A nurse is assessing a client who is postoperative and has a pca

It has A nurse is assessing a client who is postoperative and has a PCA. The patient depends on the knowledge of the nurse and relies on the nurse to advocate for the patient and to ensure actions are taken in the patient's best interest. When you measure your baby's development—that is, when you look at what is "normal" for your baby's age—consider both of those dates. Postoperative Nursing Management - Free download as Word Doc (. The client has been vomiting for the past 24 hr and reports a pain level of 8 on a scale from 0 to 10. No needles are injected into your muscle. , 60 ml. The nurse should: You selected: Despite the simplicity of observational methods, those responsible for assessing risks using these techniques should have some experience and know-how in order to be able to use them correctly. • Seizures • Receptive aphasia may appear to be confusion • Interpretive area memories • Assessment involves stories, pictures… • Involve family • Dominant lobe verbal memory • Nondominant lobe nonverbal. ; Jeffrey T. 83 Postoperative epidural ropivacaine 0. The nurse notes a hard, distended abdomen and absent bowel sounds. 10% CHAMBERLAIN COLLEGE OF NURSING: COMPLEX CRITICAL NURSING 341 TEST 1 Any treatment that is used to sustain A 2-year-old with bruises on both shins A 2-year-old who won't make eye contact with the nurse A 3-year-old who acts withdrawn and has bruises on his back A 10-year-old who comes to the emergency department with a broken arm RATIONALE: A 3-year-old who acts withdrawn and has bruises on his back may be the victim of physical abuse. The client has significant pleuritic pain and is unable to take in a deep breath in order to cough effectively. The nursing instructor is discussing postoperative care with the junior . Breathing, Circulation & Disability Assessment (link to Nursing Assessment Guideline) Whilst all postoperative orders need to include both post anaesthetic and PCA, Epidural, or Opioid infusion; Is receiving an Insulin infusion; Has ICP  7 May 2019 During each patient assessment, you evaluate your patient for infection. As a nurse, you will have the opportunity to minimize the risk for infections acquired within a hospital by utilizing the skills that you have learned from your training. An adult has been taking acetylsalicylic acid (ASA) 650 mg four times a day for chronic back pain. 9% NaCl solution at 125mL/hour. Nurses have a variety of roles and functions associated with the patient's surgical management. Spontaneous eye opening 2. The client's ABG results are pH 7. The nurse has been called by the client. Pain is an individualized experience. Stool is positive for occult blood. In option 3 the nurse should not assume that the client has been informed of choices for emergency care. Top 50 Staff Nurse Skills. ) The auricular lymph nodes have increased in size over the last 24 hours. A nurse is assessing a client who is postoperative and has a PCA. A nurse is caring for a client who has acute diverticulitis and is scheduled for surgery within the next 2 hr. Respiratory alkalosis d. It is important for the client to understand the purpose and use of postoperative pain control measures to allow early mobility and reduce complications associated with immobility. Up until now, the patient has refused to learn how to change her dressing. Overdosing is totally eliminated because the PCA machine has a lockout system. Although clients with chronic pain can be relatively stable, the interaction with this client will be time consuming and may cause the new nurse to fall behind. Hypokalemia 5. Skill 20-3 Performing a Neurologic Assessment on a Critically Ill Client Skill 20-2 Using a Pupillometer Skill 20-3 Assisting with a Lumbar Puncture Section 2: Caring for the Client with Increased Intracranial Pressure Skill 20-4 Caring for the Client who Has an External Ventriculostomy Skill 20-5 Using an Intracranial Pressure Monitor Routes of Opioid Administration. A client has an order for ABG analysis on radial artery specimens. When assessing a child for pain, the nurse is aware that a. 27 48 53 Purpose: The study examined the effects of preoperative patient controlled analgesia (PCA) education on postoperative pain, knowledge of PCA, and attitude toward pain medication. The blood pressure increases from 120/80 to 142/94 D. . In spite of receiving a dose of pain medication, the client rates the pain at 8 on a 0 to 10 pain scale. The nurse was assisting her from the bed to a chair when the client felt dizzy and fell into the chair. The client is in no apparent distress. Scribd is the world's largest social reading and publishing site. After conferring with the provider, which of the following actions should the nurse take A nurse is assessing a client who is postoperative and has a PCA. The extent of postoperative care required depends on the individual's pre-surgical health status, type of surgery, and whether the surgery was performed in a day-surgery setting or in the hospital. The nurse was assisting her from bed to a chair when a client felt dizzy and fell into the chair. , alfentanil, remifentanil) for procedural analgesia may also The incidence of POUR with epidural local anesthetics for inguinal herniorrhaphy has been shown to be lower than with spinal anesthesia. 1 Pain Perceptions and Processing The nurse is assessing a client’s nailbeds. Body mass index (BMI) is 16. " Which of the following actions should the nurse take first? a. Remind the client to push the button for the PCA device. The most appropriate action by the nurse is to do which of the following? Evaluate the relationship between nursing intervention for the relief of preoperative anxiety and the control of post-operative pain, and; Determine the relief of anxiety and post-operative pain in response to nursing interventions on the basis of gender and educational levels of surgical patients. [13-15] The first generation of transdermal fentanyl patches relied on simple diffusion of the drug down a concentration gradient. If you don't stop and look around once in a while, you could miss it. It has been reported to be between 2% and 76%, depending on the patient population and how pain was assessed. On assessment, the nurse notes crackles over the RLL. –Tells you how well the tool correctly identifies patients NOT at risk for falling. The client states that he has been labeled a “drug seeker” because he is looking for relief for the pain and feels hopeless, angry, and powerless to do anything about the situation. 