Question

The nurse is caring for a client who is receiving patient-controlled analgesia via an epidural catheter. The infusion pump was started at 8 am and was set to deliver a basal rate of 1 mg per hour. When the nurse evaluates the client's pain level at 12 pm, the client reports that their pain level is unchanged from the morning. Which action should the nurse perform first?

A
Review pump settings and confirm proper functioning. Correct Answer (Blank)
B
Increase the basal rate to 5 mg per hour.
C
Notify the health care provider as soon as possible.
D
Encourage the client to use distraction and guided imagery.

Answer 1

The nurse should first review the pump settings and confirm the PCA device is functioning correctly before proceeding with any other interventions or contacting the health care provider.

Step-by-step explanation:

When the nurse evaluates a client on patient-controlled analgesia (PCA) via an epidural catheter, and the client reports no change in pain, the first action should be to review the pump settings to confirm proper functioning. This is because before any adjustments are made, it is critical to ensure the medication is being delivered as ordered. If the basal rate of medication set at 1 mg per hour is not providing relief, the pump could be malfunctioning, or other issues such as dislodgement or obstruction of the catheter could be present. Once the equipment is checked and found to be working correctly, or if an issue is identified and corrected, further interventions could include notifying the health care provider for possible order adjustments or suggesting nonpharmacological pain management techniques such as distraction and guided imagery. However, it would be inappropriate to adjust the medication rate without a specific order from a health care provider.