counter analgesic would be best to take for her discomfort.
The nurse tells her that one with NSAID properties would be best.
Which would it be best to take?

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.

The correct answer is choice B. "Why do you think your husband needs more medication when he is asleep?"

Choice A rationale:

"Your husband should decide when more medication is needed.” This response is incorrect because it implies that the partner has the authority to decide when the client needs pain medication, which violates the purpose of a PCA pump. A PCA pump is specifically designed for client-controlled pain management, ensuring that the patient, not anyone else, controls when they receive pain medication. Allowing someone else to press the button can lead to overmedication and safety risks.

Choice B rationale:

"Why do you think your husband needs more medication when he is asleep?" This response is correct because it prompts the partner to reflect on their actions and provides an opportunity for the nurse to educate about the proper use of PCA pumps. It addresses the immediate issue without being confrontational and opens the door for further discussion on the importance of client safety and correct PCA use.

Choice C rationale:

"It's a good idea to help make sure your husband can sleep comfortably.” This response is incorrect as it endorses inappropriate and unsafe behavior. It encourages the partner to continue pressing the PCA button, risking the client's safety due to potential overmedication, which can lead to severe complications, such as respiratory depression.

Choice D rationale:

"Next time you think he needs more medication, call me and I'll push the button.” This response is incorrect because it contradicts PCA protocols and removes the control from the client. The nurse is responsible for monitoring the client’s pain and safety, not administering medication upon another person’s request. This approach also increases the risk of dosing errors and undermines the purpose of patient-controlled analgesia.