The client who receives PCA with an opioid analgesic reports that the pain level is 9 out of 10. Which does the nurse implement to increase client pain control?
1. Elevate the head of bed to 30 degrees.
2. Increase interval between demand doses.
3. Increase the demand and the basal doses.
4. Check client manipulation of PCA button.
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4. The nurse checks to ensure that the client understands and executes depression of the PCA button for on-demand doses. If the client does not operate the button or does so ineffectively, client receives inadequate pain control.
1. The nurse can elevate the head of the bed (HOB) if the client is oversedated and difficult to arouse, unless it is contraindicated. By elevating the HOB, the nurse repo-sitions and enables the client to receive more environmental stimulation.
2. The client receives less medication when the time between demand doses is in-creased.
3. 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.
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