A client is postoperative day one and has a patient-controlled analgesia (PCA) pump with a continuous basal dose for pain control. Currently, the client is stating that the operative pain is escalating. What is the first action of the nurse?
a. Try diversion to take the client's mind off the pain.
b. Ask the client to ambulate around the unit.
c. Assess the client's pain according to PQRST.
d. Call the physician to request an order to increase the basal dose.
C
Assessment is the first step in the nursing process. The nurse will need the information gleaned from the assessment using PQRST (factors precipitating the pain, quality of the pain, region and radiation of the pain, severity of the pain, and timing of the pain) to request a change in medica-tion order. Diversion and ambulation can be used in client care but will not control escalating pain in the postoperative client.
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