2 BACKGROUND 2. When the nurse notifies the surgeon, he directs her to continue to take the client's vital signs every 15 min and call him back in 1 hr. The nurse is caring for a postoperative patient in the critical care unit. What nursing intervention would you take Postoperative Care after Appendectomy. During the first post operative assessment, after the nurse has received a hand over from the theatre nurse, the patient will arrive back at the ward with an intravenous infusion. Yawning Rhinorrhea Sweating Hot and cold flashes Severe backache Yawning, rhinorrhea, and sweating are early symptoms of abstinence syndrome If your baby was born early, you have 2 important days to mark on the calendar: the day your baby was born and your estimated due date. Other findings are present, but not related to immobility. By looking at the If your baby was born early, you have 2 important days to mark on the calendar: the day your baby was born and your estimated due date. The nurse is caring for a client who had surgery 24 hours ago. Chapter 20 Nursing Management Postoperative Care Christine Hoch Life moves pretty fast. ) A nurse is caring for a client who is postoperative following a total knee arthroplasty and is prescribed a continuous passive motion (CPM) machine and PCA. When assessing this client, the nurse should stay alert for signs and symptoms of: 1 – calcium and phosphorus abnormalities. Ms. population have shown positive, but limited benefits of PCA, although others have shown that patients may prefer an attentive nurse and that the cost of this technology when used with burn patients may not be justified. standardization of intravenous Patient Controlled Analgesia (PCA) medication administration in the care of the opioid naïve . trustworthiness b. A Vaseline gauze may encircle the stoma with a “fluff” type dressing applied. Medical Surgical Unit. Chapter 39: Pain Management for Children Test Bank MULTIPLE CHOICE 1. A client who is postoperative Day 1 has rung the call light twice during the nurse's shift in order to request assistance transferring to a bedside commode. The RN on the previous shift reported that a new 1000 ml bag would be hung. The doctor orders: a bolus of 500mL of gelofusion, to be followed by 0. Neonates do not feel pain. The client was nauseated after a previous surgery. As part of preoperative teaching, the nurse informs the client of postoperative measures to prevent atelectasis. b. Case Study 82: A 68 ylo female client has come to the healthcare providers office with concerns of osteoporosis. The nurse will monitor the patient’s vital signs, drain site and assess for pain. Test Bank for Nursing Care of Children Principles and Practice, 4e (James, Nursing Care of Children) 4th Edition PREDICTOR TEST 3. Describe and provide a rationale for your immediate nursing assessment and immediate interventions. Focus topic: Physiological Integrity: Nursing Care of the Adult Client. 67) The nurse is evaluating the outcome “Client describes surgical procedures and postoperative treatment” and determines that the client has not achieved this outcome. A patient-controlled analgesia (PCA) system is prescribed for a postoperative client to control pain. A one-day postoperative abdominal surgery client has been complaining of severe throbbing abdominal pain described as 9 in a 1-10 pain rating. 7 Jul 2008 application of postoperative patient-controlled analgesia (PCA) using intravenous nurses with the aim of improving postoperative pain management. It should be dry and the wound should be completely closed. During this time, the nursing staff checks temperature, heart rate, and breathing at frequent intervals. Nurses can support patients recovering from surgery and identify complications Principles of monitoring postoperative patients NURSING CARE OF CLIENT HAVING A NEPHRECTOMY PREOPERATIVE CARE •Provide routine preoperative care as outlined in Chapter 7. “ effect after the PCA use,” and “epidural anesthesia”, as items of patient information  With diligent care, the surgical patient should eventually return to his or her preoperative . Not only is the type of tissue damage with a burn injury likely to generate unusually high levels of pain, the nature of standard burn care is likely to worsen whatever pain is present. 53 In addition, the risk of respiratory depression with PCA use appears to be higher in the elderly patient,26 and it has, therefore, been suggested that a lower PCA bolus dose should be used. In assessing the problems of potassium balance in the postoperative patient,  1 Dec 2018 Includes plans for pre and postoperative or post-surgery. The impact of therapeutic relationship on preoperative and postoperative patient anxiety. The nurse records the following amounts for 2 consecutive hours: 8 a. The incidence of POUR with epidural local anesthetics for inguinal herniorrhaphy has been shown to be lower than with spinal anesthesia. A nurse is caring for a client who is 2 days postoperative following a cholecystectomy. Nurses often are in the position to recommend use of different mattresses to physicians for improved patient comfort. The nurse ensures that which of the following has been performed or tested before the ABG specimens are drawn? a. The prevalence of chronic nonmalignant pain—such as chronic low back pain, osteoarthritis pain, fibromyalgia, and chronic daily headaches—has not been well characterized in cancer patients. C. Routinely assess client for organic contributors to behavior: Dehydration, Poor nutrition, Infection (systemic, urinary) Many organic factors may contribute to an increase in client’s confusion or changes in mental status. 1. Duties & Responsibilities, include, but are not limited to: Completing the initial assessment visit as applicable and re-assessing each client’s nursing needs on a regular basis c. Nurses must quickly work to assess their patient; administer sublingual nitroglycerin and aspirin, if indicated; obtain a 12-lead EKG; and notify the physician. Increased urinary frequency Postoperative Pain Control: Uncontrolled pain has been associated with higher rates of cardiovascular events and delirium. Photosensitivity 6. Which of the following would the nurse most likely be assessing? Select all that apply. Patients using PCAs administer and titrate the dose to their own needs using a small microprocessor-controlled pump. PCA must be monitored closely but is considered very effective in managing acute postoperative pain  23 Jan 2018 Patient controlled analgesia (PCA) and nursing controlled Postoperative pain A Registered nurse, who has attended the Pain Study Day and had their CADD Pain Assessment, PEWS - as per Starship Children's Health  30 Aug 2012 The nurse who programmed the pump may have done exactly as he was told to the part of nurses that if a PCA pump is ordered and the patient can receive, oximetry) and ventilation (nursing assessment) are not adequate for reliably drug-induced respiratory depression in the postoperative period. Assess color and temperature of the extremity, capillary refill time, sensory and motor function, and pulses by palpation and Doppler q 1 hr for 1st first 8 hrs and then q 2 hrs for 1st 24 hrs. The nurse should: A. pdf), Text File (. 2. • Specificity is the ability of a fall risk assessment tool to screen out patients who are NOT at risk for falling. Retinal detachment 6. A nurse is providing teaching for a client who is in the immediate postoperative period and has a PCA pump. , FAPhA, BCPS Reviewed by Beth A. Sherer, Pharm. Sproule, Pharm. A 3-way-tap at the syringe end of the opioid infusion line is not required. 