NUR 376 Exam 2 Questions With Verified Answers A Graded

Reasons to use PCA/PCEA - right answer--reported better pt. satisfaction with post-op pain control (more steady); fewer pulmonary complications (can cough and deep breath more effectively with pain under control); earlier ambulation - reducing other complications; shortened hospital stays Pt. selection for PCA - right answer--awake and alerted; must be able to understand concept and follow instruction on PCA; able to independently push button; PCA by proxy not recommended and if used TIGHTLY controlled and monitored; pt. must recognize the activation button; AVOID in young children, confused, pt. taking meds that potentiate effect of opioids (benadryl, phenergan, some muscle relaxants, benzos); opioid naive pts. continusous rate not recommended information obtained prior to PCA initiation - right answer--Vital signs; type and last dose of pain med with time of administration; pt. response to analgesic medication; pain rating/score PCA history display - right answer--records pt. history for up to 24 hours including: total demands; delivered demands; total drug delivered; total amount of drug delivered via PCA doses, continuous infusion, loading, and bolus doses; average drug per hour pt. history displayed in intervals of 1,2,3,4,8,12, or 24 hours PCA vital signs and sedation score - right answer--every 30 minutes x2 and then every hour x3 at onset of therapy; then every 4 hours for duration of therapy pt. history recorded in eRecord every 4 hours (number of demands and mg of med delivered) Respiratory Depression - right answer--RR less than 8 DISCONTINUE INFUSION and be prepared to administer Narcan per orders if pt. requires assisted ventilation, support with bag-valve-mask ventilation as needed (1 breath every 6 seconds) until Narcan can be given continuous epidural analgesia good for after - right answer--thoracic surgery; abdominal surgery; orthopaedic surgery; obstetrics for labor Place