Question

A PCA has been ordered for a client who is experiencing significant postoperative pain. To minimize the risk of adverse effects of this therapy, the nurse should perform what action?

Answer 1

To reduce the risk of PCA adverse effects, a multidisciplinary team approach is required. This includes confirming key details and a 'time out' to review critical information and monitoring the patient during PCA therapy use.

Step-by-step explanation:

To minimize the risk of adverse effects of patient-controlled analgesia (PCA) for a client experiencing significant postoperative pain, the nurse should engage in a multidisciplinary team approach. Before the administration of anesthesia and commencement of the PCA, the following steps must be taken to ensure patient safety:

• Sign in - The nurse and anesthesia professional should orally confirm key details such as the administration of prophylactic antibiotics within the appropriate time frame, and verify that all essential imaging results are displayed and reviewed.
• Time out - The entire surgical team takes a 'time out' before the skin incision to confirm the patient's identity, surgical site, and procedure. The surgeon, anesthesia staff, and nursing staff review anticipated critical events, including concerns specific to the patient. This may include discussing the dosage and monitoring protocols for the PCA.
• The nursing staff should frequently monitor the patient's response to the PCA, watching for signs of over-sedation or respiratory depression, and ensure that the patient understands how to use the PCA device properly.

These proactive steps are essential to optimize patient outcomes and minimize risks associated with PCA therapy.