24 Sep 2018 Provide the client with information about advance directives. Patient information as evidence of postoperative wound pain included Nursing Assessment, Thought Process, Patients, Nursing Problems, Patient Strength Prior studies have clarified through qualitative analysis how nurses carry out . Prioritize nursing responsibilities in admitting patients to the postanesthesia care unit (PACU). When reading the emergency department nurse’s notes, the nurse reads that the client has Battle’s sign present on the right side of the head. 5%. What assessment has the highest priority before initiating the PCA pump? What should the nurse do in response to this statement? After having a total hip replacement, a client receives morphine sulfate (Duramorph) by patient-controlled analgesia (PCA) pump. The patient’s radial pulse is 105 beats/minute B. Floods are the most frequent and the most damaging natural disaster in Canada. By looking at the NR304 Musculoskeletal Case Study Case Study N: A 74 ylo male client has come to the healthcare provider’s office for a yearly examination. The patient will be seen by PT at 10am today and they will determine how much activity should be done today. Continuously assessing and monitoring the client: Nurses are also responsible for continuously assessing and monitoring the client in terms of their vital signs, responses to anesthesia, their ECG readings, their pulse oximetry, their loss of blood, their intravenous fluid intake and their output, their laboratory values and their pulmonary The nurse is caring for a client admitted to the hospital with right lower lobe (RLL) pneumonia. A preoperative nurse is assessing a client prior to surgery. Study 1666 NURSE PNN-168 Study Guide (2014-15 Pulliam) indicate to the nurse that the client has responded to fluid therapy? room of a client receiving PCA Chapter 3: Assessment and Care of Patients with Pain Ignatavicius: Medical-Surgical Nursing, 8th Edition MULTIPLE CHOICE 1. Which of the following instructions should the nurse include? Use cool compresses on your eyes, nose, and face A nurse is planning care for a client who is postoperative and has a closed-wound drainage system in place. The nurse understands that this method of pain relief alleviates pain and increases client satisfaction because of which factor? 1. ) A nurse is caring for a client who has been prescribed furosemide (Lasix) and is monitoring for adverse effects associated with this medication. The client  In assessing an adult client with a partial rebreather mask, the nurse notes . However, perhaps the most important use of opioids postoperatively is through intravenous self-administration with PCA devices, and a greater number of safety studies with larger patient numbers have been reported with this approach. Moote's article I with interest. The client tells the nurse that she has called a taxicab and is leaving the hospital. The nurse should be aware that heparin can be stored in adipose tissue and some patients may have an increase in bleeding 4 hours postoperatively depending on the body's adipose composition. After a motor vehicle accident, a client is admitted with numerous fractures and a closed head injury. Which of the following statements should the nurse include in the teaching? "Do not allow your family to push the PCA button if you are sleeping. She received 2 mg of morphine sulfate I. The client is SOB, appears restless, and has a RR of 28/min. Assessing level of sedation along with level of pain would also be useful. Reassessment is vitally important as this allows you to decide whether you have managed the pain problem successfully or need to consider another avenue. block incorporating a local anaesthetic infusion combined with PCA is the most  We describe implementation of “smart” PCA pumps with continuous Infusion System Improve Safety of Patient-Controlled Analgesia in the Postoperative Period . A client with Addison’s disease comes to the clinic for a follow-up visit. 27 48 53 Concurrent use of a background infusion is contraindicated in these patients, if they are opioid‐naive. professionalism 24. Nursing diagnosis has been additionally interpreted by the Department as including patient assessment, that is, the collection and interpretation of patient clinical data, the development of nursing care goals and the subsequent establishment of a nursing care plan. This has been shown to reduce the incidence of adverse side-effects such as nausea and vomiting, respiratory depression and reduced gut motility (Peeters-Asdourian and Gupta, 1999). Although patient-controlled analgesia (PCA) is in place, it is rarely used, even when suggested by the nurse. The nurse assessing this client knows that a common side effect of high dose of ASA is a. The nurse’s assessment then reveals the client has a hematoma in the venipuncture area. Following surgery, the patient is taken to the postanesthesia care unit (PACU) until the anesthesia wears off. The nurse is caring for a postoperative patient who needs daily dressing changes. B. 98) Nurse Badz is assessing the level of consciousness of a client who suffered a head injury. #2 Infection issues. • Sensitivity is the ability of a fall risk assessment tool to correctly identify a fall risk patient. He has numerous risk factors for heart disease, including diabetes. We analyzed 442 risk assessments of actual jobs carried out by 290 professionals from 20 countries to determine their reliability. When the nurse respects the client's self-disclosure, this is a gauge for the nurse's: a. A nurse is caring for a client who is postoperative and has signs of hemorrhagic shock. The patient is 3 days post-op and should be going home the next day. d. They must respond rapidly and efficiently to patients who are experiencing symptoms of acute MI. A) Apply a scultetus binder as soon as the client is fully awake to assist with deep breathing. 3. Transdermal fentanyl has a long duration of action and can be used in patients who cannot take medications orally. , BCPS Baseline Review Resources The goal of PSAP is to provide only the most recent (past 3–5 years) information or topics. assessing quality of respirations once per shift. The client asks the nurse, “When I will be allowed to eat three meals a day like the rest of my family?”. The colostomy pouch may or may not be applied in surgery. My husband tries to help but he has to work long hours to pay the bills. B) Closely observe the client's intake of fluids to liquefy secretions. PCA provides stable pain relief in most situations. The client complains of palpitations, nausea and is diaphoretic. Potential issues include failure, technical difficulty and hypotension. Chapters and medication, pain management, wound care, IV infusion, and postoperative instruction. While asking if the client has given thought to their spiritual needs provides an opportunity to discuss any client needs, it does not allow for the nurse to be of help with attending to these needs. I am committed to have this time available for us while you are at the hospital and ends after your discharge. The nurse develops postoperative plan of care for a client undergoing arthroscopy. Nursing plays a critical role in postoperative patient monitoring . Three-year 23. Jackson expresses fear that she might accidentally overdose herself, since she will be sleepy after surgery. In both cases, however, the client has been unable to defecate. Reverse trendelenburg with extended neck. Unconscious or Debilitated Client Nursing Skills List Return demonstration in simulated lab Care of the Adult Client Care of the Pediatric Client Student Self -Assessment Cleaning Dentures Shampooing Hair of a Bedridden Client Shaving a Client Performing Nail and Foot Care Care of the Client’s Environment: Making an Unoccupied Bed When the client has an indwelling urinary (Foley) catheter, the nurse assesses the urine for color, clarity, and amount. The ICU has posted visiting hours, but some of the patient’s family is from out of town and would like to see her even though it is not time. • Provided nursing care to surgical clients completing preoperative and postoperative procedures, performed physical assessments, documentation through Meditech system, administered medications through different routes including PCA pumps, infusion pumps, care of PICC lines, wound care and assessment, etc… Read about updated guidelines for management of patients after percutaneous coronary interventions (PCI). Cram. Understanding the mechanism of action of different pain medications would not be a priority area to assess when trying to find the reason a client in pain refuses medication. [12-15] Postoperative pain Oncology Nursing - Assessment and Clinical Care Pain Management - Principles and Practice This peer-reviewed journal offers a unique focus on the realm of pain management as it applies to nursing . , MPH, BCPS; and Patricia H. Presence of fever and chills d. It is not offered when there is local or systemic sepsis. Intravenous Patient-Controlled Analgesia (PCA) Further assessment and testing indicates that Wrenda has a back problem that requires surgery, which is scheduled for the next day. The nurse would be MOST concerned by which of the following? A client had a total abdominal hysterectomy and bilateral oophorectomy for ovarian carcinoma yesterday. m. Skill 20-3 Performing a Neurologic Assessment on a Critically Ill Client Skill 20-2 Using a Pupillometer Skill 20-3 Assisting with a Lumbar Puncture Section 2: Caring for the Client with Increased Intracranial Pressure Skill 20-4 Caring for the Client who Has an External Ventriculostomy Skill 20-5 Using an Intracranial Pressure Monitor A) Observe the appearance of the client's oral mucosa. Common causes of confusion in the postoperative period include . 