Question

A patient is scheduled to have a cemented total shoulder arthroplasty. History includes sleep apnea obesity hypertension. Patient arrives with PCA patient states that she is in severe pain and doesn't want to push some buttons and the nurses instructed the patient on PCA use what is the next step

Answer 1

The healthcare team should reassess the patient's pain management plan, especially her use of the PCA given her severe pain and reluctance to use the device. They should review key recovery concerns aloud and ensure the patient's comfort and safety given her history of sleep apnea, obesity, and hypertension.

Step-by-step explanation:

The next step after instructing the patient on the Patient-controlled analgesia (PCA) would be to address her severe pain concerns directly. Since the patient is hesitant to push buttons for pain relief, it may be necessary for the healthcare team to reassess the patient's pain management plan. The surgeon, nurse, and anesthesia professional should verify that the patient understands the PCA use and explore alternative pain management strategies if necessary, especially considering the patient's comorbidities such as sleep apnea, obesity, and hypertension which could affect pain control and recovery.

The team needs to review aloud the key concerns for the recovery and care of the patient. They should also ensure that the patient's airway and risk of aspiration have been evaluated, and that appropriate equipment and assistance are available, given the patient's history of sleep apnea. The patient's comfort and ability to manage pain post-surgery are critical for a successful recovery from a total shoulder arthroplasty, which is considered a very invasive procedure that can provide relief from chronic pain and enhance mobility within a few months.