The patient who receives patient-controlled analgesia (PCA) with an opioid analgesic reports that the pain level is 9 on a scale of 0 to 10 . Which does the nurse implement to increase patient pain control?

Question

a. Elevates the head of the bed (HOB) to 30 degrees
b. Increases the interval between demand doses
c. Increases the demand and the basal doses
d. Checks patient manipulation of the PCA button

Answer 1

D
The nurse checks to ensure that the patient understands and executes depression of the PCA but-ton for on-demand doses. If the patient does not operate the button or does so ineffectively, he or she receives inadequate pain control. The nurse can elevate the HOB if the patient is oversedated and difficult to arouse unless it is contraindicated. By elevating the HOB, the nurse repositions and enables the patient to receive more environmental stimulation. The patient receives less medication when the time between demand doses is increased. The nurse avoids increasing the basal rate and demand dose simultaneously to prevent oversedation because increasing each rate of administration increases the total potential dose twice.