37. assessment, planning, implementation, evaluation and documentation of care to meet the needs of clients in the preoperative, intraoperative and postoperative phase, the role of the nurse in the physical, psychological and educational care during the phases of surgery, classification of surgical procedures, surgical risk factors (include current drugs with special implications for the surgical client, herbal products), lab work and diagnostic tests ordered in the pre and postoperative phases Epidemiology • Hip fracture is a major health problem as population ages • HK (1995): 11/1000 in women, 5/1000 in men >70yrs (Lau et al, 1999) The postoperative nursing intervention that would be contraindicated for a 45-year-old patient who has had a repair of a cerebral aneurysm and is presenting signs of increased intracranial pressure (ICP) would be: Physical Modalities. Assessment of the client's status before surgery establishes baseline data to  Earn CE credit online: Go to http://www. Patients who have procedures done in a day-surgery center usually require only a few the nurse taking over his or her care should assess the patient again, using the same   The nurse has entered the room of a client who is postoperative day 1 and finds The nurse discusses these assessment findings with the health care provider due The client is receiving patient-controlled analgesia (PCA) with morphine. A child with sickle cell anemia whose PCA (patient-controlled analgesia) medication cassette is empty d. D, a 57-year-old man was admitted with acute pancreatitis in a medical-surgical unit. 2% at different infusion rates was studied in a group of patients who underwent anterior cruciate ligament repair, and it was found that high infusion rate was associated The first action the nurse should take is to attend to the client who is receiving blood. operation time may need to be changed if an emergency patient comes in. A nurse cares for a client who has obstructive jaundice. D. The journal reaches over 175,000 dedicated nurses in a multitude of specialties and practice settings. nurse to be concerned about (c) is generally defined as more than 30mls per hour of urine excretion and is uncommon in the immediate post-operative period (d) is generally defined as less than 30mls per hour of urine excretion and, left untreated, may lead to acute renal failure 4. The nurse is caring for a cancer survivor who has been hospitalized in the intensive care unit (ICU) for an unrelated and stable problem. Nursing Assessment nursing care plans for Benign Prostatic Hyperplasia (BPH) Palpation discloses a distended bladder, A digital rectal exam (DRE) reveals a rubbery enlargement of the prostate, but the degree of enlargement does not consistently correlate with the degree of urinary obstruction. Discontinue the PCA immediately. Following surgery, a client has great difficulty getting out of bed, walking, and coughing and deep breathing. The nurse is assessing a 36 year old woman who has been admitted for knee surgery. Tinnitus 3. Client has had four ulcers in the last 5 years. Mr. Below we've compiled a list of the most important skills for a Staff Nurse. ) Assessing the patient as a whole and focussing on the pain assessment. A bluish discoloration in the flank area. . Assess patient's level of understanding. Suring assessment, which observation needs an immediate intervention? Pain described as 7/10 unrelieved by medication that radiates to the back. We ranked the top skills based on the percentage of Staff Nurse resumes they Asking simply is a client has a religious preference is a closed-ended question and provides little encouragement to discuss spiritual needs. Note: Continuous epidural infusions may be used for 1 to 5 days following procedures that are known to cause severe pain such as certain types of thoracic or abdominal procedures. They might also have a PCA (patient controlled analgesia) and drain (Pudner, 2005). Gastrointestinal bleeding d. When assessing the client for postoperative infection, the nurse places priority on which assessment? a. Daily white blood cell count c. PAIN —the “fifth vital sign” in the care of clients; a complex subjective sensation; unpleasant sensory and emotional experience associated with real or potential tissue damage. Which of the . loyalty c. A Nursing Assistant will then go with you to theatre and will stay with you until PCA will give you a set amount of painkiller from the syringe, through a fine  The patient will have adequate pain relief while maintaining satisfactory then sign name along with first nurse on same signature line of PCA flowsheet or the order is Document assessment in the electronic medical record including pain level on pain scale, Comparison of postoperative pain management using two. The client tells the nurse, "I am in so much pain. Postoperative nurses are provided only when the operating theatre has a recovery room. Patient-controlled analgesia-related medication errors in the postoperative period. Nurses caring for PCI patients must be alert to recognize vascular related complications. Which of the following actions should the nurse take? Place the client in a modi±ed Trendelenburg position. 61. A recent research to compare the outcomes during conventional analgesia in the form of intramuscular dosing and patient-controlled analgesia (PCA) in postoperative patients by analyzing data of 15 randomized control trials with seven hundred eighty-seven adult patients aged between 16 to 65 undergoing various operative procedures has revealed 50 mL Braun Omnifix syringes are used for PCA, together with 180 cm minimum volume extension tubing. A postoperative client has been receiving a continuous IV infusion of meperidine (Demerol) 35 mg/hr for four days. Obtain the consent, because this is expected with preoperative anxiety Nursing Management Postoperative care monitoring for signs of thrombosis in arteries distal to the surgical site. Nurse Ronn is assessing a client The most appropriate action by the nurse is to do which of the following? A client tells the nurse on admission that she is uneasy about having to leave her children with a relative while being in the hospital for surgery. " A nurse is monitoring a client receiving succinylcholine during a surgical procedure. “Bile salts accumulate in the skin and cause the •Discuss postoperative pain control measures, including use of patient-controlled analgesia (PCA) or epidural infusion as ap-propriate. D. What should the nurse do first? Prior to a patient’s surgery, a nurse is assessing whether a PCA would be appropriate during the post-op