PCA PRACTICE EXAM QUESTIONS AND ANSWERS 2024

PCA Patient controlled analgesia -reusable pump that administers drug via IV route when patient presses button PCEA Patient controlled epidural analgesia -drug administered via catheter into epidural space around spinal cord -binds to nerve roots -blocks sensory impulses PCA therapy uses -post op -trauma -terminally ill -chronic disease pain -labor/delivery Candidates for PCA -mentally alert -Able to understand and comply with instructions Contraindications for PCA -Hx of respiratory conditions -Hx of drug abuse -Psychiatric disorder -Mentally confused Use of PCA begins with: teaching! -how to administer dose -take dose prior to pain exceeding their pain goal PCA advantages -gives PT control -Pain relief tailored to PT's size/tolerance -Small doses at short times stabilize serum drug concentrations -Lower narcotic use -improved post op breathing/coughing/ambulation/rest -pts dont depend on nurse for pain control PCA types of drug delivery Basal dose (continuous infusion) Patient Demand Dose Basal + Demand Dosing Opioid analgesia delivered: Morphine and Hydromorphone (Dilaudid) RN must assess or change: -the effectiveness of PCA relief -The need for continuous infusion + demand -the need to change dose/lock out interval -the need to change drug Safety mechanisms for PCA -lock out time between doses -prevents pt from self overdose Settings od PCA/PCEA must be verified by TWO RNS when: -pt is admitted to new unit -at change of shift -when pump settings or medications are changed When receiving PCA, all previous orders for opioids are: discontinued When receiving PCEA, the patient is to receive NO additional narcotics or sedation unless cleared by: the anesthesiologist Should family/the nurse push the button on PCA for the PT? NO