The nurse knows that a PCA pump would be most appropriate for the client who:
1. Has psychogenic discomfort
2. Is recovering after a total hip replacement
3. Experiences renal dysfunction
4. Recently experienced a cerebrovascular accident (stroke)
ANS: 2
Patient-controlled analgesia is a safe method for postoperative pain management, such as the cli-ent recovering from total hip replacement surgery. PCA would not be the mode of choice for treating psychogenic pain or for the client with renal dysfunction. The client with renal impair-ment would be at increased risk for drug toxicity because of decreased drug excretion. Clients must be able to understand the use of the equipment and be physically able to locate and press the button to deliver the dose. The client who recently experienced a cerebrovascular accident may have difficulty managing the PCA system.
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