period. At 8 AM, the registered nurse is admitting to the outpatient surgery department a client who is scheduled for sinus surgery. After conferring with the provider, which of the following actions should the nurse take A nurse is caring for a client who is 2 days postoperative following a cholecystectomy. Which of the following actions should the nurse take? Post-operative pain can have a significant effect on patient recovery. The basal rate is ordered to be 1 mg/hour and the patient can have a 1-mg bolus every 15 minutes. Once at home, the patient must check the incision site. The physician orders hourly urine output measurement for a postoperative client. MULTIPLE CHOICE. The nurse has conducted preoperative teaching for a client scheduled for surgery in 1 week. Your assessment revelas bowel sounds on all quadrants and the dressing is dry and intact. The Differentiated Scope of Practice of Licensed Practical Nurses (LPNs) and Registered Professional Nurses (RNs) Such diagnostic privilege is distinct from a medical diagnosis . The nurse knows that a patient-controlled analgesia (PCA) pump will be prescribed as part of Wrenda's postoperative care. Mattress options include fluidized, air, and foam overlays. Which responses did the nurse assess in this client? Select all that apply: Nclex SATA 1. " 2. Research Questions Postoperative Care Postoperative Care Postoperative care is a process that starts right in the recovery room and consequently continuing throughout the period of recovery. Which factors would the nurse assess that would help her determine the appropriateness of a PCA? the nurse is caring for several clients in the postoperative unit which client does the nurse assess first because of their elevated risk of respiratory complications after general anesthesia: the young adult with a BMI of 40: one hour after admission to the PACU the postoperative client has become very restless, what is the nurses best first 7- A postoperative client that recently returned from surgery has a morphine PCA pump. From the time that a patient leaves the care of the anaesthetist after an operation until he wakes in the ward his physiological state should be continuously and expertly supervised. The nursing staff continues to monitor the patient for signs of infection and checks that the incision is healing. If there is none, the nurse must offer information about what an advance directive implies. The most appropriate action by the nurse is to do which of the following? 6648The nurse explains to the client that the main reason a back rub is used as therapy to relieve pain is because the massage: SC; 6649Nursing responsibilities for the client with a patient-controlled analgesia (PCA) system include: SC; 6650A client has a patient-controlled analgesia (PCA) infusion to manage postoperative pain. doc), PDF File (. The client asks, “Why is my skin so itchy?” How should the nurse respond? a. The nurse determines that the client needs additional teaching if the client makes which statement? 1. Instruct the client to use the patient-controlled analgesia (PCA) before the pain becomes severe. • Provided nursing care to surgical clients completing preoperative and postoperative procedures, performed physical assessments, documentation through Meditech system, administered medications through different routes including PCA pumps, infusion pumps, care of PICC lines, wound care and assessment, etc… • Monitored client’s status Patient Care. Respiratory acidosis b. Patients on a PCA have a decreased overall narcotic use and have . 1 4 The development of national pain assessment and management standards implemented by The Joint Commission in 2001 Pain management after cardiac surgery: Experience with a nurse-driven pain protocol Article in European Journal of Cardiovascular Nursing 11(1):62-9 · March 2012 with 168 Reads How we measure 'reads' Physiological Integrity: Nursing Care of the Adult Client: PAIN MANAGEMENT. The doctor has also ordered a unit of packed cells. 84. However, he complains that he has nausea whenever a nurse brings a bag of intravenous solution into his room because it reminds him of his chemotherapy. It has proven safe and successful in such children in the control of postoperative pain, sickle-cell pain, and pain associated with bone-marrow transplantation. 6. The client exhibits restlessness, an elevated pulse, and decreased blood pressure. Change in behavior b. txt) or read online for free. Thus, when seeing the client for the first time, the nurse would expect to find: 5. Join LinkedIn Summary • Competent in delivering quality and safe patient care consistence with professional standards by using evidence based practice in diverse care settings including ENT and urology postoperative care, paediatric chronic complex continue, orthopaedic postoperative care, rehabilitative care, long-term care, palliative care, primary care, acute medical care and community care. Chapter 18: Care of Postoperative Patients Test Bank MULTIPLE CHOICE 1. com/CE/nursing and receive a You have an order to give a 1-mg dose of morphine I. integrity d. He is on patient-controlled analgesia (PCA). A survey among consultants and The nurse is reviewing the use of the patient-controlled analgesia (PCA) pump with a client in the immediate postoperative period. Intake of chocolate, caffeine, and nicotine in any form is strictly prohibited in the postoperative period to avoid induction of vasospasm that could impede blood flow. When assessing a patient’s fluid status which of the following Description: The client is a 66 year-old male admitted two days ago with an anterior myocardial infarction. The nurse understands that the PCA: (Select all that apply. It has proven difficult to develop formal preoperative teaching pro- grams in this environment, but research has shown that preoperative education can improve patient outcomes and satisfaction with the surgical experience. –Tells you how well the tool can correctly identify patients truly at risk for falling. The physician has ordered patient-controlled analgesia (PCA) for the patient. If the institution has an “Ostomy Nurse”, the application of the colostomy pouch may be delayed until the clinical specialist can work with the patient and family. A nurse is assessing a client who is postoperative following a transurethral resection of the prostate (TURP) and note clots in the client’s indwelling urinary catheter and a decrease in urinary output. Nurses play a vital role in management of an acute MI. Tachypnea, bradycardia, and hypotension 3. Nursing Assessment. The nurse has been caring for a 15-year-old boy who requires extensive home care. ” Which of the following would be most helpful to do first to provide the mother some relief? The home care nurse has been managing a client for 6 weeks. V. The nurse has a duty to protect the patient including establishing and maintaining professional boundaries in the nurse-patient/client relationship. The clinical pathway provided in this article summarizes the components of routine care after PCI procedures. What would indicate to the nurse the patient's readiness to learn how to change her dressing? (Mark all that apply. g. The nurse finds the client's IV bag empty at change of shift. , 50 ml; 9 a. pain assessment, vs assessment, infection control, wound care, PCA pump  (PCA) perioperative pneumatic compression device postoperative preoperative reassessed and the nurse collaborates with the client in planning the care. 6. Interpretive area at junction of parietal, temporal and occipital and relates to memories or learning of multisensory data. The communication between the nurse and the patient is important and when the drug intervention has caused severe side effects or non-responsive, non-drug intervention should be considered. 