Which action should the practical nurse (PNA) prioritize for postoperative patient with a PCA (Patient- Controlled Analgesia) machine?
Coffee ground secretions drainage via nasogastric tube.
Nasogastric tube suctioning.
Assessing pain management response.
Ineffective pain management report:
The Correct Answer is C
This is the correct answer because it is the most important and relevant action that the PN should do for a postoperative patient with a PCA machine. A PCA machine is a computerized device that allows the patient to self-administer a preset dose of pain medication, usually an opioid, by pressing a buton. The PCA machine is attached to an intravenous (IV) line that delivers the medication directly into the bloodstream. The PCA machine can provide effective and individualized pain relief for postoperative patients, as well as increase their sense of control and satisfaction¹².
The PN should assess the pain management response of the postoperative patient with a PCA machine by monitoring their pain level, vital signs, oxygen saturation, sedation level, and side effects. The PN should use a valid and reliable pain scale, such as the numeric rating scale (NRS) or the visual analog scale (VAS), to measure the patient's pain intensity and relief. The PN should also check the settings and functioning of the PCA machine, such as the dose, lockout interval, and limit. The PN should document and report the patient's pain management response and any problems or complications with the PCA machine to the health care provider.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Worsening perineal pain after medication could indicate inadequate pain relief or a potential complication such as infection or hematoma. It is important to reassess the client to determine the cause of the increased pain and take appropriate action before transferring to the postpartum unit.
The other scenarios described in the options may also require attention, but they do not indicate an immediate need for reassessment before transfer:
B. A primigravida who passed a small clot when she sat up on the edge of the bed: Passing small clots is a normal part of the postpartum period, and it may not necessarily require immediate reassessment. However, the PN should monitor for any excessive or large clots and report any concerning findings.
C. A multigravida whose peri-pad is 1⁄2 saturated with lochia rubra after one hour: Lochia rubra is the normal discharge following childbirth, and some saturation of the peri-pad is expected.
However, the PN should continue to monitor the amount and consistency of the lochia and report any significant changes.
D. A multigravida complaining of strong afterbirth pains when breastfeeding: Afterbirth pains, also known as uterine cramps, are common during breastfeeding as the uterus contracts. While discomfort is expected, strong afterbirth pains should be assessed for severity and managed appropriately. The PN should provide comfort measures and assess if the pain is within the expected range or if it requires further evaluation.
Correct Answer is D
Explanation
Verifying the completion of all new prescriptions is crucial because it ensures that necessary medications or treatments are not delayed or missed for the clients. By reviewing the new prescriptions, the PN can ensure that any necessary medications or treatments are ordered and completed as required. This task takes priority because it directly impacts the immediate care and well-being of the clients.
While the other tasks mentioned are also important, they are not as time-sensitive or critical as verifying the completion of new prescriptions:
A. "Clean up and organize the nurses' work-station": While maintaining a clean and organized work-station is important for efficiency and safety, it can be done after the more critical tasks have been completed.
B. "Write a narrative shift summary for each client": Providing shift summaries is important for effective communication and continuity of care, but it can be done after ensuring the completion of new prescriptions, as it involves documenting and reviewing the events and assessments that occurred during the shift.
C. "Calculate and record intake and output totals": Tracking intake and output is important for assessing fluid balance, but it can also be done after verifying the completion of new prescriptions, as it involves documenting and calculating fluid volumes.
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