PCAs-Purpose & Safety
This is the key reason patients must be awake and alert when using a PCA.
What is, that only the patient should push the PCA button?
Patients should do this as soon as they begin to feel pain to achieve optimal relief.
What is use the PCA button?
PCA therapy must be stopped and the clinician notified immediately if this vital sign drops below 8.
What is the respiratory rate?
Chest tubes are used to remove air or fluid from this anatomical space.
What is the pleural space?
Continuous bubbling in the water chamber indicates this.
What is an air leak?
This emergency medication must be ordered to manage excessive sedation or respiratory depression.
What is narcan?
Visitors should be told to never do this with the PCA pump.
What is push the PCA button for the patient?
Nurses must never rely on this alone for assessment, because opioids may suppress respirations without affecting it.
What is pulse oximetry?
If there is a sudden increase in drainage or >200 mL in one hour, the nurse must do this immediately.
What is notify the physician?
If a chest tube is dislodged and there is an air leak, cover with gauze and tape on this many sides.
What is three sides?
This type of monitoring must be used continuously with PCA to detect respiratory depression and hypoxemia risk.
What is capnography? (EtCO2)
Patients should ask for help before doing this activity during the first hours of PCA therapy.
What is getting out of bed?
Constricted pupils, slow pulse, low BP, pale, clammy, or cyanotic skin. These symptoms indicate this.
What is over sedation?
This should be visible on the atrium only when attached to suction.
What is the orange bellow/accordion?
This determines the severity of the air leak.
What is the increased number at the bottom of the water chamber?
Before initiating PCA or when changing the medication or rate, nurses must perform this safety step with another clinician.
What is double verification?
Patient education must include that the pump has these settings designed to prevent overdose.
What are lock-out settings?
This should be done if your patient is over sedated.
What is STOP the infusion, call RRT, administer Narcan per MAR?
This should not be done without physician orders and parameters.
What is clamp the tubing?
During dressing changes this technique should be used and be performed daily or PRN.
What is sterile technique?
Name two reasons a patient might need a PCA.
What is surgery, cancer, sickle cell crisis...?
This is how you can check if the patient is getting adequate pain control.
What is checking the patient history on the pump?
Nurses should assess these indicators without waking the patient, as waking them can alter them.
What are the respiratory rate, heart rate, capnography, and pulse oximetry?
This sounds like crunching rice crispies and should be reported to the physician.
What is crepitus?
To obtain a sample, nurses may draw from this specific location.
What is the sampling port? (or tubing with a syringe and 20g needle or smaller)