2 – Notify the physician. c. Each intervention has potential side effects whether it be epidural top ups or intravenous opioids. just returned to the unit from PACU with patient-controlled anesthesia (PCA). As hip fractures most often occur in the persons who are elderly or frail, the approach to caring for these complicated patients must be thorough and evidence based. patient and thus relieving a client from pain and suffering is decreased. The nurse notes that the client has become increasingly restless, irritable and confused, stating that there are bugs all over the walls. The issue of assessing and managing the risk related to this disaster has become increasingly crucial for both local and national authorities. 52, PaO2 89 mmHg, PaCO2 28 mmHg, and HCO3- 24 mEq/L. When the nurse assesses the client, the nurse finds the client stuporous, hard to arouse, with a respiratory rate of 6 breaths/minute. When the anesthesia wears off and vital signs stabilize, the patient is transferred to their hospital room. Transdermal opioids are contraindicated for use in acute post-operative pain or in opioid naive patients, due to the risk of respiratory depression. The nurse is caring for a client with otitis media and notes purulent drainage in the ear canal during the physical assessment. If outcomes are not achieved, the nurse and client need to explore the reasons before modifying the care plan. [12-15] Postoperative pain The nurse is caring for a client with peptic ulcer disease. Push the PCA control for the client. Download the complete Public health topic and material (chapter 1-5) titled EVALUATION OF PREOPERATIVE NURSING INTERVENTION ON ANXIETY STATE AND POST OPERATIVE PAIN AMONG SURGICAL PATIENTS OF OBAFEMI AWOLOWO UNIVERSITY TEACHING HOSPITALS COMPLEX, ILE-IFE OSUN STATE here on PROJECTS. com makes it easy to get the grade you want! The nurse should also inform the client of available pain management techniques and incorporate any preferences or objections to interventions for pain management that the client may have when establishing a plan of care; using all forms of available pain management techniques is not necessary. Includes studying games and tools such as flashcards. PCA is considered very effective in managing acute postoperative pain with smaller amounts of opioid and increased client satisfaction. Description: In this scenario, learners are to assess the postoperative patient, recognize All three patients will have needs that will require nursing intervention. com. Check the intravenous (IV) line for patency every 2 hours 4. Comparison: The nurse's role as a secondary member of the multidisciplinary team without any specialized training and is only involved in perioperative care of the bariatric adolescent patient. Global or mixed aphasia – patient has difficulty in understanding and speaking/ communicating. Postoperative care is the management of a patient after surgery. In PCA, a computerized pump called the patient-controlled analgesia pump, which Although research has revealed the benefits of preoperative education for surgical patients—such as decreased lengths of stay, reduced requests for postoperative pain medication, and in-creased patient and family member satisfaction with the surgical process— it has proven difficult for nurse man-agers in ambulatory surgery facilities Abstract. to a patient on morphine PCA prior to A PCA pump design feature that might result in oversedation of a postoperative patient is b. Since pain assessment was not recorded once PCA was taken off,. What is the best method to determine the quality of care provided by a home health care aide assigned to assist with the care of this client? A) Ask the client and family if they are satisfied with the care given B) Determine if the home health aide's care is consistent with the plan A nurse suspects that a client who has been receiving morphine is exhibiting early symptoms of abstinence syndrome. A relative or form at the Pre-Operative Assessment clinic this will now be done with you. The trustees represent Santa Fe's Alachua-Bradford County service district and ensure that the education and Science; Health Science; Nursing; Prioritization, Delegation, and Assignment: Practice Excercises for Post‐operative PCA opioid requirements in adults are known to decrease as patient age increases,53 and it has, therefore, been suggested that a lower PCA bolus dose is prescribed for elderly patients. Nausea 2. Prone with the head on pillow and turned to the side. Bacteriuria, blood coagulation abnormalities, or other signifi-cant abnormal values may affect surgery and postoperative care. Which one of these assessment data will require the most rapid response by the nurse? A. The most appropriate action by the nurse is to do which of the following? A client tells the nurse on admission that she is uneasy about having to leave her children with a relative while being in the hospital for surgery. The nurse has administered 3% saline to a patient with hyponatremia. The regimens can be administered as an infusion, patient controlled analgesia or both. The state-of-the-art three-volume, concept-based, student-centered introduction to nursing focuses on 51 indispensable biophysical professional and healthcare concepts; and more than 435 nursing skills. If the client is voiding, the nurse also assesses the urinary fre­ quency, associated amount per void, and any symptoms. Patient-controlled analgesia (PCA) has been recommended for pain relief with relatively few side effects. ”. The nurse should ____? PCA may be used by children as young as seven years old. 45. The PCA/PCI/PCR reports to the nurse that the client has a red, raised area where the needle was inserted. His PCA pump is of morphine 1-3mg every 8-10 minutes, he has only used it twice so when the doctors round perhaps we could look into getting the order changed to a PRN medication instead of a PCA pump. The client has a PRN prescription for Demerol 100 mg PO q3h. It can also reduce the effectiveness of coughing, especially in patients who already have a low FEV1. Metabolic alkalosis 33. What is the nurse’s next action? a. Tolerance of increasing activity 2. Vocabulary words for Combination of sets from all over , containing practice questions and study cards for NCLEX preparation on the just about everything. Once the client has agreed to pain medication, the nurse should instruct the client on how the particular medication the client takes works. Brigham, a municipality located in southern Quebec Province, is one of the heavily affected regions by this disaster because Santa Fe Community College is governed by a citizen board appointed by the governor. Search Search The nurse discusses postoperative pain management with Ms. Chapter 59: Care of Patients with Problems of the Biliary System and Pancreas Ignatavicius: Medical-Surgical Nursing, 8th Edition. by patient-controlled analgesia (PCA) 10 minutes ago. It is your responsibility to facilitate patient recovery while also minimizing any complications that could lead to future infection. Powell, Pharm. The postoperative gastrectomy client is scheduled for discharge. 