PCA Questions and Answers

PCA Questions and Answers PCA Common Usage POST-OPERATIVE CARE ( ORTHOPEDIC / GASTROINTESTINAL / GYNECOLOGICAL, palliative care, hospice INS STANDARD (INFUSION NURSE SOCIETY STANDARD) The nurse should assess the patient for the appropriateness for the use of PCA therapy and the patient's comprehension of, and the ability to participate in , the intended therapy. (INS ,2011) Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:06 / 0:15 Full screen Brainpower Read More PURPOSE FOR PCA TO PROVIDE GOOD PAIN MANAGEMENT WITH MINIMAL SEDATION PUTTING THE PATIENT IN CONTROL OVER THERE OWN PAIN & SUFFERING GIVING SMALL DOSES OF NARCOTICS FREQUENTLY THAN LARGE DOSE INFREQUENTLY CANIDATES for PCA ●Those that anticipate pain that is severe and intermittent. ●Have constant pain that worsens with activity. ●Can comprehend the usage of pushing the button for pain (technique). ●Have the functional ability to push the button. Never have another person press PCA Button or by proxy. ●Are motivated. ●Are not sedated from other medication. Nursing Process for PCA How does the nurse ASSESS pain Nursing Diagnosis - Differentiate between chronic and acute pain Plan (Patient centered - (What does the patient normally use?) Implement Interventions for pain Evaluation of effectiveness. Nursing steps For PCA 1.Follow ;the rights of medication administration 2.Verification of Order before administering drug. 3.Check Expiration Date on Medication Container 4.Determine the correct dilution, amount, and length of administration time as appropriate 5.Administer medication using the appropriateness infusion method. 6.Maintain aseptic technique at all times OPIOIDS ●HIGH ALERT DRUGS ●INSTITUTION FOR SAFE MEDICATION PRACTICE ●DOUBLE CHECK PROCEDURE PRIOR TO INFUSION ●CONSIDERATION: DRUG, CONCENTRATION, DOSAGE, RATE OF INFUSION Route prior to Initiation of PCA Administration Solution Container Changed When Drug or Dosage is Changed New Technologies for Hospitals ●Custom Drug Libraries to support Therapy and Medication best practice. ●Stored protocols assigned to specific clinical area that will reduce programming steps. ●Wireless network access allowing real-time monitoring of infusions. ●CQI reports providing actionable information for performance enhancements. ●Pharmacy generated bar codes for customized medication. OVERSEDATION RISK FACTORS ●OLDER ADULTS( 60 YEARS OLD, RISK INCREASES WITH INCREASING AGE. ●MORBID OBESITY ( SLEEP APNEA). ●SNORING ●NO RECENT OPIOID USAGE ●POSTOPERATIVE PATIENT WHO UNDERWENT UPPER ABDOMINAL OR THORASIC SURGERY ●LONG DURATION OF ANESTHESIA ●TAKING OTHER SEDATIVE MEDICATION ●PRE-EXISTING CARDIOPULMONARY DISEASE OR MAJOR ORGAN FAILURE ●OBSTRUCTIVE SLEEP APNEA OR OTHER SLEEPING DISORDERS Prevention of Opioid-Induced Respiratory Depression ●SAFETY FEATURE OF CAPNOGRAPH MEASURES IN REAL-TIME THE ADEQUACY OF VENTILATION. ●"Force Function" Capnograph will delay PCA pump when it senses a deterioration in ventilation of patient. Where the CO2 level is too high. ●CONTINUAL PULSE OXIMETRY USAGE WITH ALARM SETTING OF SATURATION. ●Monitoring respiration , Level of Consciousness, Pain Levels