The nurse takes into consideration the Joint Commission on Accreditation of Healthcare Organizations (CAHO) standards for pain assessment and treatment.
Include:.

Choice C rationale:
Keeping a night light on in the room is the most helpful intervention for a child having difficulty falling asleep. Night lights provide a comforting and soothing environment, reducing the fear of the dark and making the child feel secure. It also helps prevent complete darkness, which can be particularly helpful for children who may be afraid of the dark. This intervention promotes a positive sleep environment and can facilitate the child's ability to fall asleep.
Choice A rationale:
Giving juice and cookies before bedtime is not an appropriate intervention to help a child fall asleep. In fact, providing sugary snacks before bedtime can lead to increased activity and may make it even more challenging for the child to sleep.
Choice B rationale:
Having the parents bring a favorite blanket or pillow from home is a nice gesture and can provide comfort to the child, but it may not directly address the issue of falling asleep. While it can be part of creating a familiar and comforting sleep environment, it may not be sufficient on its own to help the child fall asleep.
Choice D rationale:
Turning off all the lights in the room may not be the best approach, as complete darkness can be frightening for some children. It's important to strike a balance between creating a soothing sleep environment and avoiding overwhelming darkness, which is why keeping a night light on is often a better option.

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.