2 – chloride and magnesium abnormalities. The client has a postoperative ejection fraction ejection fraction Cincinnati Pre-Hospital Stroke Scale • May be done by EMS oOne of many o F – facial droop on one side o A – arm drift (hold a pizza box, close your eyes) Use mask and gown during care of the MRSA client; 42. Outcome : When the nurse is involved as one of the primary members in the multidisciplinary team approach, the bariatric adolescent patient has better continuity of care. Design: The study used a randomised clinical trial design. Tap into the articles presented in this year’s education guide for tips and thoughtful advice on nursing education. ASSESSMENT FOLLOW UP: Notify the physician of all abnormal findings!! Use the nursing process to: o Analyze subjective and objective findings. A postoperative female client has a prescription for morphine sulfate 10 mg IV q3 hours for pain. Beds are often overlooked as a pain control strategy. 9 Apr 2012 Patients with sleep apnea should not use PCA and the nurse should thus, the nurse should focus on assessing patient response and . Today, nurses must be able to transfer their knowledge to new situations, and stay current with CHAMBERLAIN COLLEGE OF NURSING: COMPLEX CRITICAL NURSING 341 TEST 1. Pain after a TKA can be severe and, when inadequately controlled, can impair or prevent functional rehabilitation with physiologic, psychologic, and economic consequences (Sawyer, 2004). For scenario – click here Intravenous Patient-Controlled Analgesia (PCA) Patient-controlled analgesia (PCA) is a computerized pump that safely permits you to push a button and deliver small amounts of pain medicine into your intravenous (IV) line, usually in your arm. Which information obtained during the preoperative assessment should be reported to the surgeon before surgery: The patient's statement that her last menstrual period was 8 weeks previously Improving Reassessment and Documentation of Pain Management Performance Improvement M uch has been accomplished in recent years to improve the recognition of inadequate manage-ment of pain as a major health care problem. Brigham, a municipality located in southern Quebec Province, is one of the heavily affected regions by this disaster because Floods are the most frequent and the most damaging natural disaster in Canada. The client says, "This pump doesn't help my pain at all. Patients with uncomplicated surgeries usually leave the hospital 1 or 2 days following surgery. Metabolic acidosis c. Critical control within this process involves pain management, chest drain management or control, wound healing as well as the airway clearance commonly referred to as respiration. "Aspirin can cause bleeding after surgery. A student asks the nurse what is the best way to assess a clients pain. 2% at different infusion rates was studied in a group of patients who underwent anterior cruciate ligament repair, and it was found that high infusion rate was associated An older client is hospitalized after an operation. The principles of postoperative care Reasons for vital signs monitoring Considerations for transferring postoperative patients Monitoring, assessment and observation skills are essential in postoperative care. Bed rest minimizes vasospasm. o Make a nursing diagnosis. The client has a history of arthritis and has been taking acetylsalicylic acid (aspirin). A nurse is caring for an older adult client who has dementia and has become aggressive. 126. PCA has been developed for the management of postoperative pain and its use has not been systematically studied in SCD, but a number of small studies in the early 1990s suggested that it could be effective for acute sickle pain, in both adults and older children (Holbrook, 1990; McPherson et al, 1990; Gonzalez et al, 1991; Shapiro et al, 1993). The nurse is completing a health assessment of a 42-year-old female with suspected Graves’ disease. Which assessment finding indicates to the nurse that the client most likely has an ulcer in the stomach rather than in the duodenum? a. The Effect of Patient-controlled Analgesia on Intensity of Postoperative Pain in 1 Research Center of Chronic Disease Care, Department of Nursing, Nursing and Patient-controlled analgesia (PCA) has emerged as a standard technique to . Q. W. “Respiratory Depression in PCA Patients: What Continuous Monitoring Has Revealed” was . a fresh voice of nursing across America. Often secondary to extensive damage of the language areas of the brain. What elements of delegation have been breeched? Study Flashcards On NCLEX questions Med/Surg Chapters 1-12 at Cram. Rapport has been established in the nurse-client interaction time. Pain Management in Patients with Substance-Use Disorders By Valerie Prince, Pharm. " 6650---A client has a patient-controlled analgesia (PCA) infusion to manage postoperative pain. The prevention of postoperative pain: shouldn't it begin at medical school? To the Editor: I read Dr. Supine with neck hyperextended and supported with pillow. Background: Postoperative pain after a total knee arthroplasty (TKA) is a major concern for the patient and nurse. Although postoperative pain assessment and management is an integral part of surgical nursing practice, it remains ad hoc despite numerous costly empirical research studies. These are just some of the skills you'll need as a Registered Nurse Med/Surg The most appropriate action by the nurse is to do which of the following? A client tells the nurse on admission that she is uneasy about having to leave her children with a relative while being in the hospital for surgery. She uses the Glasgow Coma Scale and determines that the client's score is 15. 26–31 This may be Intravenous Patient-Controlled Analgesia (PCA) Patient-controlled analgesia (PCA) is a computerized pump that safely permits you to push a button and deliver small amounts of pain medicine into your intravenous (IV) line, usually in your arm. A nurse is assessing a client who is using PCA following a thoracotomy. Postoperative care involves assessment, diagnosis, planning, intervention, and outcome evaluation. It is now 1130 hours. Post‐operative PCA opioid requirements in adult patients are known to decrease as patient age increases. In option 1 just recording the information is not sufficient. After abdominal surgery, a client is admitted from the recovery room with intravenous fluid infusing at 100 cc/h. ) The tympanic membrane is pearly gray with white patches. accomplished with a standard nursing assessment. Patient Safety Issues With Patient-Controlled Analgesia Although the patient has control of PCA, that does not free the nurse from the responsibility of managing the PCA protocol and assessing Nurses provide care of a client before, during, and after surgical operation, this is collectively called as Perioperative Nursing. The RN has delegated a venipuncture to a PCA/PCI/PCR, who has been off orientation for five days. Ask the physician if the client can switch to an oral analgesic. ng. A more efficient method of intravenous opioid delivery is patient-controlled analgesia (PCA). Options for pain control include epidural, PCA, or nurse administered analgesics. He has been on bed rest all tonight. A client had Total Abdominal Hysterectomy and bilateral Oophorectomy for Ovarian Carcinoma yesterday. In order to assess the severityof nausea, it was considered mild if patients  Thirty minutes later the patient had no detectable pulse or respirations. Opioids are the most commonly used class of medications for postoperative PCA differs from nurse-controlled analgesia, which usually involves This symptom should have provoked the clinical staff to further assess the patient and the infusion. Based on these amounts, which action should the nurse take? 1 – Continue to monitor and record the client’s hourly urine output. The appropriate nursing response is: “You will probably have to eat six meals a day for the rest of your life. A child with pyloric stenosis who has vomited 44. A nurse is caring for a client who has a sealed radiation therapy implant. " a. The nurse is conducting the initial health assessment and is 1 answer. The nurse might consider the following questions: 3. Since the introduction of Patient-Controlled Analgesia (PCA) in the early 1980s, the daily management of post-operative pain has been enhanced. Jackson and explains the use of a patient-controlled analgesia (PCA) pump. 3 – sodium and chloride abnormalities. 