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PCA use
PCA
| Question | Answer |
|---|---|
| What are the important Teaching concepts when teaching Pt. about PCA meds? | * Demonstrate how it works * press button to deliver additional bolus if needed * Tell client that after each dose, must wait a minimum amount before they get the next dose (Lockout). * client returns demo before starting * Pain scale * Only Pt. push |
| What do you need when setting up for PCA? | * Physicians order * Gloves, PPE * PCA pump, tubing, key * IV kit, tubing, catheter, fluids * Extension set w/Leur-lock adapter * Analgesic med cartridge & injector * PCA Admin. Record * PCA booklet for Pt. |
| What are the steps in administering PCA? | * Check ID * Establish IV access for PCA * Assemble PCA vial injector and infuser pump * Program infuser for continuous infusion plus a bolus dose * Independent double check by 2nd RN. |
| What are some common Meds for PCA use? | * Morphine (Most common, Most studied) * Hydromorphone (Dilaudid) * Fentanyl (30-40 X more potent than morphine) |
| What are some dose calculations needed with a PCA? | * Know mg/mL or micrograms/ml of drug * Basal or continuous rates * Bolus Rate (depends on Pt. tolerance and drug) * Lockout TIme (avoid stacking) |
| What are the steps with a RN administered bolus w/PCA? | * Open door, set dose volume to dose ordered * Set lockout interval to 00 * Administer dose * Set dose back to original order * Set lockout interval to original order * Close and lock door |
| What three main components are involved in Monitoring PCA use? | * Evaluate client's response (getting enough?) * Remind them to notify staff with alarms or pain increases and only pt. to operate. * Assess and document per policy. |
| What would you include in your assessment with a PCA? | * Pain onset, pattern description, location, intensity. * Amount and type of pain medications administered * Sedation level of client * Interventions, levels of pain relief. |
| What are some side effects or complications with PCAs? | * RESPIRATORY DEPRESSION * Nausea/Vomiting * Pruritis * Over-sedation * Cardiac arrest |
| What is the antidote for PCAs? | Naloxone or Narcan. |
| How do you terminate a PCA infusion? | * Close clamp * Unlock & open door * Remove injector or cassette and disconnect. * OFF button * Record amount of narcotic remaining * Dispose of remaining w/witness and co-signature. |
| How are PCA safetly controlled in oversedation? | Patient is then unable to press the button for more meds, this is why only the patient should control it |
| What is required of the patient for a PCA to be considered safe? | Patient must be cognitively, physically,and phsycologically capable of understanding the concepts of the PCA |
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zj mepn
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