The nurse caring for a patient who has a PCA knows that it:
a. allows the family to participate in pain management for the patient.
b. prevents mistakes in medication administration.
c. can be used by all hospitalized patients.
d. provides a more constant level of medication.
D
PCA allows more constant serum levels of the opioid, and, as a result, it avoids the peaks and troughs of a large bolus. Because the blood level is maintained within a narrow range of the minimum effective analgesia concentration for the individual, pain relief is enhanced, and the incidence of side effects, such as sedation and respiratory depression, is decreased. Potential concerns involving PCA use are pump failure, and operator errors. Patients may misunderstand how PCA therapy works, may mistake the PCA button for the nurse call button, or may have family members who operate the demand button. Instruct the family not to push the timing device for the patient unless the patient is unable to push the button himself, and the nurse has instructed the family to do so. Use of a PCA pump does not prevent mistakes. The pump may fail to deliver drug on demand, may have a faulty alarm or a low battery, or may lack free-flow protection. Operators may incorrectly program the dose, concentration, or rate. Not all patients are candidates for PCA. Assess the patient's cognitive ability to determine the appropriateness of PCA pain management.
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