70. The two authorised persons who make up each PCA syringe must sign the record of infusion on the Patient Controlled Analgesia prescription. Prio. The PCA administration of potent, short-acting opioids (e. Hip fractures are associated with 15–25% mortality and 30% risk of nursing home placement within the first year [3–6]. On the third postoperative day, S. Paralytic ileus c. I. Witch appearance indicates further follow-up is needed for problems associated with chronic hypoxia? A client who had a percutaneous transluminal coronary angioplasty (PTCA) two weeks ago returns to the clinic for a follow up visit. He is alert and oriented when awakened and reports pain, but goes back to sleep when not being stimulated. The doctor reviews Mr Pearson and decides that he is hypovolaemic. ” On questioning the client, the nurse discovers that the client have experienced chronic pain since being involved in an accident 2 years previously. NCLEX Practice Questions with Rationale. Answer 2 is an effect of immobility. The intervention that will best accomplish this goal is to . ANS: Initiate the dosage lockout mechanism on the PCA pump A nurse is reinforcing teaching with a client who has osteomyelitis of an open A nurse is caring for a client who is postoperative following a total knee the client's understanding of the PCA and facilitate consistent pain control, but Each step of the nursing process builds on the previous step, beginning with assessment  6 Sep 2013 Pre-operative assessment is required prior to the majority of elective surgical assessment consultation is usually led by a specialist nurse or a member of . Care of the Hip Fracture Patient: Preoperative Evaluation assessment tool to correctly identify a fall risk patient –Tells you how well the tool can correctly identify patients truly at risk for falling. Hypotension 4. It is then the client’s choice to sign it. One hour later, the nurse finds the clamp wide open and notes that the client has received 850 cc. Patient education is a major concern for perioperative nurses in an ambulatory surgery setting. Quickly memorize the terms, phrases and much more. Which information given by the client would be of most immediate concern to the nurse? The client has an allergy to iodine and shellfish. The client now has a positive Rinne test, with AC > BC. In 2001, completion of an ISMP Medication Safety Self-Assessment led to an If nurse programming of the infusion device exceeds the pre-established limits,  Recognition of clinical deterioration is guided with use of the ViCTOR graph. ’s nausea and vomiting have been well controlled, and he can tolerate oral intake. 25 PCA morphine, usually of around 1 mg bolus doses with a 5–10 min lockout period and administered for widespread uses, is concluded to be generally associated with a low incidence of respiratory depression, typically between 0. What nursing intervention would you take Rationale: The nurse is evaluating for signs that the client has suffered no effects of immobility. INCORRECT. A nurse is caring for a client who has bradycardia following a surgical procedure using spinal anesthesia epinephrine a nurse is planning care for a client who is postoperative and has a closed-wound drainage system in place clamp the drain while ambulating and check patency every 12 hours are wrong a nurse is reviewing the … 19. The nurse interprets that the client has which acid base disturbance? a. Which of the following actions should the nurse take? A nurse is providing discharge teaching for a client who is postoperative following a rhinoplasty using general anesthesia. 4 – sodium and potassium abnormalities. Induced hypothermia, the use of the CPB machine, and the administration of heparin for anticoagulation can all contribute to postoperative bleeding. Semi-fowler’s with neck flexed. The mother is the primary caregiver and states, “I’m just drained, physically and emotionally. American Nurse Today 2019-20 Education Guide, provides you with facts, figures, other nurses’ experiences, and tons of other resources to help you in your journey. 4. I have heard it said that "patients expect to be in pain after surgery, and the doctors and nurses who care for them see to it that they are not disappointed"! Read about updated guidelines for management of patients after percutaneous coronary interventions (PCI). Unequal pupil size 4. After notifying the surgeon, which of the following actions should the nurse take next?-have pt sign Against Medical Advise (AMA) A second day postoperative client who needs medication prior to dressing changes has predictable and routine care that a new nurse can manage. 11. Charge Nurse. Burn pain is very likely the most difficult form of acute pain to treat from any type of etiology. Third, it establishes the nurse’s role in helping the client be more comfortable and in control of his or her condition. She received 2mg of Morphine Sulfate IV by patient-controlled analgesia (PCA) 10 minutes ago. 10 naïve and needs postoperative pain management, the. In the outpatient medical setting, VA has instituted several measures to improve pain management, including routine standardized assessment (or pain as the fifth vital sign), audit and feedback to clinical staff, specialist-level pain consultation services, nurse-level pain services, and palliative care services. Ibuprofen (Motrin) is prescribed for an adult with chronic pain. Pain is Patient-controlled analgesia (PCA) is a method of pain control that gives patients the power to control their pain. It is a specialized nursing area wherein a registered nurse works as a team member of other surgical health care professionals. The nurse may observe the mucosa for signs of fluid volume deficit since the client is taking a diuretic, but since the client is receiving an established daily dose, this is not the most important preoperative intervention. How should the nurse respond? A) "You will only use the PCA pump for the first 24 hours after 40. nursingcenter. •Report abnormal laboratory values to the surgeon. Ferris Bueller Learning Outcomes 1. 85. Assess the client’s pain level and vital signs frequently. In all cases, the child should manage the PCA pump himself or herself. The client will receive morphine 1 mg IV per hour basal rate with 1 mg IV every 15 minutes per PCA to total 5 mg IV maximally per hour. Transdermal fentanyl has been established as a mainstay of chronic pain management in cancer and noncancer patients. There is sediment and blood in the patient’s urine C. Liver failure b. Which of the following should the nurse recognize as a potential adverse effect Select all that apply. Objective: The aim of this study was to determine the effectiveness of Peplau's Interpersonal Relations Model on preoperative and postoperative patient anxiety. The nurse should assess this client for: The nurse is completing a health assessment of a 42-year-old female with suspected Graves’ disease. 2 and 0. Bedding itself often can be wrinkled or irritating. The PACU nurse will maintain postoperative T and A client in what position? A. a nurse is assessing a client who is postoperative and has a pca

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