Final answer:
The Practical Nurse should consider respiratory depression as the highest priority when monitoring a patient with a PCA pump postoperatively given the risk associated with opioid use. Monitoring the patient's respiratory rate and oxygen saturation is essential for early identification and intervention if respiratory compromise occurs.
Step-by-step explanation:
When a client in the immediate postoperative period is prescribed morphine via a patient-controlled analgesia (PCA) pump, the highest priority for the Practical Nurse (PN) would be to monitor for signs of respiratory depression, which is a potentially life-threatening side effect of opioid administration. Because morphine can suppress the respiratory center in the brain it is critical to observe the client's respiratory rate, oxygen saturation (using a pulse oximeter) and overall breathing pattern.
If the patient shows signs of respiratory distress, decreased respiratory rate or oxygen desaturation, immediate intervention is required. Additional concerns postoperatively would include ensuring the effectiveness of analgesia, monitoring for signs of over-sedation and other opioid-related side effects like nausea or pruritus. However these are not as immediately life-threatening as respiratory depression. The PN must balance pain control with vigilant monitoring to maintain patient safety.